Borderline personality disorder and its impact on public health: population health and healthcare models from work-based learning and practice

Introduction: Despite extensive research on borderline personality disorder (BPD) and its implications for public health, a cohesive theoretical framework integrating behavioural and general health models to amalgamate data from various fields re-mains absent. I propose that practitioner-researchers with direct engagement in their respective settings and target populations should formulate theories based on their experiential knowledge acquired through practice. This approach would transform everyday research outcomes into actionable healthcare strategies, enhancing lives through research endeavours. Understanding practice-based research is most effectively achieved through self-reflection and the analysis of critical incidents within work-based learning. Although BPD is the primary focus of the context statement, the theories, conclusions, and frameworks presented also apply to other mental health conditions. Additionally, where relevant, these insights can extend to clinical conditions beyond mental health, broadening their applicability.

Methods: I employed grounded theory alongside the meta-synthesis of my published works on BPD, work-based learning, Eraut’s Tacit Knowledge, and Kolb’s Reflective Learning theories, as well as ethnographic-naturalistic research methodologies to generate middle-range theories, overarching concepts, and recommendations for future research that can ultimately inform public health strategies. A review of eleven of my writings on BPD enabled the construction of a conceptual and practical model concerning health and population health behaviours, emphasising practical implications.

Results: My theoretical constructs and reflective practice about BPD, bolstered by direct work experience and serendipitous learning opportunities, led me to conclude that early disruptions in attachment (between a child and their parents), instances of child abuse, and exposure to violence may precipitate health and social vulnerabilities in adulthood. Traumatic bonding experiences during early childhood and adolescence can have a detrimental impact on resilience and health behaviours in the face of social, emotional, and biological challenges. The interconnectedness be-tween population and individual health significantly influences regional and global human and logistical healthcare resources.

Conclusions: The limited generalizability of my findings, derived from work-based research, constrains my methodological approach. Nevertheless, this framework can motivate practitioners to leverage their tacit knowledge and experiential learning, thereby becoming change agents capable of disseminating their findings through practical theories and strategies. Professors Elda Nikolou-Walker and Liang Liu at Middlesex University provided invaluable insights that deepened my understanding of global health challenges and facilitated my professional development through the context statement.