Treatment Availability for Borderline Personality Disorder

All responses are anonymous and there is no information specific to you that would identify you as the respondent.

Thank you so much for your support in this effort.

* 1. I have borderline personality disorder

* 2. I am answering this survey as a family member.

If no, skip to Question #4

* 3. My relative is my:

* 4. If you are answering this survey about yourself, please answer the following 10 questions.

If you are answering this survey about someone else, your relative/other person, please SKIP the next 10 questions and answer questions 15-25.

I have been in treatment for BPD for:

* 5. I live in-----please name city/town and state

* 6. There is treatment for BPD within

* 7. I have had inpatient psychiatric admissions

* 8. I have been refused admission to a psychiatric hospital. If no, skip to Question #10

* 9. The reason for not admitting me to a psychiatric hospital.

* 10. I have been in the following treatments

* 11. I am currently in

* 12. In general, I have been pleased with the treatment I have received

* 13. I feel that when I seek treatment for BPD, I am easily able to get into treatment

* 14. I feel that I have been discriminated against receiving treatment because of my symptoms

* 15. My relative/friend was or has been in treatment for BPD for:

* 16. My relative/friend lives in

Please name city/town and state

* 17. There is treatment for BPD within

* 18. My relative/friend has had inpatient psychiatric admissions

* 19. My relative/friend has been refused admission to a psychiatric hospital. If no, skip the next question

* 20. The reason given for not admitting my relative/friend

* 21. My relative/friend has been in the following treatments

* 22. My relative/friend is currently in

* 23. In general, I am satisfied with the services that have been available for my relative/friend

* 24. As a family member/friend, I feel that I have needed support and/or services for myself

* 25. There are supports/services available to me as a family member/friend of a BPD sufferer

* 26. My age is

* 27. If it is your relative that has the disorder, the age of your relative is -------

* 28. If it is your relative that has the disorder, how does your relative spend the day. e.g. job, stay-at-home mother, day treatment program, without any structured activity.

* 29. If it is your relative that has the disorder, please estimate about how many years your relative has had the disorder. ------- years

* 30. Please feel free to add any information you feel is relevant in explaining your experience in finding available treatment for BPD either for yourself or your family member or friend.

* 31. If you have attended any conferences, workshops or family programs specific to borderline personality disorder, please list them here..

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