The investigation will also probe systemic failures, which advocates claim have contributed to the deaths of a dozen young South Australians during the past two years.
Coroner Mark Johns confirmed to InDaily that he will examine the 2013 death of 22-year-old Miranda Howard and the 2015 death of 18-year-old Aurora McPherson-Smith in an inquest beginning Tuesday next week.
He declined to discuss the circumstances of the deaths or the reasons for his inquiries, but said he believed them necessary.
Adelaide psychiatrist Dr Martha Kent OAM says she has been called to give evidence about problems with the South Australian mental health care system, which she argues prevent evidence-based treatment for the most severe sufferers of BPD – and potentially contribute to avoidable suicides.
Treatment for BPD is available in South Australia, but is extremely difficult to access – and carers say a stigma surrounding the condition among some health professionals has exacerbated family trauma.
Kent, who was awarded a Medal of the Order of Australia for her BPD work earlier this year, was the lead author of a 2012 report warning the State Government about failures of service delivery for BPD treatment and recommending changes.
She says the State Government has failed to take any meaningful action since.
“We’ve seen no real developments – meanwhile, young people are dying,” she told InDaily.
“This is a scandal.
“The people who are most severely effected … are just not getting the service that they desperately need.
“They are the people who are very much at risk of suicide.”
She said she had identified the deaths of 12 young South Australians over the past two years, who had been diagnosed with BPD.
She believes a large-scale training program for clinicians, police and paramedics plus a state centre for excellence in BPD care, among other changes, would have helped those people receive evidence-based treatment and potentially prevented their deaths.
“We believe this to be the tip of the iceberg,” she said.
“There’s not, currently, mandatory reporting … of deaths in the context of borderline personality disorder.”
Young people (are) dying while they’re waiting for these people to make decisions.
She said a widespread, outdated view among some doctors and other medical professionals that BPD was neither a treatable nor legitimate mental illness needed to be combatted with effective education in order to save lives.
“We would support up-skilling and training around BPD across the health services, mental health services, NGOs, ambulance (service) and police,” she said.
“There are a significant number of clinicians … who, to this day, do not consider BPD to be a legitimate mental illness.
“They dismiss people with this diagnosis out of hand … they are discharged (from hospital) into an effective void, and then they re-present (to hospital, or) self-harm.
“The understanding that BPD can be treated has been available for about 20 years now.”
However, she said many South Australian clinicians did good work in BPD treatment, and wider change needed to come from the top.
She said interstate models of care had proven successful, and could be replicated here.
“The answer that we get when you talk to the Government and the representatives within the mental health services is that … they understand the seriousness of the problem, but there’s no money available,” she said.
“A decision … needs to be made at the executive levels in Health.
“Young people (are) dying while they’re waiting for these people to make decisions.”
A project steering group led by Mental Health Commissioner Chris Burns developed an action plan to improve BPD service delivery in SA last year.
The plan recommended the Government establish a dedicated treatment “hub” for the disorder, modelled on the success of a similar facility in Victoria.
Mental Health Minister Leesa Vlahos received the report in November last year, but has yet to release it.
A spokesperson for the minister told InDaily this morning: “The South Australian Government has been developing its response to (the) borderline personality disorder action plan, the details of which will be released in the coming weeks.”
“The aim is to assist recovery, improve quality of life and to minimise the personal and social impacts of people living with BPD in South Australia.
“Mental Health Minister Leesa Vlahos will meet with BPD advocates prior to publicly releasing the response.”
Readers can access support and information about mental health by calling Lifeline on 13 11 14 or the Kids Helpline phone counselling service on 1800 55 1800.
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