BPD diagnosis being used by hospital to deny treatment.

[joeflood]

Our 21 year old daughter is under normal circumstances a beautiful, kindly, intelligent and popular girl with no obvious problems. However since the age of 17 she has been subject to shortish psychotic episodes of the most extreme kind, the kind which in less enlightened days might have been called "demonic possession". In the USA several hospitals have diagnosed her as bipolar with episodic psychosis, taken into hospital, treated for about a month and put back into the community where she has functioned normally for nine months or so.

However after coming to Australia over two months ago she almost immediately fell ill, and was diagnosed with BPD. Her care plan, for which we were not consulted or given a copy, says she is "not to be admitted to hospital in emergency situations". So she has systematically been denied treatment and grudgingly admitted only after extended forceful arguments by us, the police and the community sector. They usually take her into Emergency and throw her back on the streets in an hour, completely out of her mind. Frequently they call the police to remove her. Typical statements "hospital is for mentally ill people and she has BPD", "if she was going to k*ll or seriously injure herself she would have done it by now, she knows exactly what she is doing" "laymen might well think she is insane but we are doctors and we know".

This is to a girl who cannot recognise her own mother except sporadically, is completely dissociated and mostly unable to respond to commands, is having auditory and visual hallucinations, throws off her clothes and walks down the middle of the busy road. The police have picked her up about ten times now, and she has had five ambulance trips to hospital; where of course they just release her. We have been evicted because she broke five windows trying to escape, and attacked me biting and spitting. We have been threatened with much worse by the landlord if the police should be called here yet again.

Under the Australian system she is not allowed to go to any hospital except this one, her regional centre.

Has anyone else had a situation where hospitals have systematically denied treatment because of a BPD diagnosis and deliberately allowed psychotic patients to wander the streets in grave danger, despite the vociferous opposition of parents, the police and public?

[NikNik]

Hi @joeflood 

Welcome to the forums. I'm sorry such a devastating situation is what has  brought you here

Unfortunately, I haven't heard of such an instance. I know some members of the forums who are carers and may have some advice about carers' rights. Maybe Jo, @Alessandra1992

@Brodie gave some helpful tips about BPD that you might find helpful. The post can be found here

You mentioned that your daughter was previously diagnosed with Bipolar. Do you have a gut feeling either way about whether she does  have BPD or bipolar. I'm not sure if getting a second opinion is possible or if it would make a difference - but it is common (& frustrating) that diagnosis can change. I think this is an experience @waves had, where the person they care for had a diagnosis change between personality disorder and schizophrenia.

I will look into some support services that may be helpful for you and get back to you tomorrow.

In the meantime, if any other members have experience in this area, please jump in.

Nik

[Alessandra1992]

I think BPD is often used to deny treatment,as is antisocial disorder.
Very tricky and upsetting for all of you, especially your daughter.
If you are in Melbourne though, there is a great service called Spectrum that has been using ACT, acceptance commitment therapy and getting great results for people with a diagnosis of BPD.
There are also support groups available if you call Spectrum, I have heard there is one running in Footscray.
If your daughter does not identify with BPD and identifies more easily with bipolar, there's a group called the bipolar babes also running in Melbourne.
If your daughter says why would I want to attend any group at all, yuck groups suck..well maybe you could ring spectrum and seek out a psychologist who might be able to help your daughter.
Me, I went to grow and got well but grow is what worked forme..there are many different types of groups that might help normalise what your daughter is going through..
For yourself, well I attend grow better together as well as am a carer too..but other organisations such as ARAFEMI, Tandem, MIF, Mind I think also offer carer supports..

On another tangent entirely, there are also mental health community support services that you can ask your daughter to be referred into. Many offer youth outreach services, such as cohealth and mind.. You might need to ring a centralised. Intake and assessment number, which depending on where you live will be run by NEAMI, EACH or other services.
Just google Mental Health Community Support a Services Intake and Assesment or rung tandem.I am sure they will be able to give you some good advice and help.

[Brodie]

I'm not a doctor, but that does not sound like BPD to me. BPd is a pattern of behaviour and thinking over an extended period of time, it shouldn't be diagnosed when a person is in crisis, as their baseline would need to be monitored for the personality "issues".

BPd is highly stigmitised and the Australian system is well...crap for the most part in handling it. Do you have private health insurance which covers psychiatric hospitalisation? If not, I would suggest HCF. There is a private clinic in Sydney that treats BPD on an inpatient basis...I'm trying to find it now, but otherwise there is The Hills Clinic which treats psychotic disorders and bipolar, there is also Northside Clinic in Sydney which is quite good, St John Of God Burwood Hospital specifically states on their website they treat BPD, and South Pacific Clinic...links to the websites of these units are below.

I would encourage you to look into these inpatient units and also look into having your daughter assessed by the Black Dog Institute (link for them also below). It would definitely be beneficial to get a second or third opinion on your daughters diagnosis...particularly from someone who states they treat adolescents who have psychotic disorders. I would encourage you to talk to The Black Dog Institute about finding a good psychiatrist who may be appropriate in your area.

As for your daughters poor treatment, next time you need help and you are refused, tell them if they do not take her and get her back to sanity, you will contact the Ombudsman with your daughters high risk information and their failure to adhere to their duty of care for patients. 

Remember you have a right to a referral. If the psychiatrist/psychologist/whoever that is treating your daughter you believe is not doing their job, request a referral. That is your right. If they refuse, again tell them you will contact the ombudsman if they do not give you a referral to another psychiatrist who treats psychosis disorders.

Hope this helps!

http://www.thehillsclinic.com.au/

http://www.northsideclinic.com.au/Our-Programs/clinical-services.aspx

http://www.sjog.org.au/hospitals/burwood_hospital/hospital_services/inpatient_programs/personality_d...

http://www.southpacificprivate.com.au/

http://www.blackdoginstitute.org.au/

[NikNik]

@Alessandra1992 @Brodie are like human directories 🙂 Thank you both!

As Sandy mentioned, Spectrum is one of the more common organisations who work specifically for and with people with BPD - they run a variety of programs and also help with advocacy. Another good contact could be the Australian BPD Foundation I hope with (or both!) of these organisations can assist you.

Both have offered some great referrals.

Because your daughter is under 25 and still considered a 'young person' you could also utilise Headspace

I think your perseverance and determination is to be admired.

I hope you keep visiting the forums and keep us updated. You have lots of support and encouragement here waiting for you if you need it.

Take care,

Nik

[Alessandra1992]

Great list of resources for NSW...

[Brodie]

headspace don't really treat people who have "severe" mental illness, it is more so the mild to moderate...but some clinics including Melbourne and soon the Gold Coast will have psychosis programs which will include outreach. I am unsure about other headspace centres and whether or not they are having the psychosis programs yet.

[Brodie]

Melbourne has Spectrum, on the Gold Coast there is Currumbin Clinic although I would not recommend it for much inpatient treatment as the program seemed lacking when I was there, Brisbane from what I've heard isn't great, Canberra has Hyson Green which is a fantastic inpatient unit but I don't believe appropriate for this situation as it is in open ward with bush land surrounding it and if patients are severely unwell they are sent to the crappy lock down ward. Most of the people I have met had actually travelled from hospitals in states outside of NSW to get to the Sydney clinics because elsewhere just wasn't great.

Most of the people I have known and spoken to have been treated in Sydney as it seems to have the best clinics...this includes people I've met from Perth, Melbourne, Brisbane, Gold Coast, Newcastle, Western NSW, regional Victoria...I am only comfortable recommending places I know people have had success with...Hence my list being primarily Sydney clinics. 

[Alessandra1992]

Orygen Youth does, they are located in Parkvilke and I think Footscray Hospital. Orygen is clinical, headed by Patrick McGorry. Has peer programs like Platform. Youth Residential Support Services are are available through Cohealth, located in St Albans, Reservoir and Essendon.Contact Neami Intake and Assessment. Cohealth also offers youth outreach services. There are also youth residential support services I think in Bsyside suburbs and Voyager rings a bell, possibly a Mind residential service?

Eheadspace online also good as are hearing voices groups, Google voices Vic, then group listings..

[Alessandra1992]

Main thing is, young people are getting help and you might have to make a lot of noise sometimes to get it..
Spectrum however is exceptional with BPD..