The availability of dialectical behavior therapy in partial hospitalization and residential services for borderline personality disorder: An exploratory longitudinal study of the National Mental Health Services Survey from 2014 to 2021.

What is it about?

We used the National Mental Health Services Survey (NMHSS) data to examine the availability of DBT for BPD in residential and day-treatment services in the US over time. Specifically, we investigated whether the availability of residential and day-treatment DBT care was increasing over time or not. We found that yes, since 2014, access to residential and day-treatment care in DBT in the US has been growing. However, we also found that residential and day-hospital facilities who accepted state-insurance benefits were significantly less likely to offer DBT.

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Photo by National Cancer Institute on Unsplash

Photo by National Cancer Institute on Unsplash

Why is it important?

Our results suggest that DBT, one of the evidence-based treatments for BPD is less available and thus more difficult to access for those patients reliant on Medicaid for residential and day-treatment. This is important because it suggests that patients may not have opportunities to access care that are gravely needed. In addition, dialectical behavior therapy was the only treatment that was tracked in the National Mental Health Services Survey, despite the existence of several evidence-based approaches to BPD, including transference-focused psychotherapy, mentalization based therapy, and schema therapy. We need more research on these other approaches and whether they too are being implemented across the United States. In short, greater research and access is needed, particularly with low-income communities attempting to access treatment for BPD.