Recovery in Borderline Personality Disorder (BPD): A Qualitative Study of Service Users' Perspectives

PMCID: PMC3355153This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Why do some voluntary patients feel coerced into hospitalisation? A mixed-methods study

This study aimed to investigate factors linked to perceived coercion at admission and during treatment among voluntary inpatients. Quantitative and qualitative methods were used. Two hundred seventy patients were screened for perceived coercion at admission. Those who felt coerced into admission rated their perceived coercion during treatment a month after admission. Patient characteristics and experiences were tested as predictors of coercion. In-depth interviews on experiences leading to perceived coercion were conducted with 36 participants and analysed thematically. Thirty-four percent of patients felt coerced into admission and half of those still felt coerced a month later. No patient characteristics were associated with perceived coercion. Those whose satisfaction with treatment increased more markedly between baseline and a month later were less likely to feel coerced a month after admission. In the qualitative interviews three themes leading to perceived coercion were identified: viewing the hospital as ineffective and other treatments as more appropriate, not participating in the admission and treatment and not feeling respected. Involving patients in the decision-making and treating them with respect may reduce perceived coercion

Acceptability of offering financial incentives to achieve medication adherence in patients with severe mental illness: a focus group study

BACKGROUND: Offering financial incentives to achieve medication adherence in patients with severe mental illness is controversial. AIMS: To explore the views of different stakeholders on the ethical acceptability of the practice. METHOD: Focus group study consisting of 25 groups with different stakeholders. RESULTS: Eleven themes dominated the discussions and fell into four categories: (1) ‘wider concerns’, including the value of medication, source of funding, how patients would use the money, and a presumed government agenda behind the idea; (2) ‘problems requiring clear policies’, comprising of practicalities and assurance that incentives are only one part of a tool kit; (3) ‘challenges for research and experience’, including effectiveness, the possibility of perverse incentives, and impact on the therapeutic relationship; (4) ‘inherent dilemmas’ around fairness and potential coercion. CONCLUSIONS: The use of financial incentives is likely to raise similar concerns in most stakeholders, only some of which can be addressed by empirical research and clear policies

Participants' perspectives of recovery in Borderline Personality Disorder (BPD).

<p>Participants' perspectives of recovery in Borderline Personality Disorder (BPD).</p

Participants' socio-demographic and clinical characteristics.

*<p>only applicable to those receiving psychological therapy.</p