The impact of austerity on the delivery of an NHS mentalisation-based therapy service.

Historically, a group of people experiencing distress were largely viewed by health services as untreatable, because of a chronic sense of mistrust and difficulties in being cared for. This group of people have attracted labels such as ‘Emotionally Unstable Personality Disorder’ and ‘Complex Emotional Needs’. However, the recent developments in so-called evidenced-based psychological treatments offer hope that these patients can ‘<italic>recover</italic>’, or what one therapy has called ‘<italic>a life worth living</italic>’. It follows that these newer psychological treatments hold the promise of keeping hope alive, that even the most traumatised and disturbed people may be coached into functioning, and, perhaps more cynically, to reduce their burden on already-stretched health services. This cultural shift towards optimism is not the target of the paper. Instead, this paper offers an insider clinician’s perspective to outline how austerity has negatively affected the capacity to offer care and containment to patients presenting with life-threatening behaviours. [ABSTRACT FROM AUTHOR]