Gold Card SA is a four-session structured psychological intervention offered soon after an acute crisis presentation to people with symptoms characteristic of borderline personality disorder. This study describes individual and system-level outcomes from a large-scale health-care improvement initiative to implement Gold Card SA across South Australia. An uncontrolled pre-post study design was utilized examining service user ( n = 332) patient-reported outcome measures and hospital service utilization records (6 months before and after Gold Card SA). Mixed-effects negative binomial regression analysis revealed a significant decrease in rates of service utilization across emergency department presentations (63%), mental health-related inpatient admissions (65%), and bed days (82%). Linear mixed-effect regression indicated large reductions in borderline symptoms and nonspecific psychological distress, and small to moderate improvements in psychosocial functioning. People presenting with or experiencing borderline personality disorder symptoms may benefit from a brief crisis intervention embedded within a stepped care model.
Keyphrases
- borderline personality disorder
- healthcare
- mental health
- emergency department
- sleep quality
- public health
- quality improvement
- randomized controlled trial
- patient reported
- palliative care
- high intensity
- case report
- liver failure
- study protocol
- single cell
- acute care
- intensive care unit
- chronic pain
- hepatitis b virus
- working memory
- mechanical ventilation
- health information
- neural network