Mental health charity says ‘personality disorder’ diagnosis causes harm and injustice

Adam Johannes

A new report from the mental health and social change charity Platfform argues that the diagnosis of ‘personality disorder’ is causing “major harm and injustice”, warning it can act as a barrier to compassion and prevent people from receiving the help they need

According to the charity, when people suffer deeply, the first question should not be “What is wrong with you?” but “What has happened to you?” This simple question is too often missing from mental health care.

They say that it is a grim irony that people should have to flee the very systems that are supposedly designed to care for them in order to find safety.

The organisation argues that the way personality disorder is currently diagnosed and treated is “scientifically shaky and socially damaging”, and can hide the real origins of distress.

Many of those who receive this label have experienced trauma, neglect, or abuse, especially in childhood. Instead of recognising these experiences and their lasting effects, the system may treat the person’s pain as a personal flaw. In this way, suffering is misunderstood and the person becomes isolated.

Around three quarters of people diagnosed with personality disorders are women, while 82% are reported to have experienced significant childhood trauma.

The report says this raises important questions about how systems respond to trauma, and whether diagnostic labels may unintentionally reinforce inequalities in power between professionals and clients, leaving people feeling stripped of credibility and autonomy.

The stories shared in the report show how powerful labels can be. Once a person is described in a certain way, their words may no longer be trusted, and requests for help can be interpreted as manipulation or attention-seeking.

The individual learns that their own feelings and perceptions are doubted, repeating earlier experiences in which their reality was not seen or believed.

Drawing on the experiences of 30 people who have received the diagnosis, the report found many felt the label negatively affected how professionals treated them.

Disbelieved

Some described feeling disbelieved, judged, or dismissed, while others said it affected the quality of care they received and made it harder to access support at times of crisis.

Participants said they were sometimes dismissed as “difficult”, “dramatic”, lying or accused of wasting professionals time, concerns that echo a 1988 British Journal of Psychiatry article which found psychiatrists viewed patients with personality disorder as “more difficult and less deserving of care compared to other patients”.

Platfform says similar attitudes persist today. The charity claims the diagnosis can increase the risk of exclusion from vital services and lead to restrictive interventions such as restraint, seclusion, and forced medication, which it says can further traumatise individuals and “pathologise distress”.

When care removes a sense of control or autonomy, it risks reinforcing earlier experiences of powerlessness rather than supporting recovery.

Dr Jen Daffin, Community Clinical Psychologist and Director of Policy and Campaigns at Platfform, said many described the diagnosis as the beginning of worsening distress: “For many, a diagnosis of personality disorder marks the devastating beginning of isolation, exclusion, and deepening distress.”

“We saw that the treatment of people given this diagnosis often results in real harm, human rights breaches, and exclusion.”

Dr Daffin said change is needed across the mental health system, with a greater focus on human rights, compassion, and listening to lived experience, and called for approaches that recognise distress in context and support recovery through understanding, safety, and meaningful collaboration.

Undeserving

Jessica Matthews, who shared her experience as part of the report, said the diagnosis fundamentally changed how she was treated by services.

She said: “Some forms of care teach you to doubt your own reality…The diagnosis became a label that professionals used without my consent, and every request for help turned into a judgement.”

She described the label as a tool that silenced her, leading to stigma, discrimination, and a sense of neglect: “The moment I was given a ‘borderline personality disorder’ diagnosis. I came to a slow realisation that help and harm can wear similar faces.”

The label became an “instruction manual for professionals”, determining what care she could get, or whether she could get any at all. For her it became a “subtle conditioning process.” The message was clear: “because I had a personality disorder, I was undeserving of care.”

The report says that current approaches often overlook, minimise or misunderstand histories of trauma, coercive control and wider social injustice, while failing to take account of factors such as chronic illness, disability and personal loss.

It argues that the label of personality disorder does more than stigmatise, it undermines basic human rights and flouts the Welsh Government’s guidance on limiting restrictive practices.

It strips people of their right to free and informed consent, invades privacy, curtails liberty and security, compromises personal integrity, and blocks access to justice.

Platfform is calling for urgent reform, urging Wales to move towards a human rights-based, trauma-informed approach to mental health care, with greater emphasis on compassion and person-centred support.

At its core, the report suggests that effective care begins with recognising that people’s responses often make sense in light of what they have lived through. When services acknowledge this, care can move away from judgement and towards recovery.