Changing attitudes and enhancing competency: personality disorder initiative

Area of Science:

• Mental Health
• Psychiatry
• Clinical Psychology

Background:

• Negative clinician perceptions of personality disorders, especially borderline personality disorder (BPD), contribute to stigma and care access barriers.
• The Victorian government established the Personality Disorder Initiative (PDI) to enhance workforce capacity through training and supervision.
• A significant portion of mental health caseloads involves individuals with personality disorder diagnoses.

Purpose of the Study:

• To evaluate the PDI's impact on clinician attitudes and self-perceived competence in managing personality disorders, including BPD.
• To assess changes in clinician optimism, enthusiasm, confidence, and willingness to work with this population.
• To measure improvements in clinician knowledge, skills, and experience related to personality disorders.

Main Methods:

• A statewide pre-post survey design was employed, with data collected in July 2020 and March 2023.
• Public mental health clinicians across Victoria participated in the survey.
• Independent samples t-tests were used to analyze changes in attitudes and competence scores.

Main Results:

• Clinician-reported attitudes and competence scores showed statistically significant improvements across most domains (p < .01).
• Improvements were noted in optimism, enthusiasm, confidence, and willingness, as well as knowledge and skills.
• Clinician experience scores did not show statistically significant improvement.

Conclusions:

• Sustained, integrated training via the PDI demonstrably enhanced clinician attitudes and competencies for working with personality disorders.
• The PDI model offers a scalable strategy for augmenting mental health workforce capabilities in complex care.
• Addressing negative perceptions and improving clinician confidence are crucial for effective personality disorder treatment.