Borderline Personality Disorder (BPD) 101: Professional Edition

The following is a list of professional development resources, treatment guidelines, & other information about Borderline Personality Disorder (BPD), designed specifically for medical professionals such as GPs.

Relevance to General Practice

“BPD is often under-recognised due to presentation with other psychiatric comorbidities. If left undiagnosed & untreated, BPD is associated with significant morbidity & mortality:
• mortality rate (8-10%)
• comorbidity rate (94%) including substance use, PTSD, depression, eating disorders & metabolic syndrome &
• substantial impacts on quality of life (disability weight 0.54 equivalent to autism 0.55 & HIV-AIDS 0.57).

With a limited number of publicly funded therapeutic services delivering care to adolescents & adults in Australia with BPD, it is estimated that less than 10% of affected individuals are able to access services to reduce their risk of suicide, self-harm, significant social dysfunction & other comorbidities outlined above.

GPs are well placed to identify individuals with BPD & to provide education, management, & access to appropriate care as needed. Structured psychological interventions have been demonstrated to improve outcomes for BPD.”

[SOURCE: RACGP website]

The Australian BPD Foundation

The Australian BPD Foundation is a group of volunteer consumers, carers & clinicians passionate in encouraging a positive culture around Borderline Personality Disorder (BPD) & promoting the ready availability & accessibility of appropriate services for everyone impacted by BPD.  The Australian BPD Foundation, in partnership with the Mental Health Professionals’ Network (MHPN), has produced a series of webinars on BPD, & a list of accompanying resources:

Webinars & resources:

The Mental Health Professionals’ Network (MHPN)

A collaborative alliance of the Royal Australian College of General Practitioners (RACGP), the Royal Australian & New Zealand College of Psychiatrists (RANZCP), the Australian Psychological Society (APS), & the Australian College of Mental Health Nurses (ACMHN), in partnership with Occupational Therapy Australia, the Australian Association of Social Workers (AASW), & the Australian College of Rural & Remote Medicine (ACRRM), MHPNs provide a coordinated & collaborative forum for issues affecting professionals involved in the delivery of mental health care.  Their aim is to improve collaborative practice between these groups, to improve outcomes in the delivery of primary mental health care.  The MHPN facilitates a range of networks around Australia, with focuses ranging from general to specialised interests, including a number of Borderline Personality Disorder Networks.

MHPN hosts an ongoing series of CPD-accredited webinars, & has a library of previous webinars available on their website, including a number about BPD (see below).  For further information about claiming CPD for accessing these webinars, please refer to the MHPN Webinar Professional Development Recognition Fact Sheet, or email contactus@mhpn.org.au for more info.

BPD webinars:

Other relevant MHPN webinars:

The Royal Australian College of General Practitioners (RACGP)

The Royal Australian College of General Practitioners’ (RACGP) Quality Improvement and Continuing Professional Development (QI&CPD) Program supports Australian general practitioners (GPs) to maintain and improve their professional knowledge and skills in order to provide the best possible care for patients and their communities. Continuing professional development for GPs includes a range of activities to meet individual learning that is relevant to their scope of practice.  Several BPD-related accredited activities are available via e-learning, & contribute points towards the 130 QI&CPD points required for each practitioner this triennium.

Activities:

  • Borderline personality disorder: diagnosis and management in general practice (for GPs & practice staff, 1 hour, 2 QI&CPD points): This activity has been developed by the Royal Australian College of General Practitioners (RACGP) with expert input obtained through Australian BPD Foundation Limited, Orygen, Spectrum, & Project Air. Its focus is to assist GPs in identifying the risk factors for, & clinical features of, BPD; discussing effective management options including appropriate prescribing & involvement of families/carers; & describing strategies to manage the doctor-patient relationship, including crisis management.
  • How to Treat quiz: Borderline personality disorder (for GPs, 1 hour, 2 QI&CPD points): Borderline personality disorder (BPD) is a severe, complex & highly stigmatised psychiatric illness. It is a great mimic of many other psychiatric illnesses. The public health impact & cost of BPD is significant. People with BPD have high use of EDs, crisis & primary care services. In addition there are substantial costs associated with resultant detrimental impact on employment, life in the community, & family interactions.
  • Clinical Enhancement Module: Youth mental health (for GPs, 5 hours, 10 QI&CPD points): This Clinical Enhancement Module offers GPs the opportunity to increase their knowledge & skills in engaging with young people with mental illness and their families. It focuses on the assessment of anxiety, depression, borderline personality disorder & psychosis.

Project Air Strategy for Personality Disorders

Project Air Strategy for Personality Disorders is an internationally recognised leader in research, education & treatment.  By partnering with health, justice, communities, schools, families & individuals, they bring new scientific discoveries to promote recovery.  Project Air works with Borderline Personality Disorder (BPD), Narcissistic Personality Disorder (NPD), Antisocial Personality Disorder (APD), & Paranoid, Schizoid, Schizotypal, Histrionic, Avoidant, Dependent, & Obsessive-Compulsive Personality Disorders.

Resources:

The National Health & Medical Research Council (NHMRC)

Caring for People with Borderline Personality Disorder – A Reference Guide for Health Professionals contains information about how to care for people with BPD. It is a summary of the 2012 National Health and Medical Research Council (NHMRC) clinical practice guideline for the management of BPD.

The full guideline & reference guide, below, are intended for health professionals, including Aboriginal health workers, clinical psychologists, general practitioners, mental health nurses, mental health occupational therapists, mental health social workers, midwives, nurses, psychiatrists, psychologists & staff of emergency services. Health professionals should refer to the full guideline for more detailed guidance, summaries of the clinical evidence on which the guidance is based, & references.

Guidelines, including references:

National Education Alliance of Borderline Personality Disorder (NEA-BPD) Australia

6-Module, Free Online Course for Professionals: Designed for professionals to learn basic principles for the diagnosis and treatment of BPD, this series of six, 20-minute modules features videos of patients/families, interactive quizzes, narrated slides, and videos from a number of experts.

A BPD Brief – An Introduction to Borderline Personality Disorder: Diagnosis, Origins, Course & Treatment (2006), is a 13-page booklet written by John G. Gunderson MD & colleagues, primarily for clinicians, presents the diagnosis, origins, course & treatments for Borderline Personality Disorder.

The Borderline Personality Disorder Clinician Resource Centre

The BPD Clinician Resource Centre is a hub of research-based information, updated periodically, with an emphasis on the treatment of BPD. Clinicians can find summaries of different topics related to BPD, including several treatment models and their guiding principles. From there, references can guide further exploration.

The National Mental Health Commission (NMHC) & Sane Australia

The National Mental Health Commission (NMHC) has partnered with Sane Australia to compile a report to review current evidence-based practice, service availability & experiences of treatment for Australians with lived experience of personality disorder, regardless of their circumstances. An overarching aim of this body of work is to improve management of & access to effective treatment and support services for these people.


And finally, for fellow Gold Coast residents, a resource with lots of local info:

Gold Coast Primary Health Network (GCPHN)

Gold Coast Primary Health Network (GCPHN) offers a variety of mental health & alcohol & other drugs (AOD) resources, information, points of contact, referral templates, & links via their new website – mentalhealthgc.com.au.  Designed for both individuals & professionals from the Gold Coast area, it offers a convenient source of information that is a helpful starting point for anyone seeking assistance, & those caring for them.

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