MHM Magazine

health professional who is trained in managing these patients, and the name of this individual should be available in the crisis plan. On a long- term basis, it’s necessary to include family members and significant others in the management. Again, this includes specialised family interventions offered by a professional who treats such patients and their families. • Integrated care. As mentioned above, it’s best to treat these complex patients, who often have specific needs and a high demand for care, with a team approach. All professionals, including the patient’s family, should be in contact with each other and have a system in place to support each other as well as the patient. The role of each team member should be clearly defined. • Addressing stigma. It’s my impression that BPD is more acceptable, e.g., on social media, but it remains a typically stigmatised disorder. Patients and their families should receive psychoeducation about the contributing factors for the development of BPD, so it’s not anybody's fault. Specific interventions: 1. Hospitalisation is typically short-term and used as a crisis intervention strategy. Many patients become more emotionally dysregulated if they’re hospitalised for long periods. As the disorder is chronic, it’s better to implement strategies that can help patients manage their distress and suicidal ideation on an outpatient basis. 2. Psychotherapy • Trauma-informed, evidence-based psychotherapy. In South Africa, DBT is the most available therapy, although other shorter (good psychiatric management) and longer therapies (mentalisation- based and transference- focused therapies) are also available. • Treating patients in groups is a cost-effective approach that also provides an opportunity to learn and practice interpersonal problem-solving skills in a safe environment. • Psychoeducation is an essential foundation of all psychotherapeutic interventions, as patients understand that BPD is a common disorder with genetic/biological origins. Patients should know that they did not cause their problems, but it’s still their responsibility to solve them. • The degree of family involvement varies between different treatment approaches, but at a minimum, the family or most significant others should be involved at least once for the purposes of psychoeducation and crisis management. 3. Medication is not the most essential part of the treatment plan. Still, it can be used if the patient’s symptoms are extreme or if they qualify for a diagnosis of major depression or bipolar mood disorder. BPD commonly co- occurs with mood disorders, and these disorders should also be treated optimally. However, caution should be used when prescribing habit- forming medications such as sleeping pills, anxiolytics, and analgesics. 4. BPD commonly occurs together with many other disorders, including substance use disorders, eating disorders, ADHD (attention deficit/hyperactivity disorder), and PTSD (post-traumatic stress disorder). References available on request. MHM | 2025 | Volume 12 | Issue 3 | Addressing the needs of patients with BPD (borderline personality disorder) and childhood trauma MHM Issue 3 | 2025 | MENTAL HEALTH MATTERS | 13 MHM