OBJECTIVE: Restrictions on social interaction during the COVID-19 pandemic necessitated a rapid transition to telehealth to continue providing psychotherapy to people diagnosed with personality disorder. This naturalistic cross-sectional study evaluated the experiences of clinicians using telehealth for the first time to treat clients diagnosed with a severe personality disorder (complex and/or high risk presentation). METHODS: Thirty clinicians working at a specialist clinic for personality disorders completed an online survey during May-June 2020 in Melbourne, Australia. RESULTS: Despite having some initial technical issues, most participants rapidly and successfully connected with clients via phone and/or video-conference, recommencing individual and group evidence-based psychotherapies. Appointments were kept more reliably than when in-person treatment was offered. Issues around privacy, confidentiality, risk, quality of interaction, and treatment boundaries were raised, highlighting the need for specific guidelines and formal processes. However, clinicians’ awareness of some of the benefits of telehealth was evident, with most looking forward to using telehealth for some aspects of their work with clients and more generally into the future. CONCLUSIONS: This experience with delivering psychotherapy using telehealth during COVID restrictions suggests that it is an acceptable platform that can be managed safely for treating patients with severe mental illness in the short term at least. This outcome encourages the pursuit of efficacy studies to evaluate telehealth as a more equitable and accessible treatment modality.

OBJECTIVE: To investigate the transition to, and experience of, telehealth in people with a diagnosis of borderline personality disorder (BPD). METHOD: A cross-sectional study using an online survey was conducted in a specialist clinic for personality disorders in March-May 2020. RESULTS: Thirty-seven clients (48% response rate) completed the survey. Two participants (5.4%) were decided not to receive treatment via telehealth. Transitioning from in-person to telehealth, the majority of participants had few or no technical issues (51.4%). Telephone, video-conferencing and a mix of telephone and video-conferencing were used. Positive and negative experiences were endorsed asking about the effectiveness of telehealth. While some participants were whether unsure (32%) or not (19%) interested in telehealth following pandemic, half acknowledged the presence of telehealth (54.8%) and wanted to have the option of telehealth following pandemic (48.6%). CONCLUSIONS: Despite some shortcomings associated with telehealth, almost every client continued to attend appointments and half of the study participants wanted to have the option of telehealth in the future. Healthcare policymakers and mental health managers should consider the challenges described in this study while developing telehealth guidelines to best support people experiencing problems living with the psychiatric diagnoses of BPD.

The purpose of this paper is to describe an Adult Community Treatment (ACT) program in Dandenong, Victoria, and its effect upon admission rates and time in hospital for 50 of the service's most disturbed patients. The implementation of the program was associated with a reduction in the annual re-admission rate from 38% (1989-90) to 21% (1990-91); the total length of hospital stay was also significantly reduced. The results support the value of community support programs in the management of the seriously mentally ill.

The purpose of this paper is to describe an Adult Community Treatment (ACT) program in Dandenong, Victoria, and its effect upon admission rates and time in hospital for 50 of the service's most disturbed patients. The implementation of the program was associated with a reduction in the annual re-admission rate from 38% (1989-90) to 21% (1990-91); the total length of hospital stay was also significantly reduced. The results support the value of community support programs in the management of the seriously mentally ill.

No abstract