People with a borderline personality disorder diagnosis describe discriminatory experiences

Abstract

The psychiatric diagnosis of borderline personality disorder (BPD) attracts considerable stigma. People given this diagnosis may be characterised as manipulative, difficult, attention-seeking or untreatable. This paper describes a New Zealand study where eight people with a BPD diagnosis who selfidentified as encountering discriminatory experiences from healthcare professionals were interviewed. Themes found included that discriminatory experiences contributed to participants' negative selfimage and negative messages about the BPD label were communicated. A self-harm history appeared to be related to an increased number of discriminatory experiences. Connecting with the person and 'seeing more' (beyond an individual's diagnosis and/or behaviour) epitomised helpful experiences. Additionally, a relationship between stigma and the complaints process was noted. This study privileges the voice of those interviewed and may stimulate thought and discussion for services and health professionals working with this group.

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

“…BPD is highly stigmatised, with many individuals reporting discrimination and invalidation from health professionals. For example, in past research, people with BPD have reported feeling shunned by a treating health professional (Mental Health Council of Australia, ), experiencing long wait times when presenting to emergency departments due to self‐harm (Lawn & McMahon, ), and being perceived to be lying, manipulative, attention‐seeking and resource‐wasting (Veysey, ). The reasons for these experiences are complex: for example, interpersonal conflict with a client with BPD may cause a clinician to develop and apply negative stereotypes to others with BPD; anecdotes and assumptions may be spread between staff members; and a lack of understanding about recovery prospects and training may lead to confusion and feelings of incompetence among clinicians (Treloar, ; Veysey, ).…”

Stigma: Content analysis of the representation of people with personality disorder in the UK popular press, 2001–2012

“…There is evidence of stigma being enacted by some nurses towards people with personality disorder, including adopting social distancing strategies linked to the fear of aggression (Markham 2003;Markham & Trower 2003;Newton-Howes et al 2008). Further research indicates that service users experience that as being reduced to a label and a stereotype of being dangerous and at times consequently being excluded from services (Bonnington & Rose 2014;Castillo 2003;Rogers & Dunne 2011;Stalker et al 2005;Veysey 2014). The repetition in the red top tabloids of linking personality disorder with homicide may have contributed to this enactment of stigma in the clinical environment.…”

“…Further, research suggests that some clinicians relate to the diagnosis, and consequently those has an effect on the quality of care received by some with a diagnosis of personality disorder who have described some staff as having prejudicial attitudes (Stalker et al . ; Veysey ) resulting in them being treated as a label (Castillo ; Rogers & Dunne ) and being excluded from services (Bonnington & Rose ). In the context of high rates of childhood trauma and abuse (Battle et al .…”

“…While this means that mental health nurses will often provide treatment and care to this group, there is evidence that they often feel ill equipped to do so (James & Cowman 2007). Further, research suggests that some clinicians relate to the diagnosis, and consequently those has an effect on the quality of care received by some with a diagnosis of personality disorder who have described some staff as having prejudicial attitudes (Stalker et al 2005;Veysey 2014) resulting in them being treated as a label (Castillo 2003;Rogers & Dunne 2011) and being excluded from services (Bonnington & Rose 2014). In the context of high rates of childhood trauma and abuse (Battle et al 2004) it has been suggested that these experiences in healthcare settings may mirror earlier negative experiences of neglect (Bowen 2013).…”

Stigma: A linguistic analysis of personality disorder in the UK popular press, 2008–2017

“…People with a diagnosis of personality disorder are considered one of the most stigmatized groups within mental health services (Sheehan, Nieweglowski, & Corrigan, ). This has included negative attitudes from some healthcare workers (Dickens, Lamont, & Gray, ), and reports that some people with this diagnosis have had their distress dismissed (Bonnington & Rose, ) have been treated disrespectfully (Lawn & McMahon, ) and treated as a label rather than an individual (Veysey, ). In the UK, this has meant that despite expansion in the provision of specialist services over the last 15 years (Dale et al., ), and the lack of consistent high quality care has recently prompted a government sponsored consensus statement to improve treatment experiences (Lamb, Sibbald, & Stirzaker, ).…”