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Specialist personality disorder services in England: a case for managed clinical networks?
- Authors:
- NORTON Kingsley, LOUSANA Julian, HEALY Kevin
- Journal article citation:
- Psychiatric Bulletin, 29(10), October 2005, pp.365-368.
- Publisher:
- Royal College of Psychiatrists
Managed clinical networks are rare among mental health services, although there have been strong advocates of their use, including in relation to personality disorder. Of themselves, these networks would not be a panacea for personality disorder; however, they could have a role (particularly in complex cases) where treatment involves primary, secondary and tertiary services or where multiprofessional or multi-agency services are involved, as, for example, with much antisocial personality disorder. Managed clinical networks ‘provide the opportunity for professional collaboration across existing boundaries, real or imagined.
Suicides associated with admission to an inpatient therapeutic community
- Authors:
- HEALY Kevin, CHAMBERLAIN Janet
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 26(2), Summer 2005, pp.206-224.
- Publisher:
- Emerald
The authors present findings from an audit on suicides associated with intensive inpatient treatment at the Cassel Hospital in Surrey. They identify the characteristics of patients likely to be most at risk of suicide during treatment. Two examples are given to illustrate the interplay between intra-psychic, interpersonal, and institutional factors that ordinarily keep these suicidal dynamic factors that can lessen the psychological containment available from staff for patients struggling with suicidal impulses. Active involvement of staff in the relationships formed in treatment, and attention to individual and institutional dynamics, alongside anticipation of the impact of any gaps in staffing levels are recommended to lessen the likelihood of suicide during treatment.