“It's very hard for me to say anything positive”: A qualitative investigation into borderline personality disorder treatment experiences in the Australian context

Abstract

Objective: To identify in the Australian context: (a) treatment and support services that are accessed by people living with borderline personality disorder (BPD) and their carers, (b) perceived benefits and challenges associated with these services, and (c) changes these individuals would like to see with regards to service provision and access. Method: This project involved semi-structured qualitative interviews with 12 participants (75% female, M age = 39.9, SD = 11.7), nine with lived experience of BPD, three carers and two identifying with both roles. Additionally, two online focus groups were conducted via online peer support communities involving 11 participants in total. Interview transcripts and focus group text were analysed thematically. Results: Participants described mixed experiences across a range of treatment types, locations and intensities. Themes were: identity and discovery, (mis)communication, complexities of care, finding what works (for me), an uncertain future, and carer empowerment. Participants described community-based psychotherapy as being critical for reducing symptoms of BPD and improving quality of life, but reported challenges at the macro and micro level with regards to costs, service access, clinician factors and client factors. Experiences were often not aligned with a recovery model of mental health. Conclusions: The current Australian mental health system is not designed to best meet the needs of people living with BPD, which remains highly stigmatised and misunderstood. Future research should consider how the system could be modified or restructured to better support recovery for these individuals and others with complex mental illness.

The voice of mental health practice in Australia: a mixed‐method cross‐sectional study of gaps and areas of need

“…This is consistent with previous Australian research indicating that many GPs find it challenging to manage patients with difficult‐to‐treat depression in primary care and value the input of other professionals 26,27 . Further, substantial numbers of HPs indicated that they were likely to require assistance with ongoing management and referral of patients with mental disorders other than depression and anxiety, in line with research suggesting that the Australian health care system is challenged when meeting the needs of patients with personality disorders 28,29 or complex needs 12 …”

Consumer perspective from people with a diagnosis of Borderline Personality Disorder (BPD) on BPD management—How are the Australian NHMRC BPD guidelines faring in practice?

“…The findings clearly show that consumers want to receive comprehensive, holistic and evidence‐based support, including psychotherapy (Carrotte et al., 2019 ). The data also highlight a shift in consumer preference from psychiatrists in 2011, to psychologists in 2017, as their main treating health professional.…”

“…A study by Zanarini and Frankenburg ( 2008 ) also demonstrated that individuals who are educated about BPD with up‐to‐date information immediately after diagnosis experience significantly lower short‐term impulsivity and interpersonal relationship distress. The recent SANE report (Carrotte et al., 2019 ) further highlights the problems with stigma from within health services, and the negative effects of unclear or insensitive communication from health professionals in the Australian setting.…”

Commenting and connecting: A thematic analysis of responses to YouTube vlogs about borderline personality disorder

“…BPD is highly stigmatized ( Cone, 2020 ; Kirtley et al, 2019 ; Masland and Null, 2021 ). Stigma can become internalized by individuals with BPD ( Grambal et al, 2016 ; Quenneville et al, 2020 ) and perceived BPD stigma can prevent people from accessing supports ( Carrotte et al, 2019 ). Morgan and Zimmerman et al (2015) suggest that reducing stigma may help improve assessment and diagnosis of BPD.…”

“…Vlogging can provide an individual with peer support, enhance self-efficacy, reduce self-stigma and encourage recovery ( Sangeorzan et al, 2018 ). Comments to vlogs can give access to a wide variety of opinions and responses, however there is a lack of research into the comments to BPD-centred vlogs, about a disorder that is often stigmatized, underdiagnosed and misunderstood ( Carrotte et al, 2019 ; Dhaliwal et al, 2020 ; Zimmerman, 2015 ).…”