A Novel Cross-Sectorial Collaboration – Increasing access to treatment for those living with Borderline Personality Disorder through improving workforce capability

Borderline Personality Disorder (BPD) is a complex and serious psychiatric condition with significant morbidity and mortality. It is often characterised by a severely and persistently impaired psychosocial functioning and a high risk for self-harm and suicide, resulting in the high consumption of healthcare resources.

Access to evidence-based interventions for Borderline Personality Disorder (BPD) is still highly limited in the current Australian health service system. Specialist mental health services are dominated by a generic case management model, with a lack of specific treatment modalities and staff struggling to provide psychologically focussed interventions. Similarly, non-government organisations (NGOs) report a lack of capacity, competence and confidence when working with consumers living with BPD.

Despite people with BPD commonly having multiple contacts with mental health services, an audit within Metro South Hospital and Health Service (MSHHS) found that access to evidence-based treatment for this group of patients was highly limited in the Brisbane South region. The need for all workers to be able to therapeutically respond to consumers needs, and better access to appropriate intervention intensities was required.

Using a stepped workforce capability framework the project aimed to increase the overall workforce capability to intervene effectively. In addition to develop higher level skillsets across NGO and public mental health and greater treatment access across the spectrum of care needs.

Outcomes were significant and have directly impacted the ability of staff to provide good care from thsoe with BPD and related disorders. Over 350 NGO and MSHHS frontline staff completed training to achieve a practice-informed level of DBT capability.

The project’s activities were highly valued in terms of content and presentation. Most participants reported greater use of and capability with Dialectical Behaviour Therapy (DBT)-informed practice and improved care coordination after training attendance.

The significant improvements in the self-efficacy of participants that were identified immediately following training attendance appear to have been maintained in the short term.

Almost 100 people attended advanced forms of training that will enable them to run DBT-informed groups, and in some cases provide individual comprehensive therapy. These individuals will serve as DBT leaders and champions who can support the maintenance of each service’s improved capability. There are new programs accessable to those with BPD in the region.