Eighty per cent of psychiatric nurses believe that people with Borderline Personality Disorder (BPD) receive inadequate care, despite the fact that one in fifty adults suffer from the condition, according to the October issue of the Journal of Psychiatric and Mental Health Nursing.
Ninety-eight per cent of nurses said service shortages played a role in inadequate care and 83 per cent said that disagreements between staff on how to care for people with BPD was a factor.
Researchers from the Republic of Ireland - Professor Seamus Cowman, from the Royal College of Surgeons and Philip James, a Clinical Nurse Specialist from the Health Service Executive - found that more than a quarter of the nurses surveyed (27 per cent) had daily contact with patients with BPD.
Despite this, only three per cent had received post-graduate training in BPD and, when training was provided, it tended to be a single workshop or lecture.
BPD is a serious mental illness characterised by persistent instability in moods, personal relationships, self-image and behaviour. This instability can affect aspects of the individual’s life and their sense of identity, resulting in self-harm and a significant rate of suicide attempts. It is more common in young women and sufferers often need extensive mental health services.
A hundred and fifty seven ward and community-based nurses working for a health service providing mental health inpatient and outpatient services were surveyed, with 67 (41 per cent) completing the detailed questionnaire.
“A worrying finding of this study is that the majority of staff believe that multi-disciplinary team disagreements lead to inadequate care” says Professor Seamus Cowman.
“This points to the need for greater guidance to avoid different approaches being taken to managing clients with the same disorder. The need for all services to develop policies on handling BPD was also highlighted by the Expert Group on Mental Health Policy in its 2006 report.”
Lack of specialist training was also a concern.
“The majority of nurses strongly agreed that they had a key role to play in the assessment and management of people with BPD and 90 per cent said they would be keen to receive further training in dealing with BPD” says Professor Cowman.
“We were concerned to note that only three per cent had received post-graduate training. In contrast, Australian nurses receive 11 times as much post-graduate training in BPD as their colleagues in the Republic of Ireland.
“This lack of training needs to be addressed as other studies have shown that it can improve both knowledge of BPD and attitudes towards it.”
88 per cent of the nurses who took part in the survey said that people with BPD were difficult to treat. 75 per cent said they were very or moderately difficult to look after and 80 per cent believed that they were more difficult to look after than other clients.