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Personality disorders differ from psychiatric illness in that they are enduring, stable, pervasive and inflexible traits established in adolescence or early adulthood and generally not amenable to formal psychiatric treatment. Without listing all the varieties of personality disorder, it can be said that one cluster includes the odd and eccentric, another the dramatic, emotional or erratic, and another the anxious or fearful. Such people often have many personal and marital problems, including suicidal ideas or a history of suicide attempts, and alcohol and substance abuse. Their history often shows a high use of psychiatric and social services.
Many of these people, particularly those who are difficult to manage or who are seen as a 'nuisance' to services, may in the past have unfortunately been labelled as manipulative, attention seeking or personality disordered. This labelling often inhibits a full assessment of their physical, social and psychological needs, and so reduces their access to needed services. It may be better to describe to the health service the difficult behaviours presented by a person and what you perceive their needs to be. In this way some agreement may be negotiated with the service to elicit from your client the necessary acceptable behaviour, in exchange for required support and regular review. This protects these individuals as well as those services meeting their complex needs.