Improving Access to Psychological Therapies
for individuals with a Personality Disorder
Providing services for the treatment seeking population
Identifying strategies for engaging with the treatment reluctant population
Working within the current economic position
What direct therapies does IMPART provide?
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Fully programmatic and adherent Dialectical Behavioural Therapy
Cognitive Behavioural Therapy adapted for Personality Disorder
Mindfulness Based Cognitive Therapy
Mindfulness skills group
Managing Emotions group (in-patient)
Motivational Interviewing
Psychoeducational groups (anxiety, anger, healthy lifestyle)
Supporters (carers) evenings
Supporters (carers) DBT skills workshops
Improving Access means inclusivity
IMPART works with:
8 of the 10 DSM-IV Personality Disorders*
Older adults
mild learning disabilities
co-morbid substance abuse
high risk
* The clinical and business case for ASPD has been developed and
is being discussed with leadership and commissioners
120
100
80
60
40
20
0
Primary PD Diagnosis
IMPART Direct Provision
10.7 wte staff
2010 – 2011
2011 – 2012
1245 Open cases [13.1 wte]
921 Open cases
6m of IAPT
177 new referrals accepted
374 discharged cases
602 open cases
22 – average caseload
Indirect provision
• Training on working effectively with PD
Mental Health Services
Psychiatric Liaison and A&E staff
Housing workers
Social Services
Child protection services
Probation
Magistrates
GPs
Health visitors
Improving Access needs robust pathways
Mental
Health
Primary
Care
Local
Authority
Psychology
Departments
Weekly
Psychology
Referrals
Panels*
GP
IMPART
Fewer assessments
Reduced waiting times
Criminal
Justice
CAMHS
Engaging with the treatment reluctant population
In-patient IMPART Therapist
assessments
facilitating pathways to community treatment
motivational enhancement
psychoeducation and coping skills
staff support groups
ward based DBT skills groups
Working within the current economic position
Providing the case for redeployment of resources
Mental Health Costs
Return of OAT contracts
Reduction in ISA placements
Reduction in bed days
2010-2011
660 less bed days
4 ISA returns
Cost savings:
£443,765
Social Care Costs
Increasing employment
Stabilizing housing
Reducing children in care
30% SU gained
employment or education
during treatment
Measuring Outcomes
IAPT Dataset
IMPART dataset
PHQ-9
IAPT employment status
WSAS (Work and Social Adjustment)
EQ-5D (Quality of Life)
WEMWBS (Warwick-Edinburgh Mental Well Being Scale)
SAPAS (Standardized Assessment of Personality)
Rates of self harm and suicide attempts
Service utilization
SCID I and II
Staxi (Speilberger Anger Scale)
Christo (modified drug/alcohol)
Treatment history (one year)
Challenges faced by IMPART
Demands to see individuals with ASPD
Care coordination – pressures on the system
Requests for more training /consultation/supervision
Continual restructuring – disrupted care pathways
Managing a wait list – high risk clients
Key Deliverables
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psychological therapy – across PDs
training package - ‘Recognizing and Working with PD’
Handbook - ‘Setting up an IMPART’
Consultation service for Trusts developing IAPT SMI (PD) services
Increasing access for difficult to engage population
South Asians
Mothers with BPD
High comorbidity
IMPART Open Day
Tuesday 9th April, 2013
9:30am-4:30pm
Ford Sports Centre, Aldborough Rd S, Ilford, Essex IG3 8HG
- near Newbury Park Tube Station
RSVP – john.liverpool@nelft.nhs.uk; 0300 555 1213
I want to live, I want to die.
A silent tear, I need to cry.
A pain so deep, so ragged and raw,
it feels like an open infected sore.
Help is at hand, it is there for you.
Learn to trust, and let it through,
to have a future free from pain,
and a life worth living once again.
I need you IMPART and the group.
The things you teach are starting to root
into little buds, starting to shoot.
Soon a tree I will see, and future on the
horizon of where I want to be.
JM 2012