Thousands of children and young people in the UK with serious mental illnesses are not getting the help they need because doctors view them as difficult and attention-seeking characters, experts claim.
Leading doctors are now calling for an immediate ban on young people classified as having borderline personality disorder (BPD), a condition described as emotionally unstable and even manipulative.
Experts say that despite being a recognised medical illness, the diagnosis encourages mental health staff to treat people as troublesome rather than as people in need of specialist psychiatric care.
He added that in some cases doctors ignore warnings that people with BPD are planning to self-harm or commit suicide, believing them to be “hoaxes”.
As a result, many are denied medication and counseling that could help them, even though studies show that one in ten people with BPD symptoms commit suicide.
Now hundreds of senior doctors have signed a letter to Health Minister Victoria Atkins calling for the term to be abolished. The letter warns that doctors are telling young patients they have character flaws when in fact many suffer from severe mental illnesses caused by trauma.
The letter, signed by former health secretary Sir Norman Lamb and leading psychiatrists, psychotherapists and mental health nurses, said: “We argue that until there is conclusive evidence that this diagnosis does not harm children, it should not be made in the UK.”
It is estimated that in England alone, 8,000 people are treated by the NHS for suspected BPD each year. Sufferers experience confused emotions, difficulty in control, troubled relationships and disorganized thinking. They often have a deep-rooted fear of abandonment and can act impulsively. Diagnosis is made from a list of nine symptoms; if a patient has five or more, they are diagnosed with BPD.
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An estimated 1.5 million people in the UK meet the criteria for BPD, but research has found that many mental health professionals treat them differently to people they regard as having ‘real’ problems.
In one study, researchers from the University of Wisconsin interviewed 22 psychiatrists about their views on people with BPD.
The findings, published in the journal Social Science and Medicine, found that most doctors described patients as “difficult” and did their best to discharge them from the clinic as quickly as possible.
As one researcher told the researchers, “In professional circles, borderline is often synonymous with ‘troublesome.'”
In 2022, the Royal College of Psychiatrists promoted a course for its members describing personality disorders as “a source of worry for many clinicians”.
“These people have been treated really badly,” says Keir Harding, an occupational health therapist and mental health expert who has campaigned for years to get the name BPD scrapped. “But many have lived lives of neglect, trauma and abuse, and mental health services are failing them.”
Liv Johnson, 25, from Herefordshire, knows this story: she was abused as a child, which developed into an eating disorder as a teenager, and was admitted to psychiatric care at the age of 15 after self-harming and drug overdosing.
Liv only realised doctors had diagnosed her with BPD when she received her discharge letter two months later. “I don’t recall ever being given a diagnosis related to BPD and it was never mentioned to me by staff,” she told the Mail on Sunday.
At one point, she attempted to harm herself, but emergency room staff refused to treat her because of her BPD diagnosis.
“I was told they couldn’t stitch up my wounds because I was self-harming and wanted attention from it,” says Liv, who now works as a mental health peer support worker.
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When she was 22, doctors finally changed her diagnosis to complex post-traumatic stress disorder, taking into account her childhood trauma.
It meant she could now receive the treatment she had been denied as a person with BPD.
Angela Mays, 73, from Hull, lost her 22-year-old daughter Sally to suicide in 2014 after she was refused admission to an NHS psychiatric ward despite trying to hang herself in front of staff.
A subsequent hearing revealed one of the nurses said: “Leave her alone, she’ll pass out before she dies.”
Sally, who had a history of eating disorders and depression, took her own life at home a few hours later.
Angela, a retired management consultant, claims her daughter was not taken seriously because she had been diagnosed with borderline personality disorder.
“It’s a derogatory term – most doctors think it’s a behavioural disorder. An NHS psychotherapist told me my daughter wasn’t actually ill at all, even though she had been in and out of hospital for three years.”
Dr Reid Smith, president of the British Association of Psychiatrists, said: “Caring for children with mental health problems is vital and we work with experts to ensure they receive the best possible, high-quality mental health care.”
The Department of Health and Human Services has been contacted for comment.
