I appreciate the good work you are doing BlueButterfly, and I am glad the standard treatment worked for you. However, with my daughter we have a case that in some respects mimics BPD, and in others does not, so that three American hospitals came up with a completely different diagnosis. At the very least, in my opinion, she has co-occurring mental illness (see p131 of your document).
We have continued to have the same problem with the hospital - namely the complete lack of crisis care and the irrational belief by a whole group of medical professionals that it is somehow better for an ill person out of their mind to wander the streets or to be gaoled, than to be in hospital with medical professionals.
On the positive side, they eventually obtained Special Benefit for our daughter and she became eligible for crisis accommodation while having standard BPD treatment. However a few weeks ago she started saying she "wanted to get away from all this psych bullshit and get a job". Within a couple of days she entered mild manic phase, and from that point on - althoiugh she has several case workers - no-one has ever been able to arrest her path to complete psychosis. The crisis place tried to get the CAT team to come and the hospital to take her, and ended up makling a formal complaint. The hospital put her out on the streets as usual, and for four days, we think, she cruised the train system from one end to the other without sleep, ringing us and leaving strange messages from widely separated stations. We think the police picked her up at least once. Anyway some angel must look after the mentally ill, because she is still with us and as always, came down to normality faster than she went up.
It's hard to say where she will go from here, because it seems to me this BPD treatment is useless and she is deteriorating. I suppose eventually she will die or she will manifest such obvious symptoms of standard psychosis that they will have to change the diagnosis. Or maybe they will actually get somewhere. But it is all a very high risk approach on behalf of the hospital, none of the other agencies will tolerate having acutely mentally ill people on the premisis and the public are absolutely opposed, frightened even.
Sorry Butterfly, I did look at the document you provided and it seemed to me that all it did was reinforce the hospital's position, BPD sufferers are not ill, they are attention seekers who go to hospital to get attention and they dont belong there. They should be given only the briefest of treatments and "crisis stabilisation" is not a goal. They should be "involved in their own treatment". All this is just laughable when we are talking about someone who in crisis cannot recognise anyone, cannot respond to simple commands and has little more intelligence than a wild animal.
