We all know that mental health systems are completely broken. That people are forced to get sicker before they receive treatment and have to wait weeks or months for a mere assessment.

But for people living with Borderline Personality Disorder this system is, in my opinion, nearly useless.

BPD is characterised by many symptoms, one of which is intense and rapidly changing moods. Think of it as having a very thin skin, or third degree emotional burns, where every slight trigger can cause intense and often painful emotional responses such as despair, devastation and hopelessness. These responses last anywhere from hours to days, but personally, I have never really exceed a 2 – 3 week period.

An example I can give is that last year I was told I would need to reapply for my own job. No big deal? Perhaps. Slightly frustrating at best? For me, I was left feeling like a complete and utter failure. I felt like my bosses and colleagues hated me and were trying to get rid of me, and I was seriously paranoid when I was at work. I felt emotional, often tearful, and my life felt like it was over. I wasn’t sure how to move forward and my head was clouded with intense emotions and intrusive thoughts. I couldn’t sleep, lost my appetite and began to see anorexic behaviours creep back in. I also turned to self-harm in those all too frequent moments of overwhelm.

I knew my reaction didn’t match the situation, but having BPD means emotional regulation is incredibly difficult for me and I just couldn’t mange. As the situation also shifted my unstable sense of self worth, with intrusive thoughts repeatedly telling me I had failed and was hated, I was really struggling.

So I went to see my GP. She was actually one of the better ones I’ve seen. She asked me what had helped before and I explained I’d previously used additional medication to get me through similar periods. She prescribed me some and informed me she would send letter of referral to the local CMHT.

Thing’s began to improve as I grasped the situation and began to process it. The additional medication slowed down my paranoia and intrusive thinking, allowing me to get back into a more stable routine, and finally allowing me some much needed sleep. Eventually I made the decision to move on from my job and I was feeling confident in my decision and the direction of my life.

It was around this time, possibly 3-4 weeks later, that I received an assessment phone call from the CMHT. They asked about the circumstances leading up to the referral and how things had been since. I explained the situation and noted I was feeling slightly better. The lady on the phone quickly rattled off a list of questions (you know the ones – how often have you thought about suicide, do you have people who can support you etc.) which I answered. She then perkily said “well it seems like things have gotten better on their own and you don’t really need support right now. But call us back if you ever do.”

I have had this conversation probably around 5 times in the last year. It always ends the same. By the time I make it to the top of the assessment list my emotions have calmed, I have managed (albeit with a mammoth struggle) and am feeling better. I no longer need support, but couldn’t get it when I did.

I’m fortunate, I have always managed to get through these periods. Often I rely on less helpful strategies, but I also have a fantastic family and a boyfriend who understands my BPD well. But what if I wasn’t so lucky? What if I didn’t manage? I know we have crisis teams but from what I’ve heard they can be equally useless and in my area even getting access to their service is the equivalent of trying to find a reasonably priced parking space in London.

The system simply doesn’t work for those managing Borderline Personality Disorder. I rarely need to engage with services, but when I do I need it urgently. I need something more flexible. Support at those times absolute crisis, for a matter of days to weeks. Not a two-year DBT programme at the end of a 6 month wait list. I need help today. Often it’d taken me at least a week to go to a GP as I know they’ll want to see persistent symptoms, so an assessment in a further 3 weeks is useless.

I’m tired of seeing people struggle so desperately, who just need small, temporary, efficient inputs. They’re left to get to crisis and put at unnecessary risk only for their distress to then be dismissed at the point of assessment as we somehow managed to make it out to the other side. We’re palmed off with a leaflet and a phone number to re-refer ourselves next time.

And then when we dare to point out the flaws in this baffling system we get labelled ‘difficult’ or ‘unwilling to engage’. I am willing to engage, just not in a service that doesn’t meet my needs. I need help when I say I need it, not 3-6 weeks later. And yet that gets labelled as a negative reflection on myself and my willingness to recover, not on the system failing to adapt to it’s clients.

I don’t have a solution. I am all too aware of how stretched mental health services are. But with as many people living with BPD as Schizophrenia, surely we deserve services as adapted as Early Intervention for Psychosis teams?

Lorna

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