A brief guide to borderline personality disorder for pre-hospital clinicians in an emergency setting

Abstract

Paramedics and ambulance staff are frequently in contact with patients with mental health diagnoses, whether this is the primary reason for contacting the emergency services, e.g. self-harm, crisis or suicide ideation; or, incidental to their primary clinical concern. Patients in mental health crisis can be challenging and demanding. Most paramedics will not have had specific guidance on identifying or understanding the features, aetiology and responses to treatment of patients with a diagnosis of borderline personality disorder. Borderline personality disorder is associated with a high risk of self-harm, risk-taking behaviour and suicide. Building a rapport with patients is often crucial to paramedics achieving optimum patient care. There are features of borderline personality disorder that may make rapport building more complex, and the establishment of trust harder for the clinician to achieve and maintain. There is potential for frustration and a lack of understanding to interfere with patient-centred care. In order to support patients with borderline personality disorder, ambulance staff need to be aware of the particular characteristics of this condition and the current best practice guidance.