Factors Associated With High Use of Public Mental Health Services by Persons With Borderline Personality Disorder

2003 ◽  
Vol 54 (8) ◽  
pp. 1149-1154 ◽  
Author(s):  
Katherine Anne Comtois ◽  
Joan Russo ◽  
Mark Snowden ◽  
Debra Srebnik ◽  
Richard Ries ◽  
...  
2019 ◽  
Vol 33 (3) ◽  
pp. 326-340 ◽  
Author(s):  
Lene Halling Hastrup ◽  
Mickey T. Kongerslev ◽  
Erik Simonsen

Earlier studies report that although people with borderline personality disorder (BPD) experience symptom reduction in the long term, they continue to have difficulties in work recovery. This nationwide 9-year register-based study (N = 67,075) investigated the long-term labor-market attachment of all individuals diagnosed with BPD during first admission to Danish mental health services in comparison with other psychiatric disorders. Controlling for baseline characteristics and co-occurring secondary psychiatric diagnoses, the BPD group had 32% lower odds (OR = 0.68; 95% CI [0.61, 0.76]) of being in work/under education after 9 years. Individuals diagnosed with BPD also showed more impairment in long-term vocational outcome than other personality disorders, and lower labor-market attachment than other psychiatric disorders except for schizophrenia, schizotypal and delusional disorders, and mental and behavioral disorders due to psychoactive substance use. Intervention programs addressing social psychiatric aspects of BPD in terms of work functioning is henceforth an important area for future research.


Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman

Borderline personality disorder (BPD) is a prevalent, debilitating syndrome. Patients with BPD heavily utilize mental health services and have historically had a poor prognosis. In the IPT adaptation for BPD, the therapist presents BPD to the patient as a poorly named syndrome that has a significant depressive component. The goals of IPT in this population are threefold: to link mood (including anger) to interpersonal situations, to find better ways of handling such situations, and to build better social supports and skills. When patient–therapist problems crop up, the therapist addresses them in a here-and-now, interpersonal fashion rather than making psychodynamic interpretations. Because patients with BPD are sensitive to abandonment, termination is discussed early and often. Research on the use of IPT in patients with BPD is tantalizing but fragmentary, in need of a larger and more definitive trial.


2010 ◽  
Vol 61 (6) ◽  
pp. 612-616 ◽  
Author(s):  
Susanne Hörz ◽  
Mary C. Zanarini ◽  
Frances R. Frankenburg ◽  
D. Bradford Reich ◽  
Garrett Fitzmaurice

2021 ◽  
pp. 103985622199264
Author(s):  
Henry Jackson ◽  
Caroline Hunt ◽  
Carol Hulbert

Objective: Clinical psychologists are practitioners with expertise in mental health, who apply advanced psychological theory and knowledge to their practice in order to assess and treat complex psychological disorders. Given their robust specialised mental health training, clinical psychology is an integral component of the Australian mental health workforce, but is under-utilised. Recent reviews have identified significant problems with Australia’s mental health system, including unequal access to clinical psychology services and fragmentation of service delivery, including convoluted pathways to care. Conclusions: Clinical psychology is well placed to contribute meaningfully to public mental health services (PMHS). We describe what clinical psychologists currently contribute to team-based care in PMHS, how we could further contribute and the barriers to making more extensive contributions. We identify significant historical and organisational factors that have limited the contribution made by clinical psychologists and provide suggestions for cultural change to PMHS.


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