# MHApps BPD Be Aware Of Hospital Limitations BPD EUPD GP Health Professional

8 Hospitalisation
GP

- 8. Be aware of the limitations of hospitalisation Admitting an individual with BPD / EUPD into hospital when they are expressing suicidal ideation can make their long term prognosis worse - it has been shown that admissions statistically increase the probability of successful suicide in the future. Admission reinforces the belief that they are sick and it is someone else's responsibility to make them better. It has been shown to increase regression and passivity and decrease autonomy, and it identifies the hospital, and by default you, as the rescuer. There is also the possibility of a contagion effect with increased risk of more extreme behaviour and evidence that hospitals can actively re-traumatise already vulnerable individuals.
  Working with this group of patients is often about taking short term, clinically indicated risks for long term benefits, although knowing that may not necessarily help you with the anxiety you experience in not sending them to hospital. If you dont have a sense that your anti-suicide strategies have made an impact, or that your patient has connected with you into the future, then the first step should be to involve the community mental health service for assessment. This avoids the expectation from the patient that they will automatically be admitted. It also usually saves considerable time waiting and gives you the benefit of an experienced mental health opinion.

8 Hospitalisation
GP