Carers provide unpaid support to family or friends with physical or mental health problems. This support may be within the domain of activities of daily living, such as personal care, or providing additional emotional support. While research has explored the carer experience within the National Health Service in the United Kingdom, it has not focused specifically on carers of individuals with a diagnosis of borderline personality disorder (BPD). Eight carers for those with a diagnosis of BPD were invited to take part in two focus groups. The first carers' focus group, entitled 'The role of Mental Health services,' produced four super-ordinate themes. The second carers' focus, entitled 'Experiences in the Community,' produced six super-ordinate themes. It seems carers of those with a diagnosis of BPD are continuing to be overlooked by mental health services, and subsequently require more support to ensure their own well-being.

The focus group led to a range of issues, including concerns over staff attitudes and inpatient safety, which need to be addressed in the NHS to improve the inpatient experience for those with a personality disorder. Equally important, positive developments were recognised; including listening to inpatient feedback and joint decision making.

National Institute for Clinical Excellence recommended the use of medication only in times of crisis for individuals with borderline personality disorder (BPD). Despite this recommendation most service users referred to a specialist personality disorder service were found to be on numerous medications. Although a number of qualitative studies have explored the experience of individuals with a diagnosis of BPD they have failed to discuss their experience of being treated with medication, despite its high prescription with this group (e.g. Sansone et al.). The aim of this study was to explore the experience of service users being treated with medication for the BPD diagnosis. Semi-structured interviews were carried out with seven service users under a specialist service for personality disorder. Interviews were transcribed and analysed using thematic analysis. The main themes to emerge were: staff knowledge and attitudes, lack of resources for BPD and the recovery pathway for BPD. Overall, service users felt that receiving the BPD diagnosis had had a negative impact on the care they received, with staff either refusing treatment or focusing on medication as a treatment option. The introduction of specialist services for this group appears to improve service user satisfaction with their treatment and adherence to the National Institute for Clinical Excellence guidelines.

A newly developed specialist personality disorder service in the United Kingdom arranged a focus group with seven service users with a diagnosis of borderline personality disorder (BPD) to explore their experiences of the Care Programme Approach (CPA) while under the care of a community mental health team. A thematic analysis generated seven themes. Understanding Borderline Personality Disorder and Understanding Recovery were highlighted as difficulties service users face, with a lack of staff understanding. They also spoke about the struggle of having a voice in their CPA meetings and the lack of information they received in the CPA process. They discussed the deliberation between progression versus consistency and moving on from services. Service users discussed the challenges of accessing treatment and lack of follow up in the CPA process. Greater service user involvement in the process would help address the dissatisfaction and disempowerment in care planning experienced by individuals diagnosed with BPD. [Journal of Psychosocial Nursing and Mental Health Services, 51(10), 38-45.].

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