Too many people with complex emotional needs face stigma, fragmented services and poor support, says Centre for Mental Health

12 April 2022

The Government must set out plans to improve support for people with complex emotional needs, a new briefing by Centre for Mental Health has said today.

Dismissed on the basis of my diagnosis finds that too many people with complex emotional needs (or a diagnosis of ‘personality disorder’) find themselves excluded, marginalised and subject to discrimination in all aspects of life, including from health and care services.

Produced as part of the NIHR Mental Health Policy Research Unit, the briefing summarises evidence from six studies on people’s experience of community services for complex emotional needs. It finds that many mental health practitioners demonstrate negative views of people with complex emotional needs, who often receive poor quality treatment or are turned away from services altogether.

In partnership with University College London, King’s College London, City University London, University of Birmingham, and University of Greenwich, the briefing finds that while tailored psychological therapies can be effective, they are often short-term and fail to have a sustained impact because follow-up care is inadequate and people don’t get offered holistic help longer term.

The briefing identifies some of the key features of effective support, such as consistent therapeutic relationships, recognising the impact of trauma, and taking a long-term approach.

The briefing calls on the Government to set out clear plans to improve support for people with complex emotional needs in its forthcoming mental health plan, as well as urging mental health service providers to ensure training and supervision are in place so that their staff offer non-stigmatising and compassionate care.

Sarah Hughes, chief executive of Centre for Mental Health, said: “No one should be dismissed on the basis of their diagnosis, particularly by those who are employed to provide support. The discrimination and lack of support faced by so many with complex emotional needs is unacceptable. The forthcoming mental health plan and the next phase of the Long Term Plan are both clear opportunities to set out how services will provide consistent, sustainable, high-quality care for people with complex emotional needs.”

Marsha McAdam, mental health campaigner and ambassador for the Centre, said: “Too many of us with complex emotional needs have largely been dismissed and discriminated against by services, purely because of our diagnosis. Everyone deserves compassionate care and effective treatment. Mental health services and training bodies need to ensure that all basic education includes training in complex emotional needs – including by people with lived experience – to address the persistent stigma among professionals.”

Dr Kylee Trevillion, Deputy Director of the NIHR Mental Health Policy Research Unit, said: “There is a startling lack of research evidence to inform high-quality mental health care for people with complex emotional needs. We know that people with complex emotional needs define quality care as extending beyond solely access to psychological therapies. It includes positive interpersonal connections with compassionate/non-judgmental staff who recognize and address their longer-term needs in a holistic manner. Evidence is needed on how best to meet social needs and those related to trauma, comorbid mental health and substance use problems, and we need to understand how best to design services systems. It is critical, therefore, that researchers establish a robust evidence base, co-produced throughout with people with relevant lived experience, on effective models of treatment and support”

Download the report

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