Dedicated community-based services for adults with personality disorder: Delphi study

Area of Science:

• Mental Health
• Clinical Psychology
• Psychiatric Services Research

Background:

• Community-based services are recommended for personality disorder (PD) care.
• Optimal configuration of these dedicated services remains poorly understood.
• Evidence-based guidelines for PD service organization are lacking.

Purpose of the Study:

• To assess expert and stakeholder opinions on the organization and delivery of dedicated community-based personality disorder services.
• To identify areas of consensus and disagreement regarding PD service configuration.
• To inform the development of best practices for PD service delivery.

Main Methods:

• A Delphi survey methodology was employed.
• A diverse panel of experts, including authors, service providers, and service users, participated.
• 54 statements regarding service organization and delivery were evaluated for consensus.

Main Results:

• Consensus was achieved on only 39% (21 out of 54) of the statements.
• Significant disagreement persisted on critical issues.
• Key areas lacking consensus included managing violent offending, community outreach strategies, and the application of compulsory treatment.

Conclusions:

• There is a lack of agreement among experts and stakeholders on how to best structure dedicated personality disorder services.
• Further research and deliberation are essential to establish optimal models for community-based PD care.
• Defining consensus on controversial aspects of PD service delivery is crucial for improving patient outcomes.