Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature
Background Mental health crises are common in people with complex emotional needs (our preferred working term for people diagnosed with a 'personality disorder'), yet this population is often dissatisfied with the crisis care they receive. Exploring their experiences and views on what cou...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-03-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472422000011/type/journal_article |
| _version_ | 1811156895497453568 |
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| author | Kristiana DeLeo Lucy Maconick Rose McCabe Eva Broeckelmann Luke Sheridan Rains Sarah Rowe Sonia Johnson |
| author_facet | Kristiana DeLeo Lucy Maconick Rose McCabe Eva Broeckelmann Luke Sheridan Rains Sarah Rowe Sonia Johnson |
| author_sort | Kristiana DeLeo |
| collection | DOAJ |
| description |
Background
Mental health crises are common in people with complex emotional needs (our preferred working term for people diagnosed with a 'personality disorder'), yet this population is often dissatisfied with the crisis care they receive. Exploring their experiences and views on what could be improved, and those of carers and healthcare staff, is key to developing better services.
Aims
We aimed to synthesise the relevant qualitative literature.
Method
Five databases were searched. Eligible studies included service users with a diagnosis of personality disorder and their carers or relevant staff, focused on crisis responses and used a qualitative design. Data were analysed with thematic synthesis.
Results
Eleven studies were included, most focusing on emergency departments. Four meta-themes emerged: (a) acceptance and rejection when presenting to crisis care: limited options and lack of involvement of carers; (b) interpersonal processes: importance of the therapeutic relationship and establishing a framework for treatment; (c) managing recovery from a crisis: clear recovery plan and negotiating collaboration; and (d) equipping and supporting staff: training and emotional support.
Conclusions
Our findings suggest that emergency departments have major limitations as settings to provide crisis care for people with complex emotional needs, but there is a lack of research exploring alternatives. The quality of the therapeutic relationship was central to how care was experienced, with collaborative and optimistic staff highly valued. Staff reported feeling poorly supported in responding to the needs of this population. Research looking at experiences of a range of care options and how to improve these is needed.
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| first_indexed | 2024-04-10T04:57:38Z |
| format | Article |
| id | doaj.art-0e144487696045bab4fb263553db173c |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:57:38Z |
| publishDate | 2022-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-0e144487696045bab4fb263553db173c2023-03-09T12:29:19ZengCambridge University PressBJPsych Open2056-47242022-03-01810.1192/bjo.2022.1Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literatureKristiana DeLeo0Lucy Maconick1https://orcid.org/0000-0002-0174-367XRose McCabe2Eva Broeckelmann3Luke Sheridan Rains4Sarah Rowe5https://orcid.org/0000-0003-1072-6182Sonia Johnson6Division of Psychiatry, University College London, UKDivision of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UKSchool of Health Sciences, City University of London, UKHealth Service and Population Research Department, NIHR Mental Health Policy Research Unit Complex Emotional Needs Lived Experience Working Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKDivision of Psychiatry, University College London, UKDivision of Psychiatry, University College London, UKDivision of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK Background Mental health crises are common in people with complex emotional needs (our preferred working term for people diagnosed with a 'personality disorder'), yet this population is often dissatisfied with the crisis care they receive. Exploring their experiences and views on what could be improved, and those of carers and healthcare staff, is key to developing better services. Aims We aimed to synthesise the relevant qualitative literature. Method Five databases were searched. Eligible studies included service users with a diagnosis of personality disorder and their carers or relevant staff, focused on crisis responses and used a qualitative design. Data were analysed with thematic synthesis. Results Eleven studies were included, most focusing on emergency departments. Four meta-themes emerged: (a) acceptance and rejection when presenting to crisis care: limited options and lack of involvement of carers; (b) interpersonal processes: importance of the therapeutic relationship and establishing a framework for treatment; (c) managing recovery from a crisis: clear recovery plan and negotiating collaboration; and (d) equipping and supporting staff: training and emotional support. Conclusions Our findings suggest that emergency departments have major limitations as settings to provide crisis care for people with complex emotional needs, but there is a lack of research exploring alternatives. The quality of the therapeutic relationship was central to how care was experienced, with collaborative and optimistic staff highly valued. Staff reported feeling poorly supported in responding to the needs of this population. Research looking at experiences of a range of care options and how to improve these is needed. https://www.cambridge.org/core/product/identifier/S2056472422000011/type/journal_articleBorderline personality disorderself-harmpersonality disordersqualitative researchcrisis intervention |
| spellingShingle | Kristiana DeLeo Lucy Maconick Rose McCabe Eva Broeckelmann Luke Sheridan Rains Sarah Rowe Sonia Johnson Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature BJPsych Open Borderline personality disorder self-harm personality disorders qualitative research crisis intervention |
| title | Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature |
| title_full | Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature |
| title_fullStr | Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature |
| title_full_unstemmed | Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature |
| title_short | Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature |
| title_sort | experiences of crisis care among service users with complex emotional needs or a diagnosis of personality disorder and other stakeholders systematic review and meta synthesis of the qualitative literature |
| topic | Borderline personality disorder self-harm personality disorders qualitative research crisis intervention |
| url | https://www.cambridge.org/core/product/identifier/S2056472422000011/type/journal_article |
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