Experiences of consumers, carers and clinicians during borderline personality disorder presentations to the emergency department-An integrative review

Abstract

Introduction: People with a borderline personality disorder (BPD) diagnosis or symptoms may experience emotional crises which necessitate use of the emergency department (ED). No existing reviews focus specifically on experiences of consumers^a, carers^b and clinicians in relation to ED presentations by people diagnosed with BPD.

Aim/question: The aim of this study was to synthesise knowledge on consumer, carer and clinician experiences of BPD in the ED.

Method: An integrative review methodology was chosen as it best captures the complexity of varied perspectives and emergent phenomena from diverse literature sources. EMBASE, CINAHL, PsycInfo and Medline were searched for papers published before 16 February 2022.

Results: Nine papers met the inclusion criteria (five qualitative, one quantitative, one mixed methods and two letters to the editor). Key themes were barriers to timely and adequate care, and stigmatising attitudes and practices towards people diagnosed with BPD. Negative attitudes were perceived to perpetuate harmful outcomes and further ED visits.

Discussion: Predominantly negative ED experiences were expressed by clinicians, consumers and carers. Further work is needed in ED models of care and staff education to improve the experience of care for consumers, carers and clinicians alike.

Implications for practice: Opportunities for change will exist through co-designed innovation, education, advocacy and leadership.

Keywords: borderline personality disorder; caregivers; emergency department; experience of care.