Personality disorder services
People with a primary diagnosis of personality disorder are frequently unable to access the care they need from secondary mental health services and sometimes specialist services are designed to better meet their needs.
The Waterview Centre aims to help people who have long-standing emotional and interpersonal problems resulting from personality disorder. People may have been given a formal diagnosis of personality disorder or have no clear diagnosis but significant problems related to their personality.
The centre provides a service specifically designed for people with self-harming behaviour and chaotic or unstable relationships, especially those who have a history of using A&E or inpatient mental health services at times of crisis.
It works with people with anxiety and depression and other non-psychotic mental illnesses, but not those with a primary diagnosis of schizophrenia or bipolar I. It also works with people who have harmful use of alcohol and drugs but not drug or alcohol dependency.
The Waterview Centre offers an 18-month group-based treatment programme which includes individual sessions and group-based therapy. Our group programme includes mentalisation-based treatment and skills-based groups.
Mentalisation-based treatment aims to help people develop a better understanding of their thoughts and feelings and the actions of others. Treatment focuses on the 'here and now' of difficulties in relationships and the powerful and sometimes confusing feelings that interaction with others can evoke. Awareness of attachment patterns of service users also guides our work, with thoughtful and active efforts made to engage and maintain contact with the service users. We aim to help people identify and verbalise their feelings and feeling states, to work towards secure relationships, to develop a stable identity and to develop constructive coping mechanisms. We aim to help each person achieve their own stated goals which may include a reduction in self-harming behaviours, admissions to hospital, and use of emergency services.
Service users may be offered one or two groups a week depending on their needs. Group work aims to give service users the opportunity to consider relationships with others, explore perceptions and misunderstandings and transfer these skills into their daily life.
The assessment process
Group-based treatment can be challenging but can also help people realise that they are not alone and that other people with long-term problems can and do recover. There is also good evidence that group-based treatment combined with individual support is an effective approach to helping people who have personality disorder.
Nonetheless, many people still find the idea of group-based treatment difficult. To address this, we have set up a 10-week series of introductory groups called the Group Awareness Programme (GAP). This enables us to further assess service users who have never engaged in a group, or who have expressed ambivalence around group work. It also gives people a chance to find out what it is like to be in a group without having to make a commitment to longer term treatment.
Not all service users will need to access the GAP, and some of those that do may decide not to engage in the Waterview treatment programme and to access other appropriate services instead.
Because we ask most people to try attending the GAP, the assessment process includes one-to-one meetings and an assessment group.
How to access these services
Registered mental health professionals/teams can refer service users registered with a GP in Kensington & Chelsea and Westminster for treatment at the Waterview Centre. It does not accept referrals from primary care.