eprintid: 10144424
rev_number: 7
eprint_status: archive
userid: 699
dir: disk0/10/14/44/24
datestamp: 2022-03-02 11:46:58
lastmod: 2022-03-02 11:46:58
status_changed: 2022-03-02 11:46:58
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: DeLeo, Kristiana
creators_name: Maconick, Lucy
creators_name: McCabe, Rose
creators_name: Broeckelmann, Eva
creators_name: Sheridan Rains, Luke
creators_name: Rowe, Sarah
creators_name: Johnson, Sonia
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
ispublished: pub
divisions: C07
divisions: D79
divisions: B02
divisions: UCL
keywords: Borderline personality disorder, crisis intervention, personality disorders, qualitative research, self-harm
note: © The Author(s) 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/).
abstract: 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.
date: 2022-03
date_type: published
publisher: Royal College of Psychiatrists
official_url: https://doi.org/10.1192/bjo.2022.1
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1941678
doi: 10.1192/bjo.2022.1
medium: Electronic
pii: S2056472422000011
lyricists_name: Maconick, Lucy
lyricists_name: Johnson, Isabella
lyricists_name: Rowe, Sarah
lyricists_id: LMACO89
lyricists_id: ISJOH12
lyricists_id: SLROW24
actors_name: Kalinowski, Damian
actors_id: DKALI47
actors_role: owner
funding_acknowledgements: [Health Services and Delivery Research Programme]
full_text_status: public
publication: BJPsych Open
volume: 8
number: 2
article_number: e53
pagerange: e53
event_location: England
citation:        DeLeo, Kristiana;    Maconick, Lucy;    McCabe, Rose;    Broeckelmann, Eva;    Sheridan Rains, Luke;    Rowe, Sarah;    Johnson, Sonia;      (2022)    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 , 8  (2)    , Article e53.  10.1192/bjo.2022.1 <https://doi.org/10.1192/bjo.2022.1>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10144424/1/Johnson_Experiences%20of%20crisis%20care%20among%20service%20users%20with%20complex%20emotional%20needs%20or%20a%20diagnosis%20of%20%27personality%20disorder%27%2C%20and%20other%20stakeholders_VoR.pdf