title: Mentalization-based intervention to recurrent acute presentations and self-harm in a community mental health service setting.
abstract: OBJECTIVE
  A proof-of-concept study over an 18-month period to determine whether a mentalization-based intervention (MBI) in a metropolitan community mental health service, when added to a recovery-based model of care, would be of clinical benefit to borderline personality disorder (BPD) consumers with a history of recurrent, deliberate self-harm. The feasibility of implementing the intervention, and factors that could improve its implementation, will be evaluated.
  
  
  METHODS
  Three-monthly focus groups with participating community mental health service case managers (N = 8) assessed the implementation and the impact of an MBI added to a recovery model of care and the way the clinicians worked with consumers with BPD and recurrent, deliberate self-harm in this context.
  
  
  RESULTS
  Qualitative analysis revealed compatibility of the MBI with a recovery-based case management approach for the above group of consumers, albeit with operational barriers.
  
  
  CONCLUSIONS
  MBI with consumers with BPD appears to be compatible with recovery-focused psychiatric case management and was accepted by consumers. The case managers perceived that no harm was rendered in terms of deliberate self-harm and acute service utilization. The MBI led to a sense of improved therapeutic alliance in case managers working with consumers.
authors.affiliation: Director Clinical Services, St Vincent's Mental Health, Fitzroy, VIC, and; Associate Professor, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia peter.bosanac@svhm.org.au.
authors.forename: Peter
authors.initials: P
authors.lastname: Bosanac
authors.affiliation: Clinical Nurse Consultant, St Vincent's Mental Health, Fitzroy, VIC, and; Senior Lecturer, Coordinator Research Training, Department of Nursing, School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Hamilton
authors.affiliation: St Vincent's Mental Health, Fitzroy, VIC, and; Senior Clinical Adviser, Spectrum, Melbourne, Australia.
authors.forename: Josephine
authors.initials: J
authors.lastname: Beatson
authors.affiliation: Associate Clinical Director, Spectrum, Melbourne, VIC, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Trett
authors.affiliation: Consultant Psychiatrist, Spectrum, Melbourne, VIC, Australia.
authors.forename: Sathya
authors.initials: S
authors.lastname: Rao
authors.affiliation: Research Coordinator, University of Melbourne, VIC, Australia.
authors.forename: Sam
authors.initials: S
authors.lastname: Mancuso
authors.affiliation: Chair of Psychiatry, St Vincent's Mental Health, Fitzroy, VIC, and; University of Melbourne, Melbourne, VIC, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Castle
mesh_terms: D000208:Acute Disease; D000328:Adult; D001883:Borderline Personality Disorder / Q000628:therapy*; D019090:Case Management; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003156:Community Mental Health Services; D017144:Focus Groups; D006801:Humans; D017063:Outcome Assessment, Health Care; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012008:Recurrence; D016728:Self-Injurious Behavior / Q000628:therapy*; D056345:Theory of Mind / Q000502:physiology*
keywords: borderline personality disorder; mentalization