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Referral
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Icebreak Service
The Icebreak service, part of The Zone, works with young people 16-22 years who are experiencing personality disorder related symptoms which are impacting negatively upon their daily life and mental/emotional well-being. The service offers a holistic approach to working with young people utilising a psycho-social model of care through a range of interventions.
Scope
This is a non-urgent service for those who do not require secondary care based intervention.
Core service eligibility includes: (Please see 'Referral criteria' section below for more details)
- Aged 16-22 years and eligible for a GP in Plymouth at point of referral
- Individuals who have consented to a referral
- Individuals who have been experiencing emotional distress and /or behavioural difficulties for at least a year, and/or that these difficulties have been present since early adolescence or prior
- Individuals who have not received more than 6 months sustained engagement with a care co-ordinator in the community (not including CAMHS of any length )
Out of Scope
- Individuals with problems of duration less than a year (e.g. intermittent problems or reaction to a recent crisis)
- Individuals referred to gain support for a current isolated crisis
- Individuals with urgent mental health needs
- Individuals with a substantive history of specialist mental health services input (more than 6 months in last 2 years, or more than 2 years in last 5 years. (This excludes involvement with CAMHS)
- Individuals presenting with evidence of significant current violence/aggression to others who are not willing to engage with appropriate services to manage this
- Individuals with current chaotic substance misuse (where addressing this is the primary need), and who are not willing to engage with substance misuse services
- Individuals presenting with psychosis (refer to the Insight team)
- Individuals requiring psychological intervention relating to anxiety or depression refer to IAPT
Signs and Symptoms
Presentations aligned with the development of personality disorder difficulties.
Clients commonly present with:
- Experiences of abuse (physical, sexual, emotional) and / or trauma
- Difficulties developing and maintaining relationships
- Significant ongoing levels of emotional distress
- Tendency towards suicidal thinking / self harm or other maladaptive coping strategies
- Difficulties with drug and alcohol use
History and Examination
- Individuals who have previously had 2 years intervention from the Icebreak team are no longer considered appropriate for our early intervention work
Differential Diagnoses
- Individuals do not have to have a Personality Disorder diagnosis to be eligible for a service
- Referral to Community Mental Health Teams should be made for those whose self-harming behaviours may result in serious disability or death
- We are not a crisis intervention service
Main forms of intervention include:
- One to one work with a Care Co-ordinator exploring emotional well-being and coping strategies utilising techniques from a range of modalities e.g. solution-focused therapy, DBT, CBT, family work
- Additional therapies on offer: DBT, Family Therapy, Art Therapy
- Group sessions e.g. art work, social inclusion etc.
- Support with practical issues e.g. welfare rights, housing and access to education / employment etc.
Referral Criteria
- Referrals that are accepted by the team usually contain a combination of the factors below which young people will have been experiencing for more than six months
A Minimum of one from this group required
- Severe and persistent thoughts of self hatred, hopelessness, emptiness, paranoia
- Rapid mood and temper swings
B
- Previous involvement with Police / CJS for significant and repeated violence / aggression towards others
- Poor support networks
- Housing instability
C Minimum of one from this group required
- Repeated self harm and/or suicide attempts
- Difficulties forming / maintaining relationships
- Problematic substance abuse impacting upon day to day living
- Risk taking behaviour
D Minimum of one from this group required
- Significant adverse life events
- History of abuse
- Family breakdown
- School exclusion
- Previously or currently in Local Authority care
Referral Instructions
For referral to Icebreak
- Through e-Referral service selection via DRSS
- Specialty: Mental Health
- Clinic type: Not otherwise specified
- Service: DRSS-Western-Mental Health-Adult- Devon ICB-15N
Self-referral at The Zone, Mon-Fri – 10am-4pm
- Please follow the link to the referral form download, complete and return by post to:
- The Zone
14-16 Union Street
Derry's Cross
Plymouth
PL1 2SR
- The Zone
GP Information
Guidance/Diagnosis and treatment:
NICE guidelines 78 on Personality Disorder
NICE Guidelines - Conduct disorder in Young People
Emergence self help and help for professionals/carers:
Emergence personality disorder website
Patient Information
Emergence self help and help for professionals/carers:
Emergence personality disorder website
MIND information on Personality Disorder
Long-term Condition Self-Management Programme
GPs and patients can refer to Improving Lives Plymouth for patient support with any long-term physical or low level mental health condition. The service helps people to better manage their condition and to achieve a better quality of life.
Evidence
- NICE guidelines PD, BPD, Young People emotional dysregulation
Pathway Group
This guideline has been signed off by the Western Locality Psychological Therapies Strategic & Implementation Group on behalf of NHS Devon.
Publication date: December 2015
Updated: October 2018
