Borderline Personality Disorder Services

For over 25 years, St Andrew's has specialised in caring for people with complex Personality Disorders.

These services include a male Low Secure Mental Health/Personality Disorder service in Essex and a full female Personality Disorder pathway in Northampton, consisting of Medium/Blended Secure services and our specialist rehabilitation comprehensive Dialectical Behaviour Therapy programme.


What is Borderline Personality Disorder?

Borderline Personality Disorder is a disorder which is marked by emotional instability, difficulties, challenges in relationships, challenges around your sense of self, thoughts and cognitions, and challenges around being able to tolerate distress, so acting in impulsive ways. Self-harming behaviours, challenges around disordered eating, substance misuse are common. 

Personality Disorders are persistent, pervasive and problematic.

Persistent in that they have persisted through often adolescence and into adulthood. Pervasive in that they run through all walks of an individual's life. It's not just a home problem or a work problem. And problematic in that they cause problems not just to the individual but they cause problems to other people as well.

What we know about borderline personality disorder and it's causes is that there is a biological vulnerability and environmental challenges that interact so that a person living with a personality disorder learns to stop trusting the emotion and starts seeking external views about how it is that they should feel. For a person living with complex a personality disorder, environmental factors which have influenced their emotions and how they interact with the world commonly include sexual abuse, and violence within the house. It is known that 70% of all people with a diagnosed personality disorder have had some form of significant childhood trauma. 


How we care for people with Borderline Personality Disorder

We offer specialist comprehensive Dialectical Behaviour Therapy (DBT) programmes for women over the age of 18 with a diagnosis of Borderline Personality Disorder (BPD) including those often have a coexisting diagnosis of Complex Post Traumatic Stress Disorder (CPTSD).

Often women referred to our services have additional complex mental health needs, risky behaviours that can be challenging to appropriately support in community settings, and significantly impaired functioning.


Treatment and care

Dialectical Behaviour Therapy (DBT) is an evidence-based therapy developed by Dr Marsha Linehan in the 1980s. It was originally designed to treat individuals with Borderline Personality Disorder but has since been adapted for a range of mental health conditions. DBT combines elements of cognitive behavioural therapy (CBT) with concepts of mindfulness and acceptance. It operates on the dialectical principle, which means balancing opposing ideas or concepts. In DBT, this often involves finding a balance between acceptance and change.

Our treatment programme on Silverstone includes all five functions of a comprehensive DBT programme:

  • Enhancing capabilities
  • Enhancing motivation
  • Ensuring generalisation
  • Structuring the environment
  • DBT consultation. 

Our DBT provision includes a combination of group, 1:1 therapy and out of session skills coaching for patients (Stage 1 DBT). Patients are divided into two DBT group cohorts depending on progress, a Skills Acquisition Group and a Skills Generalisation Group.

Women who present with ongoing trauma symptoms are offered evidence based trauma interventions following an assessment for suitability once behavioural control has been established (Stage 2 DBT).

To find out more view our Silverstone ward page.

A life worth living

"I would like people to understand that mental illness affects anyone, It doesn’t just affect a certain type of person. Just because you’ve got a mental illness it doesn’t define you as a person, it’s just a part who you are. I’m not Kayleigh because I have a disorder, I’m Kayleigh because I am person and I like horse riding and football.” Kayleigh, 25 years

Kayleigh lives with Borderline Personality Disorder, impacted by childhood trauma. She talks about her time at St Andrew's and how, through working with our expert staff, she has been able to understand and develop the skills to live well with Personality Disorder.

Kayleigh has ambitions to become a Chef and go to College and at St Andrew's she has been able to access Workbridge, our vocational opportunities service, which works alongside a patient's treatment programme developing work and life skills for the future once someone leaves hospital.

Kayleigh also talks about the dialectical behaviour therapy (DBT) programme. She describes it as helping to slow her thoughts and give her the tools to help her think rationally about her thoughts, feelings and emotions, especially during stressful or challenging situations.

I think if I hadn't come here, I would probably be dead

Sedona was diagnosed with anorexia nervosa and Borderline Personality Disorder. She had severe self-harming tendencies, with frequent trips to NHS A&E departments and operating theatres to help save her life.

"I didn't see anyway out and I was very suicidal."

Sedona talks about a genuine kindness that she has experienced from the care team and the positive relationships she has built through her recovery. 

A full and varied activity programme has also been key to her recovery. Occupational Therapy is a critical part of our dialectical behaviour therapy (DBT) programmes, where access to activities, such as art, cooking, music, gym, swimming and sports helps keep a patient busy and aids their health and wellbeing.

I've only got support and that is something I'm beyond happy about

Saffron also struggles with borderline personality disorder and anorexia nervosa.

She was being managed in services who did not understand her complexity and support her needs, which saw her being placed on extensive periods of enhanced nursing support and constant observations.

Saffron talks about the feelings she had experienced at other hospitals and what she has experienced at St Andrew's. In nine month's at St Andrew's, Saffron has developed from 3:1 enhanced support to unescorted leave with the support of the clinical staff and by working through a structured dialectical behaviour therapy (DBT) programme.

Collaborative decision-making across the multi-disciplinary team (MDT) is also highlighted by Saffron as a positive. She says that decision making is never done in isolation and always taken based on her needs.

The DBT programmes offer women with Borderline Personality Disorder structure allowing women to explore feelings in a safe environment. Saffron praises the programme and the opportunities which have been given to her during her recovery at St Andrew's.

For the first time ever I feel good in my own skin

“I am living the life I feel I should be as the gender I should have been born. I am now eager to move on to the next stage of my life.”

Clio has received treatment in eight different mental health hospitals in just six years, but has said the only place that has helped him get better is St Andrew's Healthcare.

The 23-year-old who identifies as a male and is yet to change his name, was admitted in May 2022 having already been diagnosed with Asperger's Syndrome and Emotionally Unstable Personality Disorder (EUPD).

Having been admitted and discharged from various different hospitals, Clio had started to believe he would never get better and that his life would always revolve around his poor mental health. He said he felt hopeless and lost, constantly fighting strong urges to self-harm.

In addition to trying to understand the complex feelings he was experiencing which were associated with his gender identity, Clio had also started to restrict his food and drink intake and was hearing voices.

Clio was at breaking point, but was encouraged to start Dialectical Behaviour Therapy (DBT). In addition, he was encouraged to speak to a doctor about gender reassignment surgery and has since started the referral process.

On his darkest days, Clio says he found solace and hope from playing the piano, which Adult Education Teacher, Kelly Tracey, who works at St Andrew's encouraged. Playing the instrument took Clio away from his negative thought patterns and took him to a place of peace.

Without question DBT has saved my life. I am smiling again. I am living again

Rhiannon has been a patient at St Andrew's Healthcare for nearly two years and has come a long way in her recovery. The 22-year-old, who is originally from Ireland, started having seizures similar to the episodes experienced by those who have epilepsy. Further investigation showed they were caused by anxiety.

Her seizures, which are now very infrequent, can last from just a few minutes or several hours. She has also been diagnosed with Borderline Personality Disorder (BPD) and has been participating in Dialectical Behaviour Therapy (DBT) which she says has “saved her life”.

Estelle Randle is a Recovery College Peer Trainer and has her own lived experience of mental health struggles. She has worked closely with Rhiannon encouraging, guiding and inspiring her to engage with her treatment and keep focussed on getting better.

She is now looking towards the future and recently landed a job in the onsite café where she will be working for a few hours a week.