Personality Disorder: challenges in service development in the light of the new NICE guidelines for Personality Disorder (Garrett, Lee, Blackburn, Priestly, 2026)

Christopher Garrett, Tennyson Lee, Samantha Blackburn, Leanne Priestly, Kamaldeep Bhui

The Psychiatrist (2011), 35,22-26, doi: 10.1192/pb.bp.109.029249

Available online at this link

Aims and method Using the National Institute for Health and Clinical Excellence(NICE) guidelines on borderline personality disorder as a framework, we describe theprofile of the first 100 individuals referred to a personality disorder service in London, captured through the use of record review and case study.

Results The referral population ethnic profile does not match the wider population of the borough; a third of the borough is Bangladeshi, but only 9% of those referred to the service are. Of those diagnosed with borderline personality disorder and on psychotropic medications, only one person had a clear current indication based on NICE guidelines. Of the 100 individuals who were referred to the service, a quarter were accepted to the programme; a third either did not want to proceed with the assessment or were unprepared for an intensive programme. Clinical implications The under-representation of Black and minority ethnic individuals in referrals in the peresonality disorder service needs to be actively addressed. Interventions are required to support psychiatrists in reviewing their prescribing practice regarding individuals with borderline personality disorder. Access to the service needs to be improved.