Staff and client perspectives of the Open Borders programme for people with borderline personality disorder

Abstract

In recent years, there has been a move away from the medical model of care for people with borderline personality disorder, as hospital admission comes with a number of risks and potential adverse consequences. Although long-term outpatient-based therapy is successful, this may not be an option for those whose condition is in need of stabilisation. Brief admission for crisis intervention has been successful and is now widely used; however, research that examines both the staff and clients' perceptions of a dedicated programme is lacking. Open Borders is a residential recovery-oriented programme that provides brief admission, respite, and phone coaching for people with borderline personality disorder who are heavy users of the public mental health system. In this paper, the authors report the perspectives of clients and staff of the Open Borders programme obtained through semi-structured interviews. Thematic analysis of client and staff perspectives identified four common themes: 'Benefits of the programme', 'Enhanced client outcomes', 'Impact of the physical environment', and 'Ways of enhancing service delivery'. In addition, analysis of the staff perspectives included the theme 'Emotional impact on staff'. Benefits of the programme included the small supportive team approach, flexibility of the staff to spend time with the clients to tailor care, and the relaxed, welcoming environment. Enhanced client outcomes included a reduction in self-harming and hospitalization and an increase in self-efficacy. These results support the move away from the medical model and the empowerment of clients to self-manage their symptoms while fostering hope and self-determination.

Living with personality disorder and seeking mental health treatment: patients and family members reflect on their experiences

“…Consumers also described creating safe places separate from the emergency department, such as voluntary residential or drop-in programs. Previous research indicates that residential programs may be a beneficial alternative to the emergency department for consumers with BPD [34]. Investigating the carer perspective of alternative safe places and respite options could also be important.…”

Exploring recovery‐focused educational programmes for advancing mental health nursing: An integrative systematic literature review

“…2015; Mortimer‐Jones et al . 2019). However, the data analysis in one qualitative study lacked methodological rigour (Felton et al .…”

Mental health nurses' experiences of implementing a model to facilitate self‐empowerment in women living with borderline personality disorder in South Africa

“…The following are examples of nursing models that have been implemented and evaluated. Mortimer‐Jones et al (2019) conducted a study where they implemented and evaluated an Open Borders program. The Open Borders program provides brief admission, respite, and phone coaching for people with BPD who are heavy users of the public mental health system (Mortimer‐Jones et al, 2019).…”

“…Mortimer‐Jones et al (2019) conducted a study where they implemented and evaluated an Open Borders program. The Open Borders program provides brief admission, respite, and phone coaching for people with BPD who are heavy users of the public mental health system (Mortimer‐Jones et al, 2019). This program was evaluated by the patients diagnosed with BPD and the nursing staff caring for patients diagnosed with BPD.…”

“…This program was evaluated by the patients diagnosed with BPD and the nursing staff caring for patients diagnosed with BPD. This model was deemed successful because the patients reported using alternative coping mechanisms rather than self‐harm, and the nursing staff reported improved relationships between them and the patients (Mortimer‐Jones et al, 2019).…”