With the advent of community mental health services now being provided by Non-Government Organisations, it is becoming evident that we are catching many people with personality disorders. I work for a PHaMS program and previously was with a HASI program in NSW, and we receive many referrals from our local Mental Health Services.

I would estimate at least a third of these have PD’s, and what generally happens when we accept these referrals is the local MHS then discharges them from their case management and we are left to try and work with them.

This concerns me on several levels:

• MHS view that PDs problems are behavioural not mental illness, therefore they do not meet the criteria for services;  
• MHS inability to deal with this diagnosis so they just refer them onto Welfare organisations; 
• Lack of support from MHS to NGOs to deal with the very difficult spectrum of PDs (ie extreme borderline personality disorders); 
• Lack of training in the NGO sector to work with people with PDs, yet we have so many on our books;
• Lack of knowledge by workers in the Welfare sector on how to identify PD traits and therefore being twisted in knots by the demands of this cohort;
• No groups to send people to; 

Welfare workers having to cope with the stress that inevitably follows the breakdown in the relationship with the person with PD when we challenge their behaviours.

This is something we do successfully with others but has disastrous outcomes with people with PDs.

CINDI REES | Community Support Worker

PHaMS Hasting/Macleay
New Horizons Enterprises Limited
PO Box 5420 Port Macquarie NSW 2444