Dispelling myths and challenging neglect in ‘borderline personality disorder’ healthcare: a lived-experience perspective

Abstract

The healthcare experience of many people carrying the label ‘borderline personality disorder (BPD)’ is one of exclusion, discrimination and neglect. The letters ‘BPD’ replace our very humanity, trampling our right to receive evidence-based, appropriate, lawful and compassionate care. Within mental health services our pain, distress, unusual experiences and self-harm/suicidal actions have been reconceptualised as ‘behavioural’ issues, encouraging the promotion of punitive and cruel responses from professionals in an attempt to discourage us from seeking help. ‘Responsibilisation’ narratives, which prioritise personal independence over all else, legitimise institutional neglect. We are told suicide is a choice we have the capacity to make, while care is actively withheld to avoid us becoming dependent on support. Despite the rising suicide rates of people labelled with a personality disorder diagnosis in the UK, our risk continues to be downplayed; rewritten as a risk of death by ‘misadventure’; and accepted by services and coroners as a justifiable outcome of so-called ‘less is more’ care plans. This article explores the current mental health service landscape in which prejudice and stigma direct ‘BPD’ care through the creation and maintenance of clinical mythology, which despite its popularity across healthcare teams, is not supported by ongoing research findings and recommendations.