Personality disorder co-morbidity in primary care ‘Improving Access to Psychological Therapy’ (IAPT) Services: A qualitative study exploring professionals’ perspectives of working with this patient group

Abstract

A high prevalence of people present to ‘Improving access to Psychological Therapies’ (IAPT) in England with common mental health disorders and co-morbid personality disorder. This group have sub optimal treatment outcomes in IAPT. Whilst new short-term treatment approaches are advocated, no solutions or guidance have been provided. This qualitative study explored IAPT healthcare professional (N=28) perspectives of working with people who present to IAPT with co-morbid personality disorder. Individual semi-structured interviews were digitally recorded, transcribed verbatim and analyzed using a framework analysis approach. Results identified a lack of skills and confidence in working with this patient group, restrictive service constraints and a treatment gap between the interface of primary and secondary services. Insight into acceptable adaptions to practice are identified which have transferable utility to a wider international audience who can identify people outside of specialist mental health services with common mental health disorders and co-morbid personality disorder traits.