Improving care and reducing stigma for borderline personality disorder: Stakeholder engagement to develop a research plan to evaluate a peer support intervention

Borderline Personality Disorder (BPD) is a complex mental health condition associated with high rates of self-injury and suicidal behaviours. BPD is estimated to affect over 200,000 adults in BC. People with BPD experience challenges in accessing and engaging with mental health services due to high levels of stigma among mental health clinicians, frequent misunderstanding or misinformation about their diagnosis, inadequate access to evidence-based outpatient programs, and perceptions by clinicians and people with BPD that psychiatric care will not be effective. Together, these experiences often result in feelings of demoralization, hopelessness, and reluctance to engage with mental health services.

Peer support for people with mental health issues can improve their healthcare experiences and quality of life. However, a recent systematic review concludes that further research is needed to evaluate the effectiveness of peer support interventions. This project’s purpose is to bring together people with lived experience of BPD, mental health clinicians and decision-makers, and health researchers to lay the groundwork for a pilot trial to evaluate a peer support intervention for adults with BPD.

The activities will have three phases.

• Phase 1 will consist of reviewing and summarizing evidence for peer support interventions.
• Phase 2 will be gathering input on the needs and priorities of stakeholders to inform the peer support intervention.
• Phase 3 will be developing a research plan to assess the feasibility and effectiveness of the peer support intervention.

These activities will achieve four outcomes. They will:

1. Build research capacity in our team through training, co-development of the research plan, and collaborative grant writing.
2. Increase knowledge of community priorities and needs of people with BPD.
3. Create and summarize knowledge to guide decision-making around peer support interventions for people with BPD.
4. Instill hope in people with BPD that community input will guide care improvements.

Significant commitments from each of the stakeholder groups support the feasibility of this work. The patient-led approach ensures activities will reflect the priorities of people with BPD and their families. This work strongly aligns with the BC Health System Priority of improving care for people living with mental illness.