Borderline personality disorder in Irish Travellers: a cross-sectional study of an ultra-high-risk group
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ORIGINAL ARTICLE
Borderline personality disorder in Irish Travellers: a cross-sectional study of an ultra-high-risk group Kezanne Tong 1 & Sinead Costello 1,2 & Evelyn McCabe 1 & Anne Marie Doherty 3,4 Received: 28 August 2020 / Accepted: 9 September 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background Irish Travellers are a marginalised ethnic minority with poor health outcomes, especially in mental health: the suicide rate in this population is 6–7 times that in the general population. There is a paucity of research into associated clinical risk factors including self-harm and mental illnesses. Aims To examine the prevalence and treatments of mental disorders among Travellers attending a community mental health team (CMHT) in Galway. Methods This is a cross-sectional study of the CMHT database, and included all Travellers who were active cases on the study day were included in this study. Results Travellers formed 12.4% (51 out of 410) of the active caseload of the mental health service. The mean age was 35.7 years (SD 13.1). The most common mental disorder was depressive disorder (16/51, 31.4%). Of 51 patients, 25.5% (13/51) were diagnosed with BPD: 7 had other comorbid mental disorders. Patients diagnosed with BPD are significantly more likely to be prescribed psychopharmacotherapy (t = 2.834, p = 0.007). A diagnosis of BPD was significantly associated with history of selfharm after controlling for age and gender (OR 2.3, p = 0.005). Conclusion This study shows that there is a significant overrepresentation of Travellers in mental health services, suggesting significant need for accessible and acceptable interventions. Those with a BPD diagnosis have a significantly higher risk of selfharm, representing an ultra-high-risk population. These findings can be used to plan future service development projects to better meet the needs of this population: they may require specially adapted version of the mentalisation-based treatment programme. Keywords Borderline personality disorder . community psychiatry . Irish Travellers . mental disorders . psychotherapy . Self-harm . Suicidal behaviours
Introduction On 1 March 2017, the Irish government officially recognised Irish Travellers (hereafter ‘Travellers’) as a distinct ethnic group in Ireland [1]. Travellers have established shared
* Anne Marie Doherty [email protected] 1
Department of Psychiatry, University Hospital Galway, Newcastle Road, Galway, Ireland
2
Department of Psychiatry, School of Medicine, NUI Galway, Newcastle, Galway, Ireland
3
Department of Psychiatry, University College Dublin, 63 Eccles Street, Dublin 7, Ireland
4
Department of Psychiatry, Mater Misericordiae University Hospital, 63 Eccles Street, Dublin 7, Ireland
history, cultural values, language, customs and traditions distinct from the general population, making them a unique minority ethnic group. Health inequalities have been widely reported within the Traveller community [2–6], with shorter life expectancy and higher mortality rates recorded in Travellers
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