The Cassel Hospital Charitable Trust Frequently Asked Questions

What is The Cassel Hospital Charitable Trust?

The Cassel Hospital Charitable Trust is a charity which promotes the care and treatment of adults and young people with personality disorders and complex trauma. It does this by supporting education and training, research into personality disorders and helping with The Cassel Hospital’s buildings, equipment and facilities. Patients and staff can apply to The Charitable Trust for support around projects and activities. To find out more about The Cassel Hospital Charitable Trust, visit www.casselhospitaltrust.org

What is The Cassel Hospital Charitable Trust?

The Cassel Hospital Charitable Trust is a charity which promotes the care and treatment of adults and young people with personality disorders and complex trauma. It does this by supporting education and training, research into personality disorders and helping with The Cassel Hospital’s buildings, equipment and facilities. Patients and staff can apply to The Charitable Trust for support around projects and activities. To find out more about The Cassel Hospital Charitable Trust, visit www.casselhospitaltrust.org

What is The Cassel Hospital?

The Cassel Hospital in Richmond, South West London, is part of West London Mental Health Trust. It is an NHS Tier 4 specialist service for adults and young people with a diagnosis of personality disorder and complex trauma. Tier 4 services treat patients with complex needs usually needing inpatient treatment because their local services cannot meet their needs. The Cassel also works with adolescents at the stage of being transferred from Child and Adolescent Mental Health Services (CAHMS) to adult services. For more information, visit the West London NHS Trust website.

What are personality disorders?

In mental health, the word ‘personality’ refers to the collection of characteristics or traits we develop as we grow up and which make each of us an individual. These include the ways we think, feel and behave. The make-up of a personality, how it is developed and how it evolves is highly complex and different for each individual. Patients diagnosed with personality disorder have developed unhealthy coping mechanisms to manage difficult emotions and situations, day-to-day life and relationships. They often struggle to find a way of communicating this and are left feeling misunderstood or unheard. This impacts on their friends, family and others around them. Life is more difficult for people with personality disorders so they are more likely to have other mental health problems such as depression or drug and alcohol problems. There’s lots of useful information about personality orders online, including resources on the Royal College of Psychiatrists website

Why do personality disorders occur?

Often, people with personality disorders did not have their needs met in childhood. They may have experienced distress or trauma as children or as adults. Their past experiences continue to affect them in the present so their ways of relating to others, thinking and behaviour patterns cause them and others around them a lot of distress. With treatment, people with personality disorders can learn to manage their lives differently. Personality disorders may be associated with genetic and family factors. There’s lots of useful information about personality orders online, including resources on the Royal College of Psychiatrists website

Do all people with personality disorders need hospital treatment?

Personality disorders may be mild, moderate or severe and people may have periods of ‘remission’ where they function well. Many people have mild conditions so need help only at times of stress (such as bereavement). Other people with more severe problems may need specialist help for longer periods.

What are the statistics around personality disorder?

  • Personality disorder affects 4.4% of the adult population in the UK – roughly one in 23 people.
  • On average, sufferers die 18 years earlier than those without personality disorder.
  • A study estimated between 45% and 77% of those who commit suicide have a personality disorder.
  • The study showed whilst 80% of these people were in contact with mental health services, only 5% had been in contact with specialist personality disorder services.
  • In 2015, The National Personality Disorder Service Survey found only 55% of people with personality disorder had access to specialist services.
  • The Survey found that when they did, the quality and capacity of such services was unlikely to meet guidance from The National Institute for Health and Care Excellence (NICE).

 

What work does The Cassel Hospital do?

The Cassel is a national service and does pioneering work in the treatment of personality disorders. The Cassel delivers treatment through inpatient and outreach treatment programs. The inpatient service is a national service which provides residential treatment at The Cassel Hospital in Richmond, South West London. The outreach service provides community-based treatment for those living within the M25 and may follow on from the inpatient program or accessed directly. The purpose of The Cassel’s service is to help people reduce self-harm, suicidal and other self-destructive behaviours, build and foster healthy social and family relationships and to integrate back into the community, with a reduced reliance on local mental health services. The Cassel Hospital also carries out research and offers training and consultations to professionals.

What is the desired outcome for patients at The Cassel Hospital?

The Cassel Hospital aims to provide evidence-based treatment to reduce the symptoms of people with personality disorder as well as improve their quality of life. Research shows the treatment patients receive at The Cassel:

  • Reduces symptom severity and number of symptoms
  • Reduces self-harm and suicidality
  • Improves interpersonal relations
  • Gives patients’ families and friends better understanding
  • Improves occupational capacity
  • Helps patients gain a quality of life they can value
  • Reduces use of local mental health services
  • Is cost effective

 

What is the history behind The Cassel Hospital as a therapeutic community?

In 1919, Sir Ernest Cassel founded The Cassel Hospital as a private psychiatric hospital to treat civilians traumatised by the First World War. Originally, at Swaylands in Penshurst, Kent, it moved to Stoke-on-Trent during the Second World War. In 1948, it relocated to its present site at No. 1 Ham Common, Richmond, South West London, and entered the NHS under the leadership of Dr Tom Main. A psychoanalyst, Main pioneered the concept of a ‘therapeutic community’. This offered a different treatment approach to traditional psychiatric hospitals. Instead of viewing patients as passively ill and staff as actively knowing what was best for them, patients took part in the treatment process. A democratic structure was created in which patients played an active role in the day-to-day running of the hospital and participated in their own and other patients’ treatment, in an atmosphere that encouraged open communication. Staff worked alongside patients supporting and sometimes challenging them in their day-to-day living tasks and responsibilities. Those foundations are still at the heart of the work The Cassel does today.

What is a therapeutic community?

The Cassel Hospital is an adapted example of a therapeutic community (TC). A TC is a form of community group living therapy in which the lived experience of having a personality disorder is explored in depth. All TCs follow the principal of staff and patients working together. The therapy looks at every aspect of patients’ daily living both in treatment and at home. The therapy is based on collaboration in a culture of enquiry, democracy, tolerance and responsibility. In keeping with the principles of a TC, people learn from getting on – or not getting on – with other people in the treatment group. It differs from ‘real life’ in that any disagreements or upsets happen in a consistently safe, contained space. TCs have been shown to be effective for mild to moderate personality disorders. They require a high level of commitment from everyone involved and all patients attend on a voluntary basis.

What is psychosocial nursing?

Psychosocial nursing addresses both the psychological and social aspects of a patient’s life. The Cassel Hospital’s registered nurses and health care assistants work alongside patients on everyday living tasks so difficulties in relating to others can be thought about together. The aim is to build real relationships based on trust and honesty. Often patients struggle to know and to communicate how they feel so a key focus is being part of patients’ learning about themselves and about each other and finding a common language to begin to communicate.

What is the history of The Cassel Hospital building at 1 Ham Common
The present hospital was originally a late 18th-century house known as Morgan House, named after its owner, philanthropist and writer, John Minter Morgan. Morgan died in 1854 and is buried in nearby St Andrew’s Church, Ham. In 1863, the house became home to the newly married Duc de Chartres. In 1879, it became West Heath school for young ladies. The school moved to Kent in the 1930s, and the building became the Lawrence Hall Hotel until its purchase by the Cassel Foundation. The Cassel Hospital, which had been in Penshurst, Kent and Stoke-on-Trent, Staffs moved to 1 Ham Common in 1948. The building, which has large, mature gardens, was Grade II listed in 1950.

How can I contact The Cassel Hospital Charitable Trust? (Map)
The Cassel Hospital Charitable Trust, 1 Ham Common, Richmond, Surrey TW10 7JF

020 8483 2900