The process of deinstitutionalisation from within an institution: evaluating innovations in a closed ward for women with (borderline) personality disorder

<p dir="ltr">Although UK Mental Health services have been de-institutionalised since the end of the 20th century, women with (borderline) personality disorder are often admitted compulsorily to closed psychiatric wards due to high level of self-harm. The paper focuses on the evaluation of introducing innovative intervention methods, along side dialectical behaviour therapy, in the Daffodil ward which promoted the agency and self-responsibility of service users in managing their mental health. The evaluation reported in the article includes individualised photovoice followed by interviews of the inpatients, and in parallel receiving providers’ reports about every three months. The photovoice method enabled service users to take photos representing their experiences on the ward; this provided a basis for interview content. The new interventions promoted the recovery and empowerment of service users and utilised the transformative role of peer support and experts by experience in improving ward culture. The interim findings highlight how the impact of an effective culture of experts by experience involvement and the introduction of a new service model can provide a context for deinstitutionalisation from within an institution, providing a template for future hospital service delivery.</p>