Emotionally Unstable Personality Disorder (EUPD) and Eating Disorder (ED) – Inpatient Care and Rehabilitation

Upper Harlestone is an inpatient care and rehabilitation service providing highly specialist care for women with emotionally unstable personality disorders (EUPD) and associated complex eating disorder needs.

The service offers a solution for women who may frequently be admitted to mainstream personality disorder and eating disorder services which are unable to support their complex co-morbidities.

The rehabilitation-focussed service allows women to learn and develop skills (psychological and occupational) that will enable them to discharge to community services at the earliest stage.

Admissions criteria

The service aims to help adult women, including transgender, who are 18 years+ old who:

  • present with a primary diagnosis of EUPD and an associated eating disorder as defined in DSM-V / ICD-10. This will include anorexia nervosa and its atypical variants, bulimia nervosa and its atypical variants, and Eating Disorders Not Otherwise Specified (EDNOS)
  • have significant eating issues as part of their principle diagnosis of EUPD
  • may have a forensic history
  • have complex needs and who pose a significant risk to themselves or others requiring hospitalisation for treatment.

 

Our NEW specialist DBT hub

Located in Northampton, Upper Harlestone forms part of our new relocated specialist DBT hub, which has been developed with the aim of bringing all our DBT services for women under one roof, consolidating our wards and expert clinical teams 'under one roof'. It is perfectly located to meet the needs of women with a comorbid diagnosis of EUPD and ED in the West Midlands and East Midlands.  In areas where there is a lack of inpatient beds Northampton is centrally placed within England.

The national service is a Clinical Commissioning Group (CCG) and Healthcare Foundation Trust funded service and is able to accept referrals from these boards. Referrals from health boards outside of England will also be accepted when required.

On Upper Harlestone we are unable to admit women who;

  1. - are unwilling or unable to engage in comprehensive Dialectical Behavioural Therapy (DBT) adapted for eating disorders
  2. - have a significant Learning Disability (not ASD)
  3. - who have dissocial Personality Disorder, anti-social Personality Disorder, or a primary diagnosis of eating disorder. Those with a diagnosis of PD may be supported in more appropriate services within the charity.

Service aims and objectives

The service aims to provide:

  • A specialist solution for women with a dual-diagnosis of EUPD and ED, simultaneously treating both conditions
  • Provide a recovery and rehabilitation clinical experience, with skill learning (psychological and occupational) at its core
  • Reduce hospital length of stay and readmission for this patient cohort, addressing co-morbidities and supporting community discharge.

Patients who are admitted are unable to engage in an outpatient DBT programme due to their ongoing risk and need for hospitalisation, so the MDT on Upper Harlestone aims to teach skills and coping mechanisms (from the psychological and occupational programme) that enables patients to return to community settings within the shortest time possible. 

The St Andrew’s site provides an unrivalled range of facilities and leading therapeutic care. Delivered by an extensive in-house clinical team (comprising  or Psychiatry, Psychology, Dietitians, Speech and Language, Physios and physical healthcare clinicians) patients are able to access a multitude of vocational, educational, creative and therapeutic interventions tailored to their specific mental and physical health needs. These include sport, exercise, horticulture, art and crafts and animal care.

Vocational opportunities offer patients the chance to develop work and life skills, in a fully supportive environment.  Those women with community leave are able to attend Workbridge (our on-site vocational centre which includes a garden centre, coffee shop, IT and design suite, woodwork and ceramics workshops) or community vocational placements.

Well-established teams

The Clinical Lead, Operational Lead and Responsible Clinician have extensive experience working with women diagnosed with EUPD and eating disorders.  Alongside them is an established multi-disciplinary team with specialist EUPD knowledge and expertise.   Staff regularly work across all 3 units ensuring that specialist skills and knowledge are shared across the IPU.  Staffing levels remain stable and turnover low with staff reporting high engagement scores. 

Family inclusion

Carer involvement is key to patients in our care.  Ensuring that they have as much information as they require (including a Carer’s Pack sent to them when their loved one is admitted) and regular contact from the Social Work team to ensure their views are heard in CPA meetings.   Overnight accommodation, an onsite Carer’s Centre, as well as Family Visiting rooms are available to ensure that visits are facilitated in comfortable environments. Family members are invited to our Carer’s events with their loved ones to ensure they are part of the patient’s care.

For referrals please contact 0800 434 6690 or email admissions@standrew.co.uk

For further information about our clinical model, please contact Dr Emily Fox, Clinical Lead and Consultant Clinical Psychologist EFox@standrew.co.uk or Dr Jonathan Baggott, Consultant Psychiatrist JNBaggott@standrew.co.uk

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