A mixed methods study of the healthcare received by patients diagnosed with a personality disorder on acute general hospital wards

Aim

The study examined concurrent mental and physical healthcare received by patients diagnosed with a personality disorder on acute general hospital wards. The specific objectives were (i) to conduct a web based cross sectional survey and (ii) to explore experiences and perspectives with a subsection of the survey sample, using telephone interviews.

Design

A convergent parallel mixed methods design, which comprised a web-based cross sectional survey (n = 65) with embedded qualitative telephone interviews (n = 12). Participants were social media users, with a self-reported diagnosis of personality disorder, admitted to an acute general hospital in the UK in the previous 2 years.

Methods

Participants were recruited on social media between May 2017 and August 2017 by snowballing. Mixed data were integrated at the stage of analysis using a framework approach. Findings are reported thematically.

Results

Most of the participants surveyed (94%, n = 61) reported distress during admission to the acute general hospital. However, the findings indicated the hospital environment was not conducive to mental health. Four interrelated themes were identified and related to: patient distress; the workforce; service delivery; and service design.

Conclusion

Findings indicated that patients with a personality disorder diagnosis received disadvantaged healthcare, might be at considerable risk of treatment noncompletion, and were languishing in the gaps between mental and physical health services.

Impact

This is one of the first studies to collect primary data on the concurrent mental and physical healthcare received by patients diagnosed with a personality disorder on acute general hospital wards. Ad hoc training and education focused on raising awareness of ‘personality disorder’ would not seem sufficient to address the deficits.

This research may be of interest to people who use mental health services, acute general hospital and liaison clinicians, hospital managers and researchers.