Our service was previously known as the Nottinghamshire Personality Disorder and Development Network.
We moved away from using personality disorder in the title because people often struggle with the personality disorder label and we wanted to better engage people in the service. The title also suggested that the service worked with all personality disorder types, which is not the case.
The new title now emphasises our use of the mentalizaion based treatment (MBT) approach. This is clinically researched to be the most effective treatment for personality disorder, namely borderline and anti-social personality disorder/traits.
Referrals to the Notts MBT service are made via Secondary Mental Health Services following their assessment. In some cases we will accept direct referrals from IAPT and primary care services but we would recommend a discussion with the team prior to making any referral. Unfortunately, due to changes in commissioning and the development of the Personality Disorder Pathway, we no longer accept direct GP referrals. We will need the service user to remain open to the referring service until the referral is discussed/accepted as it may be that we do not go on to offer an initial assessment and we may make recommendations which require the referrer’s action.
If you wish to be referred to the Notts MBT Service you will need to discuss this with a healthcare professional such as your GP, community psychiatric nurse, psychiatrist, or other mental health professional.
We have a Contact system available every afternoon (1pm – 5pm). This system is available for clinicians, service users and other services who work with service users accessing our service or presenting with difficulties linked to personality traits. A clinician within the Notts MBT service will be available to manage calls regarding people in crisis, crisis services, clinical services and those ‘in the gap’ (i.e. not yet referred, referral rejected etc.), to offer advice/info and onward referral. It is also a route to accessing clinical advice for staff/teams/services.
We provide a community service of individual assessments and group therapy for people with complex personality difficulties. We work with Service Users who are motivated towards change and who feel able to make use of group therapy.
Our service users often have longstanding difficulties in relationships, early experiences of trauma, poor early attachments, and a pronounced difficulty in managing overwhelming emotions. Not everyone who uses our service has a diagnosis of personality disorder, but all will have significant issues with personality traits which are:
We do not routinely offer CPA care-coordination but work closely with those services that do. We do not prescribe or manage medication, nor do we diagnose personality disorder.
We provide both Mentalization Based Treatment groups (recommended by National Institute of Care and Excellent [NICE]) and psycho-education groups. These vary in length from 12 weeks to 1 year. We provide group therapy, as it has been proven to have the most effective treatment (positive outcome) with this patient group. Service Users benefit from developing appropriate relationships with others who have similar experiences to themselves.
We also offer a Cognitive Analytic Therapy (CAT) based group specifically developed for 18-25 year olds, for those who will benefit from specialist earlier intervention. This intervention aims to help individuals develop an understanding of the current problems affecting their wellbeing and how these are caused by earlier life and relationships.
The service covers Nottingham City and Nottinghamshire County. Services are offered in Nottingham City, Mansfield, Worksop and Newark.
Mentalizing is about: Recognising and managing your own thoughts and feelings; Recognising and understanding what other people may be thinking and feeling; Interpreting feelings, actions and behaviours as being meaningful; Attending to mental states such as thoughts, beliefs, desires and feelings.
A person who struggles to mentalize will have difficulties: in building and maintaining relationships; to manage some strong and overwhelming emotional experiences and feelings and get back to a more manageable state.
Sometimes when a person is distressed or experiencing strong emotions, their ability to recognise and manage their own thoughts and feelings, and to recognise and understand what other people may be thinking and feeling, is greatly reduced. This often means that a person may: Find it difficult to think clearly about their own and other people’s behaviour; To understand others behaviour towards them, which can lead to conflict; Have difficulties in building and sustaining relationships
Mentalization Based Treatment (MBT) aims to help a person: understand their own thoughts and feelings; develop their ability to recognise and understand what other people might be thinking and feeling; reduce the chance of misinterpreting the intentions of other people; Manage overwhelming emotional experiences which may have led to unsafe behaviour in the past.
This weekly meeting is a forum for clinicians, teams and services such as LMHTs, MHSOP, CAMHS, inpatients etc., to discuss and think about complex cases (those who have been assessed or who are on team caseloads), to consider possible treatment plans / treatment pathways, and to access support and advice from a multi-disciplinary team. It's also an opportunity to understand the treatments available within the Personality Disorder Pathway, of which Notts MBT Service is one treatment option.
This process also enables specialists in Personality Disorder within Nottinghamshire Healthcare NHS Trust to have oversight of all the elements of the Personality Disorder pathway. This includes being aware of resource versus demand within the pathway and identifying issues to consider for the ongoing Personality Disorder strategy development.
We offer training within Nottinghamshire Healthcare NHS Foundation Trust. We also deliver bespoke training (please contact the Operational Team Leader to discuss this further) and one day training to a range of statutory/non-statutory/third sector services.
Please contact us on 0115 876 0162 if you wish to discuss a possible referral to our service.
We accept referrals from Secondary Mental Health Services i.e. Local Mental Health Teams and other Mental Health Services, unfortunately we are no longer able to accept direct GP referrals. Referrals can be received directly to the service and, where the CORE assessment (RiO) documentation has not been completed, we would need to be on our referral form, and should include a recent risk assessment, child safeguarding information and past and current circumstances (please contact us on 0115 8760162 for a copy of the most up-to-date referral form). The service does have a number of exclusion criteria and so we would recommend contacting the service to discuss further if you are uncertain of these.