Personalised approach to risk: learning event 4

Safer care, deconstructing the diagnosis of ‘personality disorder’ and considerations for assessment

Tuesday, 8 April 2025

On this page:

• Recordings of the session
• Links and resources
  • Lived experience-led resources
  • Research and reports

Recording of the session

Safer care, deconstructing the diagnosis of ‘personality disorder’ and considerations for assessment

At this learning event, we highlighted contextual issues around the diagnosis of personality disorder and the importance of taking a compassionate, relational, and personalised approach to risk assessment.

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Links and resources

Lived experience-led resources

• Special edition on Borderline Personality Disorder (Asylum magazine)
  This special edition of the Asylum magazine discusses the diagnosis of borderline personality disorder, associated stigma and marginalisation, with survivor stories throughout.
• Deconstructing BPD
  A website of resources on the diagnosis of Borderline Personality Disorder, its construct validity and misdiagnosis, iatrogenic harm and staff attitudes from Dr Jay Watts.
• The epistemic injustice of borderline personality disorder (BJPsych International, 2024)
  This article by Dr Jay Watts discusses issues with the diagnosis of borderline personality disorder.
• Complex trauma and the unseen: who gets to be a victim? (BMJ Mental Health, 2024)
  Dr Jay Watts considers the diagnosis of complex post-traumatic stress disorder and advocates the need for more trauma-informed care and transdiagnostic approaches.
• Dispelling myths and challenging neglect in ‘borderline personality disorder’ healthcare: a lived experience perspective (Journal of Psychosocial Studies, 2023)
  This article explores the lack of evidence-base for the diagnosis of borderline personality disorder and how care for people with this diagnosis is impacted by stigma and prejudice.
• Service Users’ Perspectives on Communicating Compassion in Mental Health Practice (Nursing Open, 2024)
  This editorial highlights the lack of guidance for clinicians around compassionate practice. It discusses presence, engagement and skills – the three components suggested by service users to communicate compassionately in mental health settings.
• What is the long-term impact of being part of a Therapeutic Community for staff and service-users, 4 years after the closure of the service? (Therapeutic Communities: The International Journal of Therapeutic Communities, 2025). This is a lived experience led paper by one of our PAR partners, Ellie Louise Wildbore. The article overviews the impact of Therapeutic Communities on staff and patients with self-defeating behaviours, and the importance of relational care.

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Research and reports

• The experiences of autistic adults who were previously diagnosed with borderline or emotionally unstable personality disorder: a phenomenological study (Autism, 2025)
  This interpretive phenomenological study explores the experiences of autistic adults who had previously been diagnosed with borderline or emotionally unstable personality disorder.
• Safer care for patients with personality disorder (NCISH, 2018) and Annual report 2023: UK patient and general population data 2010-2020 (NCISH, 2023)
  These NCISH reports examine the key characteristics of patients who received a diagnosis of personality disorder prior to suicide and/or homicide.
• Clinical characteristics and care pathways of patients with personality disorder who died by suicide (BJPsych Open, 2020)
  This paper describes the characteristics of patients diagnosed with personality disorder who died by suicide, examines clinical care pathways and explores whether the care adhered to National Institute for Health and Care Excellence guidance.
• The personality disorder patient pathway: Service user and clinical perspective (Personality and Mental Health, 2019)
  This qualitative study examines the experiences of clinicians with experience of working with people who have received a diagnosis of personality disorder and of mental health service users who have received a diagnosis of personality disorder. Care pathways for individuals diagnosed with personality disorder were unclear to both clinicians and service users. These should be defined and consistent across services and NHS Trusts.
• Safer care for patients given a diagnosis of personality disorder: a learning resource (NCISH, 2023)
  This online resource is aimed at staff working in mental health services, to help them understand more about what it means to have been given a diagnosis of personality disorder and how to help people who present to services with this diagnosis. This resource is based on findings from the Safer care for patients who have received a diagnosis of personality disorder report and was co-produced with people who have received a diagnosis of personality disorder.

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This work was completed as part of the Culture of Care Programme. The work was supported by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC) (Grant Reference Number NIHR204295). Leah Quinlivan is fully funded by the NIHR GM PSRC, Pauline Rivart was part funded by the NIHR GM PSRC, and Professor Nav Kapur is part funded by the NIHR GM PSRC.  The views expressed on this webpage are those of the authors and not necessarily those of NICE, NIHR, NHS, or the UK Department of Health and Social Care.