The Sequoia service is part of a wider transformation under the Community Mental Health Framework (CMHF) aiming to close the gap between primary and secondary mental health services. CMHF outlines the need for a specialist provision for those with Complex Emotional Needs and who have difficulties associated with a Personality Disorder (CEN/PD). Many of the individuals who have accessed the Sequoia service report being passed from service to service- too unwell for some and not unwell enough for others. The Sequoia service exists to fill that gap.
It was recommended that the service be commissioned across public and VCSE sectors, with people with lived experience at the heart of planning and delivery. The service contract is held by AWP and part of the service is subcontracted to Rethink Mental Illness. The Sequoia service also works alongside other organisations and teams to provide a community of services for people with CEN/PD.
The latest psychiatric morbidity survey has shown that around 13.7% of the population would screen as being “likely to have a personality disorder/ difficulties” and around 4.4% would fulfil a diagnosis of either borderline or antisocial personality disorder. In the local research we have undertaken, around 1% of the population of BNSSG have been identified via their GP records as having a diagnosis of personality disorder (all 10 types), demonstrating that many service users are likely to have a personality disorder or “personality disorder difficulties” which are unrecognised and untreated. This may well be in conjunction with other mental health difficulties. (Research from P. Moran et al found that 95% of people with personality disorders also have a co-morbidity).
It is predicted there are around 12,000 adults living with CEN/PD in BNSSG. Secondary mental health services in AWP are the only organisation offering specialist support for people with a diagnosis of personality disorder in BNSSG therefore it is likely that there are many people with unmet needs who do not receive any specialist services.
The name Sequoia was chosen by a person with lived experience who had input into shaping the service from its inception. The name Sequoia comes from the Sequoia tree, a redwood tree that is one of the largest in the world. The name was chosen as these trees represent strength, the ability to cope with adversity, and a life lived best in communities – these are the values we associate with how people with CEN/PD survive and thrive.
- Ensure that people have the right information and support, at the right time, in the right place. This includes challenging stigma and embedding cultural sensitivity throughout the service.
- Deliver high-quality, evidence-based and safe support for those who need it.
- Promote improved wellness and resilience throughout the service.
- Work in partnership to give person-centred and holistic care; working 'for and with' people rather than doing 'to' people.
- Be accessible and equitable to people who need support, whether diagnosed or not.