Why you should read this article:

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To learn about the structured clinical management model for treating people with borderline personality disorder (BPD)

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To acknowledge the need for community-based crisis interventions in BPD to avoid hospital admission

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To read about a ‘managing distress pathway’ developed by a home-based treatment team for people with BPD

Structured clinical management is an evidence-based intervention for people with borderline personality disorder (BPD). There is a lack of evidence on crisis interventions for people with BPD, who are often admitted to hospital or supported in emergency care settings when they present with acute mental health needs. The home-based treatment team (HBTT) at an English NHS mental health trust undertook a pilot service improvement project in which they designed a ‘managing distress pathway’ – a crisis intervention for people with BPD adapted from the structured clinical management model. A small-scale evaluation of the project found that, after the intervention, patients spent less time in hospital and staff’s skills and confidence in supporting patients had improved. Patients reported high levels of satisfaction with their care. By using the principles of structured clinical management within an HBTT, non-specialist mental health practitioners can deliver effective community-based crisis interventions for people with BPD.