Unremitting Suicidality in Borderline Personality Disorder: A Single Case Study and Discussion of Technology in Clinical Care.

CASE HISTORYAND TREATMENT This report presents the case of a young woman, “Jane.” The case is followed by commentary from three experts in suicidal or self-destructive behavior and the use of technology in clinical care. Jane is a college-aged female with a diagnosis of borderline personality disorder (BPD) and a history of repetitive self-harm, including head banging and cutting, as well as chronic, unremitting suicidal ideation. Jane had been in an intensive residential program for many months, and during this time she was stepped up to inpatient psychiatric hospitalization multiple times due to concerns about safety. Jane had a history of multiple suicide attempts while in outpatient, residential, and inpatient settings.Most of these attempts occurred on hospital units using methods like self-strangulation with available objects, self-suffocation, and self-starvation. Upon discharge from her last inpatient psychiatric admission, Jane was admitted to an intensive specialized residential program for adult women with borderline and other severe personality disorders. This unit integrates evidence-based treatments includingdialectical behavior therapy (DBT),mentalization based treatment (MBT), and good psychiatric management (GPM). The standard treatment protocol includes daily DBT diary cards, check-ins with the program’s 24-hour counselors,