Loved-ones are often faced with a desire and obligation to help their loved-one with BPD.  If they don’t help, it feels like no one will.

In an uncontrollable situation where there is a mental or emotional breakdown, extreme conflict, violence, or threats of suicide, there are basically 4 options:

  1. Call 911.
    • The police will decide if the person needs to be taken to the mental health crisis centre for assessment.
    • This might result in criminal charges and cops may not be trained for this decision and process.
    • The police may agitate the person with BPD and make the situation worse.
  2. Call a crisis or suicide prevention hotline.
    • Operators at suicide prevention hotline are trained to reduce the chance of immediate harm to the person in crisis.
    • There may be a mobile mental health crisis unit that can come diffuse the situation and offer some options for the future.
    • Please click here for emergency and crisis phone numbers.
  3. Go to an emergency room.
    • Take the person to be assessed at the mental health crisis center or emergency room yourself.
  4. Go to court to obtain a Form 1.
    • A Form 1 can force an involuntary medical examination wellness check for the BPD sufferer to be unwillingly assessed by a mental health professional.
    • There is a cost to apply for a Form 1 as well as a lengthy application form.
    • The criteria judges at the Manitoba Court of King’s Bench look for are hard to satisfy, especially if the person has addictions as well as the mental illness.
    • If you are successful, the police will pick up the person with BPD and take them to a hospital to be assessed against their will, which can create an embarrassing scene and lead to resentment.

If the person in crisis gets a psychological assessment, regardless of whether it is voluntarily or involuntarily, the ER physician, psychiatric nurse, or psychiatrist are primarily trying to determine if the person is an immediate threat to themselves (i.e. a suicide risk with a concrete plan to kill themselves) or a threat to harm others, which is easy for the patient to deny if they are scared or don’t admit their problem.

The emergency room physicians only hospitalize or refer to a psychiatrist the people with the most serious mental illnesses due to a shortage of beds and a shortage of psychiatrists. They might refer the patient to an outpatient treatment program like STAT, but participation is voluntary and unlikely.