Early detection and timely intervention for borderline personality disorder

Although borderline personality disorder (BPD) usually has its onset in young people, its diagnosis is often delayed, and specific treatment is usually only offered late in the course of the disorder. Over the past two decades, the explosion of knowledge about personality disorder has shown that BPD is neither a variant of normal adolescent development, nor a ‘passing phase’ of little consequence. In fact, BPD is associated with harmful personal, social, and economic consequences. This has provided solid ground for early diagnosis and treatment of both subthreshold borderline personality pathology (‘indicated prevention’) and full-syndrome disorder (‘early intervention’). Over the past two decades, the Helping Young People Early (HYPE) programme has been developed and researched in Melbourne, Australia. HYPE is a comprehensive and integrated indicated prevention and early intervention programme for youth (15–25 years of age). HYPE is comprised of a service model and an individual therapy, and incorporates the principles of cognitive analytic therapy. HYPE primarily aims to alter the life-course trajectory of young people with borderline personality pathology by improving functional outcomes, interpersonal relationships, and self-management, developing support networks independent of mental health services, promoting adaptive help-seeking, and avoiding or reducing iatrogenic harms.