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The state-wide BPD Collaborative (BPD Co) initiative has been developed in response to the demonstrated need for enhanced, evidence-based borderline personality disorder (BPD) service development in South Australia, tailored to the needs of consumers, carers and clinicians.
BPD Co operates as a stepped model of care, and will be implemented in a staged approach via a hub and spoke arrangement of services. Stepped care is described in the National Health and Medical Research Council BPD guidelines as ‘beginning with the least intensive treatment that is likely to be effective, then monitoring response to increase or reduce the intensity of the intervention according to the person’s needs’.
The hub and spoke service model will facilitate the operation of an integrated BPD service across South Australia, offering consistent, high-quality care close to where people live. The hub or central office will be located on the fringes of Adelaide, while the spokes refer to the public health BPD services located across South Australia’s local health networks (LHNs). In this model, hub clinicians become agents of BPD clinical and cultural change by promoting and facilitating evidence-based BPD service development in the LHNs, as well as offering direct therapy for consumers with the most severe and complex BPD.
This integrated system of care will also interface with a range of private practitioners and community-based services, including non-government organisations and Primary Health Network-funded services
The state-wide BPD service will include direct clinical care focussing on people with severe and complex BPD, family and carer engagement, early years and new mothers program, a young people’s program, a criminal justice program and a program focussed on the needs of Aboriginal people.
Evidence-based care initiatives will be developed, including the pilot of acute crisis Assessment and Brief Intervention Clinics. These clinics will be modeled on the Gold Card approach developed in New South Wales by Project Air and will be evaluated locally, with a view to rolling them out across the local health networks.
There will be an expansion of evidence-based group therapies and further development of clinical pathways and therapeutic options for people with the most complex and severe BPD.
In addition to these BPD clinical services, a dedicated training coordinator leads training and capacity-building across the state, while research and evaluation processes are led by the research lead and facilitated by the hub research project officer. This will ensure commitment to quality assurance processes and encourage innovation within an evidence-based framework.
Outcomes to be achieved over time include:
Common terms and acronyms associated with Borderline Personality Disorder