It’s been a busy few months for us and we just wanted to collate some of the things that we have been involved in that highlight our concerns about private Out of Area Placements for those with recurrent suicidality and self harm. While it might seem a bit self indulgent, we do want to be the loudest voices arguing for and pragmatically working for the reduction of private hospital placements for those we are committed to working with. The links should take you to all the material.
Hollie had an article published in Mental Health Practice entitled Living With Borderline Personality Disorder. It describes the change in ‘care’ and staff attitudes once difficulties are understood as a disordered personality.
This report (where Keir was one of the authors) was put together by the British and Irish Group for the Study of Personality Disorder and it details a number of concerns about the use of "specialist" placements and their quality. In the forward Sir Norman Lamb states:
"The truth is that we are spending vast sums of public money on private institutions which have a clear incentive to keep the beds occupied. This amounts to an enduring and unacceptable breach of people’s human rights"
In the same week the report was released, the BBC released a news story and documentary that raised further concerns about how people are treated within units that describe themselves as specialist. Keir was featured in both. The items that we see most regularly in our work that were highlighted in the program included
patients whose risk of suicide escalated on admission being compelled to remain in the environments where they were most dangerous to themselves
staff talking about how they had no specialist training for working on a unit that claimed to be specialist.
Keir talked about the issues involved in "specialist" placements on the BBC here
Keir and Hollie contributed to this documentary about “BPD” alongside experts such as Dan Warrender and Peter Kinderman
Keir argued that inpatient treatment for those diagnosed with “personality disorder” has been privatised here
Keir and Hollie (along with Dan Warrender) published an article describing their concerns about the use of Clozapine for the people they work with in private units. It was written after they (we? I’m getting myself in a muddle here) wanted to quote something in the scientific literature describing the concerns around ‘clozapine for BPD’ and nothing existed. Something exists now.
Keir tried to highlight BPD awareness week and ended up commenting on the boost the Heard/Depp trial has given to the stigma around BPD here in the Independent.
If it gets annoying that we bang on about this all the time, we will be delighted when the voices calling for this change get louder and more diverse. We will be looking for people to help bring about change in one of our workshops at this years British and Irish Group for the Study of Personality Disorder Conference. We’re also doing sessions on the criminalisation of suicide and how to move on if we want to abandoned the construct of personality disorder.
Beam was founded after we couldn't see any more traumatised young (predominantly) women sent miles from home to receive care that seemed unrecognisable from what NICE recommend. While all the above resources may seem self serving, we are passionate about helping patients and staff feel more supported in their local communities. We estimate we save NHS services around £200,000 for each person we work with.
We'd love to talk to you more but if not, we hope you can consider the above resources either when thinking about a patient for who a "specialist" placement has been suggested or when reviewing people who are currently placed.