Psychological Therapies Please contact Peter Hudson if you have any queries: 0207 561 9240 Summary This paper considers cutting edge research which shows that psychodynamic interventions for people with Personality Disorder (PD) and Medically Unexplained Symptoms (MUS) have the potential to save millions of pounds for the NHS. It focuses on two separate ongoing projects - the Devon Personality Disorder Service Pilot and the Birmingham Medically Unexplained Symptoms Project. Key Points The Devon Personality Disorder Service Pilot has used psychodynamic interventions to treat people with severe and complex PD. Patients have been provided with a care pathway which costs a maximum of £76,200 per patient per year and has led to significantly improved health outcomes and patients living successfully in the community. If these patients had not been in the pilot, they would have been in locked specialist PD units costing £200,000 per person per year. Therefore the pilot shows that well over £100,000 can be saved per patient with severe and complex PD per year. The Royal College of Psychiatrists and the Royal College of GPs have recently formed a working group looking into building on the Devon PD Service research nationally. The Devon PD Service Project also has significant implications for treatment of people with MUS. The service assessed the top 55 people reporting at the Devon and Exeter Hospital with MUS and found 47 of them having Attachment Disorder and PD. A pilot is required to look at effect of psychodynamic treatment and a care pathway on people with MUS. The Birmingham Medically Unexplained Symptoms Project is a whole system redesign of primary care, acute care and specialist mental health care for people with MUS. People with MUS are offered psychodynamic interpersonal therapy and, to a much lesser extent, cognitive behavioural therapy. Evaluation of phase 1 of the project has shown improved patient symptoms and reduced secondary healthcare costs by an average of £841 per patient per year. The MUS project is shortly to be expanded to a larger population. The Personality Disorder Service Project Personality Disorder is prevalent in 10 13% of the general population. It accounts for 29% – of GP attendances, 36 67% of psychiatric inpatients and 30% of community mental health – caseloads (National Institute for Mental Health in England 2003). Most people with PD do not present with complex or severe symptoms but a significant minority have psychotic symptoms, mood disorder, eating disorders, substance misuse and child protection risks.
Psychological Therapies Please contact Peter Hudson if you have any queries: 0207 561 9240 Summary This paper considers cutting edge research which shows that psychodynamic interventions for people with Personality Disorder (PD) and Medically Unexplained Symptoms (MUS) have the potential to save millions of pounds for the NHS. It focuses on two separate ongoing projects - the Devon Personality Disorder Service Pilot and the Birmingham Medically Unexplained Symptoms Project. Key Points The Devon Personality Disorder Service Pilot has used psychodynamic interventions to treat people with severe and complex PD. Patients have been provided with a care pathway which costs a maximum of £76,200 per patient per year and has led to significantly improved health outcomes and patients living successfully in the community. If these patients had not been in the pilot, they would have been in locked specialist PD units costing £200,000 per person per year. Therefore the pilot shows that well over £100,000 can be saved per patient with severe and complex PD per year. The Royal College of Psychiatrists and the Royal College of GPs have recently formed a working group looking into building on the Devon PD Service research nationally. The Devon PD Service Project also has significant implications for treatment of people with MUS. The service assessed the top 55 people reporting at the Devon and Exeter Hospital with MUS and found 47 of them having Attachment Disorder and PD. A pilot is required to look at effect of psychodynamic treatment and a care pathway on people with MUS. The Birmingham Medically Unexplained Symptoms Project is a whole system redesign of primary care, acute care and specialist mental health care for people with MUS. People with MUS are offered psychodynamic interpersonal therapy and, to a much lesser extent, cognitive behavioural therapy. Evaluation of phase 1 of the project has shown improved patient symptoms and reduced secondary healthcare costs by an average of £841 per patient per year. The MUS project is shortly to be expanded to a larger population. The Personality Disorder Service Project Personality Disorder is prevalent in 10 – 13% of the general population. It accounts for 29% of GP attendances, 36 – 67% of psychiatric inpatients and 30% of community mental health caseloads (National Institute for Mental Health in England 2003). Most people with PD do not present with complex or severe symptoms but a significant minority have psychotic symptoms, mood disorder, eating disorders, substance misuse and child protection risks.
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