With estimated prevalence rates of 6% in the Australian general population, borderline personality disorder (BPD) is the most diagnosed personality disorder in both inpatient and outpatient settings. Over 20% of consumers presenting to the emergency department (ED) and 25% of mental health inpatients in an Australian study had a diagnosis of personality disorder (PD). To date there has been very little research on delivering virtual care to consumers with BPD.
In 2021, West Moreton Health Services (WMHS) introduced a pilot project through the Living Well Team (LWT). The initiative combined (DBT) with the Project Air Strategy (Gold Card Clinic) for Personality Disorders developed by the University of Wollongong. The suite of interventions was delivered by a multidisciplinary team of clinical and lived experienced staff through a virtual care platform (Engage and GoShare). Engage is a platform from Philips Healthcare ANZ and GoShare is a content distribution platform from Healthily. Interventions offered included Gold Card Clinics (brief intervention) DBT Case Management, comprehensive DBT and Acceptance and Commitment Therapy (Wise Choices).
Qualitative (focus groups) and quantitative analysis were completed as part of the evaluation of the LWT. Quantitative was analysed using descriptive statistics and chi-sq and t-tests for group differences. 49 consumers under the care of the LWT between mid-Aug 2021 and end of Jan 2022, were included.
Inpatient days decreased from a total of 166 prior to the LWT to 61 days following the entry into the LWT (p=0.006). Emergency Department visits decreased from 92 in the 3 months prior to enrolment in the LWT to 59 in the 3 months following enrolment. The ‘Engage’ platform was valued by consumers, enabling them to stay connected to LWT staff despite disruptions caused by COVID-19. There was a positive response from the focus groups, thus addressing an identified gap in service provision for a subgroup of consumers with high levels of service use.