Citation

Vandyk A, Bentz A, Bissonette S, Cater C. Int. J. Ment. Health Nurs. 2019; 28(3): 757-765.

Copyright

(Copyright © 2019, Australian College of Mental Health Nurses Inc., Publisher John Wiley and Sons)

DOI

10.1111/inm.12580

PMID

30779279

Abstract

Through this qualitative study, we explored frequent emergency department use by persons with borderline personality disorder from their perspective. Interpretive description guided the study design, and data were collected through interviews with six individuals diagnosed with borderline personality disorder who had at least 12 emergency department visits for reasons related to their mental illness within a 1-year timeframe. Using thematic data analysis, we articulate the participants' experiences through two broad themes: cyclic nature of emergency department use and coping skills and strategies. Unstable community management that leads to self- or crisis presentation to the emergency department often perpetuated emergency department use by our participants and the ensuing interventions aimed at acute stabilization. The participants identified a desire for human interaction and feelings of loneliness, failure of community resources (such as crisis lines or therapy), and safety concerns following suicidal ideation, self-harm, or substance use as the main drivers for their emergency department visits. Our participants identified several potential strategies to protect them against unnecessary emergency department use and improve their health care overall. More work is needed to explore the viability and effectiveness of these suggestions.

Language: en

Keywords

Humans; Adult; Aged; Female; Male; Middle Aged; Qualitative Research; Young Adult; Interviews as Topic; emergency department; Emergency Service, Hospital; borderline personality disorder; Patient Acceptance of Health Care; Borderline Personality Disorder; experiences; mental health and illness; interpretive description