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Management Strategies To Minimize Suicide Risk in Borderline Patients

Management Strategies To Minimize Suicide Risk in Borderline Patients


Patients with borderline personality disorder (BPD) can present with multiple crises and minor incidents of self-harm or threats, but determining when the actions are true cause for concern can be a challenge. Assessing the patient’s current state of being, recent stressors, alcohol misuse, and support system can inform the health care provider about immediate risk. Similarly, below are suggested strategies that psychiatrists in various roles can employ to help reduce the risk of suicide. This Tipsheet is for quick reference only and not a replacement for the psychiatrist's experience and training, which are at the heart of what determines the severity of a psychiatric patient's condition. For further information, see Managing Suicide Risk in Borderline Personality Disorder Distinguishing Real Risk From Attention Seeking, from which this Tipsheet is adapted.

TIPSHEET: Management Strategies To Minimize Suicide Risk in BPD
Consultant to the Emergency Department
• Look for triggers of suicidal ideation or behavior, especially abuse, separation, or loss; are these time-limited or on-going? Ask yourself what has changed between the time of the overdose and the present to lower the risk of suicide? Consider hospitalization if there have been no changes.

• When eliciting the history, look to see whether the patient is placing blame for current difficulties onto self or onto others: the first is strongly suggestive of the guilty perpetrator state and higher suicide risk; the second is suggestive of the angry victim state and lower suicide risk.

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