Changing attitudes and enhancing competency: personality disorder initiative

Abstract

Background

Mental health clinicians often hold negative perceptions of people living with personality disorder, particularly borderline personality disorder (BPD), contributing to stigma and reduced access to effective care. The Personality Disorder Initiative (PDI) was a Victorian government-funded program to improve workforce capacity through sustained training and clinical supervision.

Aims

To evaluate the impact of the PDI on clinician attitudes and self-perceived competence when working with people diagnosed with personality disorders, particularly BPD.

Methods

A statewide pre-post survey was conducted in July 2020 (pre-implementation) and March 2023 (post-implementation). Public mental health clinicians across Victoria were invited to report their attitudes (optimism, enthusiasm, confidence, willingness) and competence (knowledge, skills, experience) using a five-point Likert scale. Independent samples t-tests were used to assess change pre- and post-implementation.

Results

Clinicians estimated that, on average, 41% of their caseload comprised individuals with a confirmed personality disorder diagnosis. Attitudes and competence scores improved; statistically significant improvements were observed in all domains (p < .01) apart from experience.

Conclusions

Sustained, embedded training delivered through the PDI significantly improved clinician-reported attitudes and competencies when working with people with personality disorders. This model demonstrates a scalable approach to enhancing the mental health workforce’s capacity in complex care settings.