Borderline personality disorder is a serious mental health disorder that affects the way that young people relate to themselves and the world around them.
It’s characterised by an incoherent sense of self, impulsive behaviours, and unstable relationships with others. Without effective support, young people with BPD may struggle to form lasting connections with others, manage intense emotions, or keep themselves safe and well.
Accessing specialist treatment is fundamental for adolescents with BPD to live a fulfilling and enjoyable life. BPD is treatable, and there are several evidence-based treatments that are proven to help young people with the disorder to manage symptoms and pursue the things they love.
However, many barriers still exist to treatment, and unfortunately, many young people still miss out on the care and opportunities that they deserve.
This blog explains why specialist treatment for young people with BPD is so important, as well as outlining some of the existing barriers to this care.
Why Is Specialist Treatment for Young People with Borderline Personality Disorder Important?
For young people living with BPD, early diagnosis and intervention are important.
Research shows that starting treatment earlier gives young people a better chance of avoiding damaging outcomes, experiencing symptoms that are more manageable, and leading independent and fulfilling lives.
However, most young people who require treatment for BPD are unable to access it – and this is particularly true of specialist, youth-specific services.
While adult treatment programs are often more accessible than youth-specific ones, young people usually require youth-dedicated services to fully benefit from treatment.
There is a widespread consensus among experts that young people should be able to access services that recognise and respond to their developmental and cultural needs. This is true for several reasons, including:
- Young people have distinct life experiences, such as moving from school to further education and taking exams.
- Teenagers’ and adolescents’ brains are still developing. This means that they may experience mental health conditions – and respond to treatment – differently from adults.
- Adolescence is a time of self-discovery and identity searching. Young people may be questioning and exploring their gender, sexuality, religion, and other core parts of their self.
Specialist youth-dedicated services for BPD are sensitive to these needs and adapt treatment programs and approaches to meet them.
They also aim to create an atmosphere that’s welcoming to young people and challenges stigma and misconceptions that may surround the disorder.
What Are the Barriers to Specialist Care for Young People with BPD?
Despite its importance, there are many barriers that make it difficult for young people with BPD to access specialist care. These barriers exist because of the way healthcare systems are set up and how young people with BPD interact with these systems.
Awareness and Understanding
BPD is one of the most under-recognised mental health disorders, both by the public and mental health professionals. This means that young people with BPD and their parents might not recognise BPD symptoms as problematic or as signs of a mental health disorder.
They may find it hard to distinguish BPD characteristics like risky behaviours or mood swings from normal adolescent behaviours, even though these symptoms are much more extreme than other teenagers experience.
Adolescents with BPD, their parents, and mental health professionals may also misunderstand or misdiagnose BPD as other mental health disorders like bipolar disorder.
Misdiagnosis may prevent or delay young people from accessing specialist BPD treatment that offers the most effective support in managing symptoms and building a stable and fulfilling life.
Lack of Expert Professionals
Compared to other mental health disorders, borderline personality disorder and its treatment are both underfunded and underresearched.
This means that there are fewer professionals with expertise in BPD than in most other mental health disorders and professionals may be less likely to identify signs of BPD in young people.
This lack of funding and research also underpins a lack of specialist services available for borderline personality disorder.
Even when the disorder is identified, there may be few suitable options available for young people, who may instead be directed towards less effective general care programs.
Service Acceptability and Stigma
When young people or their families want to seek treatment, they need to find services that are acceptable to them. Social and cultural norms, personal beliefs, and features of BPD treatment services all affect this process.
Unfortunately, immense stigma still surrounds BPD and personality disorders in general. Clinicians may have negative perceptions of people with BPD and even refuse to treat them.
When young people experience stigma trying to access treatment, they may be less likely to access services again.
Adolescents with BPD may be especially affected by stigma inside and outside of healthcare services. People with BPD tend to have an incoherent state of self and may integrate other people’s negative perceptions or criticisms into their identity. They may start to stigmatise themselves and question their worthiness to seek treatment.
Moreover, hypersensitivity to negative experiences can cause them to find these interactions even more distressing, discouraging them from reaching out for more support.
Resources and Support
Even when a young person finds specialist support that they’re willing or eager to attend, they may lack the resources or support to begin a program.
Effective treatment programs for BPD take a lot of time and even outpatient programs involve regular appointments that may be difficult for parents to fit around their work schedules.
At the same time, many adolescents with BPD lack support from family, friends, or others around them. These can happen because of stigma, misconceptions about the disorder, and or an absence of community or medical support that leaves close family members overwhelmed.
Without support from others, it can be almost impossible for young people with BPD to find the resources to reach treatment.
Absence of Specialist Services and Complex Referal Processes
There is a big global shortage of qualified practitioners and specialist services for both young people and adults with BPD.
In a recent study of 22 countries, no country had enough clinicians certified in evidence-based treatments to meet the number of people seeking treatment. They found that:
- the ratio of treatment-seeking patients with BPD to mental health professionals ranged from about 4:1 in Australia to 192:1 in Singapore.
- the ratio of treatment-seeking patients to clinicians certified in evidence-based treatments ranged from 49:1 in Norway to 148,215:1 in Mexico
Moreover, the small number of specialised services that do exist for adolescents often involve complex and inefficient processes referral processes that force young people to wait for a long time before they finally receive treatment.
Specialist programs can also be inflexible and enforce rigid timetables that may not fit around young people and their families’ needs.
The Wave Clinic: Specialist Care for Young People with BPD
The Wave Clinic offers specialist recovery programs for young people, dedicated to their unique needs. Our programs draw on expertise from around the world, led by experienced professionals who specialise in teenage and adolescent mental health care.
Our whole-person approach sets the global standard for youth-dedicated services, combining clinical excellence with education, community work, and a gap year experience.
The Wave Clinic is recognised as a Global Centre of Excellence for the treatment of borderline personality disorder by major insurance providers including BUPA, CIGNA and Allianz.
Psychiatrists and mental health professionals from global centres like London and New York consistently consider our BPD program as the program of choice for young people with a complex presentation and history of unsuccessful or partially successful treatments.
Our innovative, evidence-based approach uses relational psychotherapy to understand and overcome interpersonal difficulties, supporting young people to lasting recovery.
If you’re interested in finding out more about The Wave’s programs, get in touch with us today.