Personality disorders service for patient with ASD

[Joanie78]

Reposting from SEN boards to get more traffic.

TLDR: Is it worth getting help from personality disorders service if you haven't got a PD but you do have ASD and a history of depression and self-harming?

18yo DD who has ASD has been badly let down by MH services in the past, now she is seeking help as an adult and she's been told to self-refer to a service for patients with personality disorders.

She endured 7 years of absolute hell at school, really severe bullying and had terrible anxiety and depression. She has unfortunately suffered a bereavement recently and her MH has got worse and she has started self-harming; her poor arms are covered in cuts made with razor blade. GP has told her to self-refer to the "complex needs service". We looked this up and it is the psychiatric service for people who have personality disorders. They have group therapy and a therapeutic community. All very specialised towards people with PD. I don't see how this can help DD who doesn't have a PD but is autistic . I am worried that not only will she not be getting tailored support for patients with ASD, it will in fact be tailored specifically for a condition/s which she doesn't have. I suppose I am particularly worried that she will mimic behaviours of patients who do have PD and / or be manipulated by them. (Obviously it is her decision as she is 18 but at this moment we are both a bit confused and unsure at the moment.)

So I suppose the AIBU is
YABU - she should get help from this team
YANBU - she shouldn't get help from them

I will be honest I have met too many women with the diagnosis of PD who I have thought have Autism. I think it is massively over diagnosis and frankly it is insulting the mental health services think that it is appropriate for her or for the women who do have PD who attend.
I would complain frankly.

There are no services for adults with autism apart from accompanied by severe LD

There is unlikely to be a better for service nearly available.

Maybe their approaches can help her even if the diagnosis doesn't fit. They will be good at helping people who self harm. Presumably if they don't feel they can help her they won't take her on and maybe they can signpost to a more appropriate service.

Not sure what there is to lose by self referral if the alternative is nothing at all.

I mean you can try and find a better fit service (look up on MH Trust website) but this is a notorious service gap. Such services are not commissioned and do not exist.
You could see if learning disability services can help but it's likely they are geared to people with lower IQ.

Can’t she self refer to the adult aspergers team?

That would be if there was such a team. There's only a diagnostic clinic service in our area with no follow up or therapy. That's the same in most parts of the U.K. as I understand it. Most CCGs don't commission a specific team and consider their needs can be met by general adult mental health services or LD services.

There is such a team where I live, my 21 year old daughter is supported by them. I am in England are you in another part of the UK?

The X Asperger Team is an NHS service which offers an Asperger Syndrome (Autism Spectrum Disorder ASD) assessment, diagnostic and intervention service for people in the X area.

Aims of the service
 To provide assessment and diagnosis for Asperger Syndrome.
October 2017

 To support our service users by using creative interventions which help with the social and communication difficulties that they may face.
 To support service users with social relationships, work, recreation and activities.
 To provide advice, support and education to partners, families and care teams of people with Asperger Syndrome.
 To work with other services (for example, social services, local colleges etc.) to help support service users.
What does the X Asperger Team do?
The X Asperger Team is open to adults 18 years old and over. You may self-refer to the service or be referred by another person, for example, a family member, GP, mental health professional. We will always ask if you agree to the referral. The X Asperger Team offers diagnostic assessments and support following diagnosis if this is needed.
Diagnostic assessment
 When we receive your referral we will arrange to contact you by phone or meet with you to talk ...

@DougRossIsTheBoss above post.

Also in England but our local service for Aspergers/ adult autism is diagnosis and signposting only. It is very minimal and has very long waits. I thought it was still unusual to have comprehensive adult Asperger services but happy to be proved wrong. I guess it all depends what your CCG commissions
Certainly do try to look for such a service locally OP. I assumed the GP probably didn't refer to it because it didn't exist but maybe they are just ignorant of better options.

Just checking our local service and it currently says they have been redeployed for Covid and aren't doing any new assessments even!

If the PD service offers group DBT(Dialectical Behavior Training)skills training, it will help your daughter. I have Asperger’s, and have found DBT very helpful for anxiety and over thinking.

My partner trained with Marsha Lineham, who created DBT. She taught this to many clients with autism.
If you can’t find a DBT course, buy the skills workbook and main book to use at home.

Radically Open DBT is a therapy tha ca be helpful for people with ASD. It is fairly new so you are unlikely to find somewhere offering. I'm just mentioning because the pp recommended buying standard DBT materials and RO DBT is better suited for ASD. I can't claim to have trained with Marsha but did do my training (both standard DBT and RO DBT) with Tom Lynch

The service you mention whilst not specifically for people with ASD might be able to offer your DD something use3so it might be at least worth a trial. It's hard to say. As pp have said, post diagnostic services are few and far between.

Thank you all very much for the replies, I really appreciate it ♥️

Think DD had DBT when she was in CAMHS but it was before her diagnosis and was geared towards neurotypicals. She does not have a learning disability so couldn't get support from this team.

It sounds awful but I am worried about her getting manipulated by other patients who have PD. One of her closest "friends" has BPD and has caused her a lot of upset because she guilt-trips DD into "being there for her" with threats of suicide and self-harm I feel really sorry as this girl has been through hell and back and her manipulative behaviour is a defence mechanism and a survival skill, but at the same time DD has to be my priority.

Aldi yes we are in England (Thames Valley) but I have searched and there is nothing at all for Aspergers support like you describe - that looks amazing! But I guess as PPs have said it depends on the CCG and it must be one of those "postcode lotteries".

@10pennychews - being misdiagnosed with BPD is really common for girls with Aspergers because meltdowns can look like severe mood swings, and other behaviours are similar but they stem from completely different places. It is completely scandalous!

Joanie Reading is Thames Valley I think? Have you heard of the organisation Autangel? Might be worth contacting.

www.autangel.org.uk/

Never heard of them! Thanks so much for this. DD was diagnosed just before turning 18 so after the assessment CAMHS just washed their hands of her and sent her on her way wish we had been given information about support groups.

Just to agree that commissioning is week in this area.
I know my area is the south only has either the learning disablity team (which is for profund ld) or a neuro behavioral team which only offers diagnostic and no follow up support