P-05-812 Implement the NICE guidelines for Borderline Personality Disorder -Correspondence from Betsi Cadwaladr University Health Board to the Committee, 08.10.18

Further to your email of 30^th July 2018 in relation to the above, please see response below on behalf of Betsi Cadwaladr University Health Board.

Please accept my sincere apologies for the delay in sending this through, if you have any queries please do not hesitate to contact me.

"In North Wales people with a diagnosis of Borderline personality disorder receive specialist input via the CMHTs. The approach is stepped and tailored around the individual's needs, hence some clients will have a care co-ordinator and medical input.

Furthermore, there are psychology lead DBT services in the west and central areas of BCU, which are in line with NICE guidance as best practice for people who have a borderline personality diagnosis and have suicidal or self-harm urges. Psychology also provide individual input at secondary mental health specialist level via CMHT input, based on a person's individual formulation and NICE guidelines.

We are currently unable to provide fully comprehensive DBT services across North Wales, due to the lack of dedicated MDT resource for this approach in some areas. Recommendations have been given on how to develop these services. We recommend other evidence based approaches if DBT is not suitable for an individual, and structured clinical management in high risk cases. Given the amount of time this requires, we recognise best practice and NICE guidelines indicate specialist services are recommended to enable adequate and responsive provision. The development of the strategy and service re-design in North Wales will facilitate the development of specialist input and will address the variation of access.

North Wales is also developing a robust crisis response in partnership with the voluntary sector, as suggested by service users in the Strategy document and in accordance to the Crisis Concordat.

To specifically support survivors of abuse in North Wales, psychology provides targeted individual trauma work as well as other input at secondary care CMHT level; partnership work with Amethyst in group therapy for survivors of childhood sexual abuse (which is currently being evaluated in a joint research study with Bangor University via a Health and Social care fund); and promotion and skills teaching re: trauma informed care across MDTs in community and inpatient services."

Kind regards

Sandra

Sandra Ingham

Rheolwr Cefnogi Busnes

Business Support Manager

Cynorthwyydd Personol Cyfarwyddwr Iechyd Meddwl ac Anableddau Dysgu

PA to Director of Mental Health and Learning Disabilities