Australians With Borderline Personality Disorder Aren't Getting The Support They Need
People with borderline personality disorder are up to 45 times more likely to take their own lives, but sufferers say treatment is hard to access
New research released by mental health charity SANE found Australia's mental health system is not designed to meet the needs of people experiencing BPD.
Bea* is a 23-year-old jewellery designer, who was first diagnosed with the disorder at age 14.
In her early teens, she was extremely unhappy and found it difficult to control her emotions. She began acting impulsively, running away from home multiple times, having early and frequent sexual experiences, and flailing in school.
At 17, Bea attempted to take her own life.
She told 10 daily she has been "in and out of hospital more times than I can count -- I don't have enough fingers and toes".
BPD is a mental illness characterised by significant feelings of uncertainty in one's identity, fear of intimate relationships due to concerns of abandonment, impulsive behaviour, intense and rapid emotional peaks, as well as suicidal thoughts and behaviours.
It affects approximately 1.6 percent of the population. People with BPD are up to 45 times more likely to take their own lives than the general community.
Treatment has been extremely demanding on Bea, and significantly expensive. She has seen a therapist at least once a fortnight since her diagnosis, with each session costing $220.
"I'm really blessed that my parents are backing me in that area, I would not be able to do it otherwise," she said.
READ MORE: How To Talk About Mental Health
Bea said the Australian mental health system makes it difficult for BPD sufferers to sufficiently manage their illness. She particularly singled out that the standard Medicare Mental Health plan only accommodates subsidised 10 therapy sessions per year.
For people with BPD, the security and stability of a regular therapist is critical.
"The original [Mental Health] plan is five sessions and then you have to apply to get another five sessions on top," Bea said.
"People with BPD need that emotional attachment. To create that bond with a therapist is absolutely challenging."
The research published by SANE found such challenges are a common experience for Australians living with BPD.
SANE found people with BPD frequently reported systemic failures in the current system, including high costs and availability of specialists.
Treatment is often interrupted when patients can no longer access subsidised services and the associated costs forced sufferers to either drop out of treatment or rely on the financial support of family or friends.
Despite a federal government budget commitment of $461 million to a national mental health strategy, Medicare's Mental Health care plan has not been expanded to subsidise more psychologist sessions.
Doctor Michelle Blanchard, deputy CEO at SANE, told 10 daily that people with BPD need long-term, intensive therapy courses such as dialectical behaviour therapy (DBT) to manage their illness. She claimed the Australian mental health system is simply not equipped to provide the resources for these courses.
"People only really can access ten [subsidised] sessions at a time, potentially 20 if they start later in the year...but it's definitely not enough to get up to the recommended course of treatments," Blanchard said.
She added that many mental healthcare professionals are not familiar with BPD, are not able to understand the experience of living with it, and may have preconceptions about people who experience from it.
"There's lots of misconceptions and stereotypes around BPD and some health professionals are reluctant to treat it," she said.
Blanchard believes mental health professionals tend to have a reluctance to diagnose BPD, because of the stigma attached to the illness.
This is unproductive, she said, because "people who don't get labelled, don't get support".
Blanchard said "systemic change" was needed, with funding schemes for the illness as well as medical personnel trained specifically to identify and address personality disorders.
She added that the majority of people who develop the disorder are victims of trauma, and called for Australia to institute more informed care to address patients with complex trauma-related psychological issues.
Bea said BPD is a misunderstood illness in the wider community and the stigma that she experiences has a profound impact on her.
"People feel that you're needy or two-faced or clingy and emotional --or just can't control yourself," she said.
While Bea has made huge strides in her progress, and is confident she can understand and "honour" her mental illness, she still said BPD is misunderstood by many others.
Blanchard said that dispelling the stigma of the diagnosis is one of the most important steps to ensuring people are able to access support.
"It is entirely possible to be treated and recover from BPD," she said.
"But we have to reduce that stigma in the community by really telling the real stories about people who live with BPD."
* Name has been changed to protect privacy.
If you need help in a crisis, call Lifeline on 13 11 14. For further information about depression contact beyondBlue on 1300 22 4636 or talk to your GP, local health professional or someone you trust.
If you have a personality disorder and need support, head to Project Air, A Personality Disorders Strategy at www.projectairstrategy.org.