Summary

In the inaugural episode of PD Squared, host Chris welcomes psychiatrist Jessica Akely, who specialises in forensic psychotherapy at the Portman Clinic. Jessica explains the nature of forensic psychotherapy, which involves treating individuals who have encountered legal issues, often stemming from violent or sexual behaviours. She emphasises the importance of voluntary participation in therapy, noting that patients who come willingly tend to benefit more from the treatment. The conversation delves into the complexities of working with individuals diagnosed with antisocial personality disorder, highlighting the challenges of motivation and the stigma surrounding mental health treatment for this demographic.

As the discussion progresses, Jessica shares insights about the effectiveness of group therapy, particularly for men dealing with aggression and violence. She describes how these groups foster meaningful connections among participants, often referred to as the 'family they never had.' The episode also touches on the systemic prejudices faced by individuals with personality disorders, the challenges of communication within mental health services, and the need for a more compassionate, trauma-informed approach to care. Jessica advocates for better training and understanding among professionals to improve treatment outcomes for those with complex mental health needs.

Takeaways

Patients benefit more when they come to therapy voluntarily.

Group therapy can create meaningful connections among individuals with similar struggles.

Stigma and prejudice against personality disorders persist in mental health services.

Long-term therapy is often necessary for individuals with complex trauma histories.

Mentalization-based treatment can help individuals understand their emotions and behaviours.

Chapters

00:00 Introduction to Forensic Psychotherapy

04:04 The Role of Group Therapy

10:18 Prejudice and Stigma in Mental Health

20:18 Challenges in Communication and Care

29:43 The Importance of Trauma-Informed Care

39:29 Good Clinical Practice and Training

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Summary

In this episode, Chris interviews Naomi Salisbury, the ex-CEO of Self Injury Support, who shares her extensive experience in mental health services and advocacy for individuals with personality disorders. The conversation delves into the discrimination and prejudice faced by those labelled with personality disorders, particularly in mental health settings. Naomi discusses her personal experiences and those of the individuals she supports, highlighting the systemic issues that perpetuate discrimination and the lack of understanding surrounding these diagnoses. She emphasises the need for a more compassionate and curious approach in mental health services, advocating for a shift from punitive measures to supportive, person-centred care that acknowledges the complexities of trauma and mental health.

Keywords

personality disorder, mental health stigma, self-harm support, trauma-informed care, mental health services, discrimination, advocacy, emotional support, peer support, systemic issues

Takeaways

'The removal of curiosity is a huge problem.'

'If you don't know something, just say you don't know.'

'It's about relationships and connecting with people.'

'The system is set up to gatekeep and keep people out.'

'We need to invest in the emotional and psychological level of who gets into these jobs.'

'Being validated and believed at any life stage is crucial.'

'It's not about labelling; it's about understanding the trauma.'

'We need to treat people as individuals, not templates.'

'The tone of communication in mental health services can be hostile.'

Chapters

00:00 Introduction to Naomi Salisbury and Self Injury Support

02:20 Experiences of Prejudice in Mental Health Services

05:45 The Impact of Labels on Seeking Help

14:13 The Role of Curiosity in Mental Health Care

25:27 The Need for Systemic Change in Mental Health Services

35:45 The Importance of Validation and Support

45:35 Exploring the Future of Mental Health Services

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Summary

In this episode of the PD Squared podcast, host Chris engages in a conversation with Tommy Tierney, who shares her lived experiences with personality disorder diagnoses and her work in the homelessness sector. Tommy discusses the intersection of mental health, homelessness, and gender-based violence, highlighting the overrepresentation of individuals with personality disorder labels among those experiencing severe disadvantage. She emphasises the systemic issues within mental health services, particularly how diagnoses can serve as barriers to accessing necessary support rather than facilitating treatment. The conversation delves into the prejudice surrounding personality disorders, the challenges faced by individuals seeking help, and the need for a more compassionate and understanding approach from mental health professionals.

Tommy articulates the complexities of navigating mental health services, sharing her own experiences of prejudice and the often-punitive nature of treatment for those labelled with personality disorders. She advocates for a shift in perspective, urging professionals to recognise the underlying trauma and distress rather than attributing blame to individuals. The discussion culminates in a call for systemic change, emphasising the importance of listening to and believing individuals in distress, and creating supportive environments that foster healing and understanding.

Keywords

personality disorder, mental health, homelessness, trauma, stigma, mental health services, gender-based violence, systemic issues, lived experience, support

Takeaways

"There's a real disconnect between what the person might want and what their agenda is in that."

"The problems are being located very much in the individuals and not in the services or lack thereof."

"If we do have to have a diagnosis of this kind, it needs to be a result of a proper, thorough rigorous assessment process."

"The idea that we are choosing to be this way is just a moral failing."

"The impact of trauma is less based on the seriousness of whatever incident it was as the support you get afterwards."

"It's not just about the overt trauma; it's about emotional negligence too."

"We need to create an environment where it's safe to talk about anything that happens to you."

"The system creates a perverse incentive to be high risk to get the help you need."

"It's about being heard and cared for, not just treated as a diagnosis."

"There's a need for training that breaks the cycle of prejudice and misunderstanding."

Chapters

00:00 Introduction to Tommy Tierney and Her Work

01:25 The Intersection of Trauma and Homelessness

05:08 Prejudice in Mental Health Services

10:46 The Role of Diagnosis in Accessing Care

20:36 Experiences with Crisis Services

30:09 The Impact of Prejudice on Treatment

39:04 Understanding the Roots of Prejudice

51:22 What Good Practice Looks Like

01:01:34 Creating Supportive Environments for Healing

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Welcome to PD² with Square Pegs, an audio podcast that’s an offshoot of the work we started with the National Collaborating Centre for Mental Health, the NCCMH, which is part of the Royal College of Psychiatrists in the United Kingdom, to challenge the prejudice and discrimination experienced by people with a label, or diagnosis of personality disorder.

To be clear, the conversations in the podcast do not reflect the work or opinions of the Royal College or the NCCMH. This work originated from, but is no longer connected to either of those organisations.

PD stands for both ‘Personality Disorder’ and ‘Prejudice and Discrimination’, where ‘squared’ also reflects our intention to square up to the prejudice and discrimination experienced by so many of us with a diagnosis, or label, of personality disorder.

This podcast is a database of testimony, where your voice, your story will be cherished and valued for years to come; I’m inviting you to be part of the change we all need.

If you, or you think someone you know would like to be involved with PD², please get in touch.

You can find me, Chris Young, at hello@letswalkamile.org.uk.

Once I hear from you, I’ll send you a short explanation of what to expect as an interviewee.

Remember, we are nothing without your stories…your testimony… together, we are PD².

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