Abstract:
The mental health diagnosis borderline personality disorder is heavily
stigmatised and people with this diagnosis experience discrimination within
mental health services, leading to iatrogenic harm. Clinician attitudes are found
to be more negative toward this diagnosis than other mental illness. A wealth of
personality disorder are improving, likely due to increasing training and efficacy
of treatment. This research aimed to investigate the factors influencing staff
adult mental health services of one district health board (DHB) in New Zealand.
The study included two phases; Phase One involved distribution of the Attitude
to Personality Disorder Questionnaire to all clinical staff employed in adult
mental health services of the DHB. Phase Two involved individual interviews with
the professional leads and kaumātua to identify their perceptions of the
psychosocial and organisational barriers and facilitators to staff members
providing best practice care to clients with borderline personality disorder and
explore their recommendations for organisational change and staff support.
Phase One data for 91 respondents was analysed through ANOVA and
ANCOVAs, illustrating overall higher scores (more positive attitudes) than
previous studies; community nurses showed higher scores than inpatient nurses
and supervision was positively correlated with higher scores. Phase Two
interview transcripts were analysed through reflexive thematic analysis which
resulted in five main themes. Overall, the interview participa
and literature suggest that the current distress felt on both sides of the clinicianclient
relationship is not necessary and can be avoided. Clinician wellbeing
impacts on client care and could be supported through additional training,
accessible supervision and increasing psychologist positions for suitable careplanning
consultation.
