Organisational effectiveness and personality disorder

Abstract

Purpose – National treatment guidelines regarding Borderline Personality Disorder (BPD) (National Institute for Health and Clinical Excellence, 2009) make a number of recommendations relating to system and cultural treatment variables including: access to services, autonomy and choice, developing an optimistic and trusting relationship and managing endings and transitions. The purpose of this paper is to look at a model which could help organisational effectiveness across a range of service settings in relation to personality disorder. Design/methodology/approach – Explanation of why the McKinsey 7S organisational model (Waterman et al., 1980) may be useful in assessing organisational effectiveness in relation to personality disorder. Findings – Cultural and organisational factors across a range of levels need to be aligned to allow for effective service delivery. This is particularly important in working with this client group where strong emotional reactions and subsequent organisational splits are common. Practical implications – The application of this tool within clinical leadership and service development would be particularly important for coherence within generalist (as opposed to specialist) settings. Originality/value – To the authors’ knowledge this analysis is unique as a review of NHS culture across a range of settings and discussion of the implications for service delivery for patients with BPD.