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Young people to benefit from global best practice

​Changes to the way young people with emerging personality disorders are diagnosed and treated are set to be introduced by Norfolk and Suffolk NHS Foundation Trust (NSFT) following a fact-finding visit to a world-renowned service in Australia.

Consultant Child and Adolescent Psychiatrist Dr Sarah Maxwell travelled to Melbourne earlier in the autumn to shadow clinicians from the award-winning Orygen Youth Service. During the month-long visit, which was funded by the Winston Churchill Memorial Trust, she looked in detail at the way young people with borderline personality disorders (BPD) are assessed, diagnosed and treated with the aim of bringing back learning to the UK.

Since returning to work at the end of October, Dr Maxwell has already begun making changes to benefit teenagers in Norfolk and Suffolk, which include enhancing screening and assessment and improving the education provided for families.

“The visit was really useful and gave me an interesting insight into Orygen’s work and its pros and cons,” said Dr Maxwell, who works with the Great Yarmouth and Waveney Youth Team. “We are now adapting some of their approaches to our own services with the aim of further improving the care we provide.

“Orygen use a standardised assessment to diagnose patients at an early stage, who are then offered weekly cognitive analytic therapy sessions as well as support and education for their families and carers. The outcomes they achieve for their patients are very good, although treatment is restricted to a maximum period of two years.

“The visit showed me how important it is to pick up on young people presenting in this way as early as possible. We are now starting to use new screening tools to help us to achieve this, as well as looking at additional work we could do with the families to help them support young people more effectively.”

BPD is a disorder of mood and how a person interacts with others, and affects up to 3% of the normal adolescent population.

It can cause emotional instability, disturbed patterns of thinking, impulsive behaviour and lead to intense but unstable relationships, but because its symptoms are often associated with other conditions, it can be difficult to diagnose. As such, it can cause long-term problems lasting into adulthood, as well as increased risk of developing other mental health conditions.

NSFT has identified personality disorder as one of its key five adult pathways in its 2016 – 2021 Clinical Strategy, and will focus on further improving care over the next five years.