BORDERLINE PERSONALITY DISORDER
17/10/2012
The Hon. K.L. VINCENT (15:54): The second National Borderline Personality Disorder Awareness Day was on 6 October this year. It was celebrated with a highly educational conference at Flinders University, conducted by the Private Mental Health Consumer Carer Network, organised by the irrepressible Janne McMahon.
As I explained in question time, I was in the APY lands, so I had a staff member attend on my behalf. Whilst the federal Minister for Health and Ageing opened the conference, there seems to be a remarkable lack of will to get policy, services and training up to scratch in this country. I was disappointed to learn that neither the government nor opposition ministers for health nor their staff were there to learn more about this prevalent but under-resourced mental illness.
I have heard borderline personality disorder (or BPD, as it is more easily known) referred to as the Cinderella of mental health by some, and I think they may well be on the mark. So what does being a Cinderella mean? I guess it means that BPD is something of a disregarded or unrecognised merit or beauty. Why is that? It is not an easy mental illness to manage or deal with. It often co-exists with other mental health issues or illnesses such as depression, anxiety, self-harming and eating disorders, and it often causes presentations to emergency departments of hospitals with physical symptoms that appear unrelated to mental health issues.
Many consumers and their parents, or carers, in this area report appalling treatment in the hands of our public health system, including being treated with disdain, refused treatment, being discharged from hospital without adequate treatment or follow up. As one psychiatrist pointed out, it is standard that patients are discharged into a clinical void in this state as there is no publicly funded individual service available. How are they supposed to recover if even the trained staff they present to do not fully understand their illness?
It seems that even many mental health professionals still hold the belief that the disorder is not treatable, despite evidence suggesting that there are many effective treatments available, including, among many others, dialectic behavioural therapy. Mental health professionals widely recognise the prevalence of BPD in the Australian population of at least 1 per cent. This means in South Australia there would be a minimum of 16,500 people with BPD.
As I said in question time, 10 per cent of people with BPD successfully suicide, but do we have a single specialist counselling line, individual therapy course, clinician treatment, and an information or education service that tackles the illness in this state? No, we don’t.
From the research that has been conducted, many people with BPD have suffered early childhood trauma and/or abuse, and a far larger percentage of those presenting with BPD symptoms and resulting diagnoses are women.
If action is taken early when symptoms are detected it is far more efficient for our public health system than to be persistently dealing with people in crisis and pain when they demonstrate self-injurious behaviours or suicide attempts and present, at great expense, to our emergency departments. Hospital admissions are expensive and taking therapies and preventative health care are a possible solution.
South Australia needs a service like Spectrum in Victoria. It is appalling that when a situation like prisoner Jackie’s occurs—which I also mentioned in question time—we have to bring in someone from interstate to consult on the matter because our mental health minister won’t fund a specialist service in the area in South Australia. Not only do the people with BPD in this state need this service but the overstretched health budget also needs it.
