Title

Staff and client perspectives of the Open Borders programme for people with borderline personality disorder

Document Type

Journal Article

Publication Title

International Journal of Mental Health Nursing

ISSN

1447-0349

Volume

28

Issue

4

First Page

971

Last Page

979

PubMed ID

31081282

Publisher

Australian College of Mental Health Nurses

School

School of Nursing and Midwifery

RAS ID

29620

Funders

Funding information available at: https://doi.org/10.1111/inm.12602

Comments

Originally published as: Mortimer‐Jones, S., Morrison, P., Munib, A., Paolucci, F., Neale, S., Hellewell, A., ... Hungerford, C. (2019). Staff and client perspectives of the Open Borders programme for people with borderline personality disorder. International Journal of Mental Health Nursing, 28, 971-979. Original publication available here

Abstract

In recent years, there has been a move away from the medical model of care for people with borderline personality disorder, as hospital admission comes with a number of risks and potential adverse consequences. Although long-term outpatient-based therapy is successful, this may not be an option for those whose condition is in need of stabilisation. Brief admission for crisis intervention has been successful and is now widely used; however, research that examines both the staff and clients' perceptions of a dedicated programme is lacking. Open Borders is a residential recovery-oriented programme that provides brief admission, respite, and phone coaching for people with borderline personality disorder who are heavy users of the public mental health system. In this paper, the authors report the perspectives of clients and staff of the Open Borders programme obtained through semi-structured interviews. Thematic analysis of client and staff perspectives identified four common themes: 'Benefits of the programme', 'Enhanced client outcomes', 'Impact of the physical environment', and 'Ways of enhancing service delivery'. In addition, analysis of the staff perspectives included the theme 'Emotional impact on staff'. Benefits of the programme included the small supportive team approach, flexibility of the staff to spend time with the clients to tailor care, and the relaxed, welcoming environment. Enhanced client outcomes included a reduction in self-harming and hospitalization and an increase in self-efficacy. These results support the move away from the medical model and the empowerment of clients to self-manage their symptoms while fostering hope and self-determination.

DOI

10.1111/inm.12602

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