People in crisis services

Abstract

Objectives
The study aimed to explore which discourses staff in crisis services draw on when discussing people in crisis. Further questions were; how those with borderline personality disorder diagnosis are positioned by these discourses and what the subsequent consequences are for people in crisis.

Design
This study utilised a qualitative design. Individual interviews were conducted with participants to generate personal and reflective accounts.

Method
Twelve staff members from home treatment, day treatment or acute ward teams were interviewed. Questions related to their experiences of people in crisis. Foucauldian Discourse Analysis was used to highlight the discourses used when talking about those in crisis.

Results
Four main discourses were present in language used; ‘medical legal’, ‘personal responsibility’, ‘limited resources for the problem’, and ‘human experience and emotions’. People with a diagnosis of borderline personality disorder (BPD) were positioned differently to those with other diagnosis. Staff are positioned as experts needing to diagnose and cure distress. The discourse of human experience and emotions highlighted the emotional aspect of working with people in crisis, especially those with a BPD diagnosis.

Conclusion
The prevailing discourses within NHS crisis services remain those of the medical model, legitimising ideas of classic mental illness and practices of medication and control. This impacts the position of people with a BPD diagnosis. Further reflective spaces are required to highlight the flexibility of these discourses, practice, and the importance of emotions raised by those in distress.

Date of Award	2017
Original language	English