The experiences of people with borderline personality disorder admitted to acute psychiatric inpatient wards: a meta-synthesis

Abstract

Background: Acute psychiatric inpatient care is recommended for people with borderline personality disorder (BPD) to manage a crisis. Qualitative research exploring service user experience is valuable for the development of evidence-based treatment guidelines.

Aim: To conduct a meta-synthesis of qualitative research exploring the experiences of people with BPD on acute psychiatric inpatient wards.

Methods: Literatures searches of five electronic databases. Data were analysed using a three-stage theme identification process.

Results: Eight primary studies and three first-hand accounts met the inclusion criteria. Four overarching themes were found to explain the data: contact with staff and fellow inpatients; staff attitudes and knowledge; admission as a refuge; and the admission and discharge journey.

Conclusions: Similar experiences of acute psychiatric inpatient care were reported by people with BPD across the studies. Opportunities to be listened to and to talk to staff and fellow inpatients, time-out from daily life and feelings of safety and control were perceived as positive elements of inpatient care. Negative experiences were attributed to: a lack of contact with staff, negative staff attitudes, staff’s lack of knowledge about BPD, coercive involuntary admission and poor discharge planning.

Keywords:

• borderline personality disorder
• acute psychiatric
• meta-synthesis
• qualitative
• systematic review
• lived experience
• inpatient
• narrative accounts
• health services research
• crisis intervention