Personality Disorder Managed Clinical Network (Leeds)

The Leeds Personality Disorder Managed Clinical Network (PDMCN) is a city-wide multi-agency and multidisciplinary service that aims to work effectively with people who have difficulties consistent with a diagnosis of ‘personality disorder’, complexity of need and significant risk issues. It provides a range of different services to meet the needs of people at the varying stages of their journey in the recovery process.

The range of interventions, available from the PDMCN are only offered at present to service users living in the Leeds area and registered with a Leeds GP.

Useful information about our services

Young People’s Complex Emotional Needs Pathway

The PDMCN in partnership with the Community Mental Health Teams (CMHTs) in Leeds and Third Sector Services, have been working to enhance the core community mental health offer to young people between 18 – 25 years old.

The ‘Young People’s Complex Emotional Needs Pathway’ has been designed to support 18-25 years olds who have difficulties consistent with a diagnosis of ‘personality disorder’ (and who would be best supported within secondary mental health care), to gain access to care coordination alongside a range of bespoke interventions.

The PDMCN continues to offer:

  • Care coordination to over 25 year olds who are assessed as at risk of long term hospital admission/ or those being discharged from (or within) long term hospital placements
  • Case consultation to referrers across LYPFT services in Leeds to support working with individuals with complex emotional and interpersonal needs/ those with a diagnosis of personality disorder
  • Journey: Occupational Therapy Group work programme
  • Dialectical Behaviour Therapy (DBT) Informed Skills Groups: as part of the city wide DBT service and in partnership with Leeds Mental Wellbeing Service (LMWS)

Further information and referral details can be found below.

Care Coordination of Young People aged 18-25 years old**

Referral for this intervention can be made to the relevant local CMHT via the LYPFT Single Point of Access (SPA). Eligibility for the service will be overseen by identified CMHT ‘pathway practitioners’ in each CMHT ‘pod’ who will take the lead on the assessment and management of referrals for young people with difficulties that would be consistent with a personality disorder diagnosis.

If a young person is deemed eligible to access the service following the initial assessment by CMHT staff, there will be no secondary assessment by the PDMCN to ascertain suitability for the service and the default position will be direct acceptance into the PDMCN care coordination intervention.

CAMHS transition referrals will be discussed with the young person, CMHT and CAMHS staff and a decision reached as to the most appropriate pathway for the young person. Where it is agreed, the young person’s care will transfer directly to the PDMCN.

The criteria for PDMCN care coordination is as follows:

Young people aged between 18-25 years old, who:

  • Have a primary presentation consistent with a personality disorder/emerging personality disorder
  • Have a significant pattern of interpersonal difficulties – where there is evidence that these difficulties are longstanding and persistent (e.g. not only in the context of current/immediate stressors/events). There is a concern difficulties may be enduring without secondary care input at this stage.
  • Have a significant pattern of emotional instability, difficulty coping with distress and regulating emotions. There is evidence these difficulties are longstanding and persistent (e.g. not only in the context of current/immediate stressors/events), and there is a concern these may be enduring without secondary care input at this stage.
  • Are assessed as ‘cluster 7 or cluster 8’ via the MHCT.
  • Meet the criteria for intervention from a CMHT in Leeds.
  • Have substantial and complex mental health needs which cannot be met by primary care, the IAPT Service or other community services.
  • Or, who are 17 years old and due to transition to adult services from CAMHS.

Young people will be initially offered up to 2 years of care with the PDMCN. This will be reviewed and can be extended according to need. Young people between 18-25 years old can be re-referred to the service via SPA/CMHT assessment as described above.

Care Coordination of over 25 year olds**

Referrals for assessment are accepted from professionals only. Individuals accepted for assessment would not necessarily need to meet all of the criteria outlined below, other than in relation to the first point; the remaining factors should provide a further guide for suitability. Care coordination assessment will be viewed as an intervention in its own right, of up to 6 weeks in duration and utilising engagement strategies and formal assessment measures to develop a comprehensive narrative account of an individual’s life history. At the end of the assessment period, a decision will be made regarding whether the service user’s care co-ordination will be transferred to the PDMCN. This decision will be mindful of the presenting levels of risk and complexity, engagement with the therapeutic assessment process and made in consultation with the service user. If transfer is not indicated alternative recommendations will be outlined and the PDMCN will provide further consultation and support to the referring team if required.

The referral criteria for assessment is as follows:

  • Must be assessed as at risk of long term hospital admission/ or those being discharged from (or within) long term hospital placements
  • A diagnosis of personality disorder/ difficulties consistent with a personality disorder diagnosis
  • Multiple complex needs
  • Significant risk of self harm or neglect
  • Poor response to previous interventions
  • Difficulty in maintaining contact with services
  • Limited social networks

**Care coordination within the service is psychologically informed. Psychological understanding, or formulations, shape the aim and focus of a person’s work with the PDMCN, as well as inform risk management and subsequent multi-disciplinary interventions such as, occupational / psychological/ creative therapy, peer support and youth work.

Consultation for service-users aged 18 years old and over

The PDMCN will offer case consultation to referrers across LYPFT services in Leeds to support working with individuals with complex emotional and interpersonal needs/ those with a diagnosis of personality disorder, and as a further means of supporting workforce development. Consultation will involve the offer of up to 4 sessions to LYPFT staff following referral via Care Director. From October 2021, consultation will also be offered more widely to services across Leeds.

Changes during COVID19

All of our group work activity is now being undertaken via video link.

 

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