StopSAPAS @StopSAPAS

🧵 Hi, as people might be aware, the 5th anniversary of the death of our friend, Zoe Zaremba @AutismMH, is coming up next week. After Zoe died, her friends & family donated to buy a bench in memory of Zoe, placed in a park near her home. Every year we mark her anniversary by 1/

We know not only are there other, better, more affirmative and hopeful diagnoses available for those who want them, but that no treatment approach NECESSARILY requires a PD label for access. The core of good treatment is hope: the storylines we provide MUST foster it #HopeNotPD

I’d ask you this: if you had a daughter, a niece, or a young woman you knew who was trying to stay afloat in the world, dealing with some real disadvantage or difference, would you truly want her to be labeled with a personality disorder?

Imagine walking into any classroom or lecture hall—not a psychiatric setting—and suggesting that over 1 in 4 of the women has a personality disorder, likely those who are the poorest, most traumatised, or neurodivergent. And tell me that isn’t political and patriarchal.

I find it 'interesting' that, at this moment in history, we have predominantly white male professors insisting that telling young people (or anyone) they have a 'personality disorder' is beneficial—despite countless generations of female and queer survivors saying otherwise.

Note the sex difference entirely levels out when periods finish. It is very clear that PD = trauma/neurodivergence x hormonal cyclicity intepreted through a deply misogynistic framework to character assassinate women and queer folk.

1 in 4 women screens positive for a 'personality disorder' in young adulthood, yet this rate halves in later years. Attributing these profound difficulties to 'personality'—a supposedly lifelong trait—not only contradicts the data but reflects a misogynistic framing. #TraumaNotPD

@Shrink_at_Large This will be a big big problem with ICD-11 as it gets rolled out & every clinician is encouraged to apply 'personality difficulty' labels based on generally uninformed and brief impressions. These will go on to cause a lot of harm. We already know this & yet it seems inevitable.

It's a mere hop, skip & a jump to whittle down this "diagnosis by impression" (sniff test) to a set of 8 questions GPs can administer in a 10 minute appointment x.com/Shrink_at_Larg…

Dr Jay Watts @Shrink_at_Large

3 years ago

Introducing the SAPAS, an 8-question screening for personality disorders, in primary care is a recipe for disaster. It's a perfect excuse to offroll, exclude and delegitimise patients in an already overwhelmed system with 1.6 million waiting for mental health services.

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"Your GP cannot diagnose personality disorder. But you can speak to them about your mental health". Can someone tell the SAPAS lot?

@NellAitch @Shrink_at_Large @ritb These euphemisms for ‘PD’ such as “Complex Emotional Needs” and “probable PD” are undefined and therefore more difficult to challenge and scrutinise!

@NellAitch @Shrink_at_Large @ritb It’s another “complex emotional needs” euphemism and a way to push literally anyone down PD pathways and so called evidence based treatment whilst widening the prejudice, discrimination and neglect of the bullshit construct!

SAPAS UPDATE: I am hoping that this is rare VERY GOOD NEWS. I have never in my entire three decades in mental health come across something so utterly, universally condemned as a disastrous idea. Amazing activism esp from @RITB, Jee and @NellAitch xx

StopSAPAS @StopSAPAS

2 years ago

It seems that the SAPAS resource has been quietly deleted from the NHS e-learning Hub - Working Together: Personality Disorder in Primary Care. All other resources are still available Does anyone know why? #StopSAPAS

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It seems that the SAPAS resource has been quietly deleted from the NHS e-learning Hub - Working Together: Personality Disorder in Primary Care. All other resources are still available Does anyone know why? #StopSAPAS

Dr Jay Watts @Shrink_at_Large

3 years ago

Introducing the SAPAS, an 8-question screening for personality disorders, in primary care is a recipe for disaster. It's a perfect excuse to offroll, exclude and delegitimise patients in an already overwhelmed system with 1.6 million waiting for mental health services.

151 119 459 255K 89

This questionnaire is laughable. And it gives therapists license to dismissively label clients with an effectively dehumanizing, lazy, disrespectful (to their stories and individuality) diagnosis that is “highly resistant to treatment.” Just a copout.

Dr Jay Watts @Shrink_at_Large

3 years ago

Introducing the SAPAS, an 8-question screening for personality disorders, in primary care is a recipe for disaster. It's a perfect excuse to offroll, exclude and delegitimise patients in an already overwhelmed system with 1.6 million waiting for mental health services.

151 119 459 255K 89

Introducing the SAPAS, an 8-question screening for personality disorders, in primary care is a recipe for disaster. It's a perfect excuse to offroll, exclude and delegitimise patients in an already overwhelmed system with 1.6 million waiting for mental health services.