A transformative pathway for patients with personality disorders

Improving patient outcomes and experience for those with personality disorders

The personality disorder pathway transformation programme was implemented by Nottinghamshire Healthcare NHS Foundation Trust in 2021, to improve patient outcomes and experiences.

The challenge

Personality Disorders affect around 4.4% of the UK population and the diagnosis carries significant stigma. Personality Disorder treatment pathways are frequently fragmented, with long waiting lists, variations in services offered across regions, and poor levels of staff training and understanding of Personality Disorders. These factors are likely to impact on client wellbeing, recovery and satisfaction with mental health services.

The solution

The pathway is based on NHS England recommendations. It aims to create a clear personality disorder treatment pathway, improve access to evidence-based psychological therapies, reduce waiting times and increase available staff training on personality disorders. An evaluation funded by HIEM found a significant decrease over time in psychological distress for service users and favourable qualitative feedback showed widespread acceptability of the new care provision.

Impact and outcomes

  • Significant decrease over time in psychological distress compared to the year before the pathway was introduced
  • Quantitative individual clinical outcome data (CORE-10) and service-level Key Performance Indicators (KPIs) were analysed to assess if the changes to the Personality Disorder pathway had led to: changes in rates of diagnosis; improved access to specialist psychological therapies for Personality Disorder; reduced waiting times for specialist therapies; reduced inequalities in access to treatment; and reduced impact on other mental health services.
  • Staff participating in training programmes (Knowledge and Understanding Framework and Stabilisation Skills) reported improved confidence, skills, and attitudes towards managing clients with personality disorders.
  • Scalability – Whilst the intervention identified positive impacts for both staff and clients further work/evidence gathering would be required to ensure clarification of how specific roles complemented each to ensure cohesive delivery. Understanding communication issue/risks also require further investigation.

Mental health innovation – evaluation showcase

We held an evaluation showcase featuring mental health innovations that have been evaluated in our region. The webinar featured a presentation from the team and evaluators behind the programme.

Listen back

For queries and to receive a copy of the full evaluation report please contact This email address is being protected from spambots. You need JavaScript enabled to view it.