Services and Treatments for People with Borderline Personality Disorder: State of the Situation in Quebec and Future Prospects
Objectives People with borderline personality disorder experience significant health challenges, both in terms of their mental and physical health, resulting in significant functional repercussions. In Quebec and elsewhere in the world, it is reported that the services in place are often poorly adapted or inaccessible. The purpose of this study was to document the current situation in the different regions of Quebec for clients with borderline personality disorder, to describe the main challenges associated with the implementation of services for this clientele, and to identify possible recommendations to meet the needs of this clientele applicable in different practice settings. Method The design used was a qualitative single case study, with descriptive and exploratory aims. Twenty-three interviews were conducted in most Quebec regions with resources working in various CIUSSSs, CISSSs and non-merged institutions offering adult mental health services. In addition, where available, clinical programming documents were consulted. Mixed data analyses were conducted to provide insights based on different types of settings: urban, peripheral, and remote regions. Results Findings show that in all regions, recognized psychotherapeutic approaches are integrated but tend to need to be adapted. In addition, there is a desire to develop a continuum of care and services and some projects are already underway. Difficulties in implementing these projects and harmonizing services on the territory, due in part to financial and human resource issues, are frequently reported. Territorial issues are also to be considered. Conclusion Enhanced organizational support and the creation of clear guidelines to facilitate the development of borderline personality disorder services would be recommended, as well as the validation of rehabilitation programs and brief treatments.