Personality Disorder?

Understanding and treating individuals who have a combination of borderline personality disorders, self-injurious behaviours and sometimes suicidality, presents one of the most confusing and problematic challenges to mental health professionals. While the use of mental health legislation for this group is considered unusual, guardianship legislation in Australia is sometimes additionally utilised. To date, there has been no examination of the effectiveness of guardianship for people with borderline personality disorder in the Victorian context. This study aims to examine the role of guardianship for this population by assessing the contributing factors that led to the appointment of a guardian including the mental health responses prior to a guardianship application being made, subsequent service responses provided and finally to enhance current knowledge by determining whether guardianship is an effective intervention. This research has two phases. Phase one assessed guardianship as an intervention by the examination of case materials held by the Office of the Public Advocate. In phase two some participants from phase one were interviewed to elicit their experience of such an intervention. Findings indicated that the combination of high level self-injurious behaviours and refusal of treatment led to the appointment of a guardian. Service and system responses were quite diverse for this cohort, particularly regarding the ongoing provision of case management. Empathic responses were often not forthcoming from health professionals. Combined results indicated that advocacy rather than guardianship was more beneficial. Recommendations to improve the legal and healthcare framework are suggested