Thanks Dancing lady and Lilodian.

I wish that intensive psychotherapy would be broadly made available at free or very low cost to people who roughly meet BPD criteria..

People say, "Oh this is too expensive and will never happen." It may not happen soon in the USA, but I'd argue that the economic issue should be framed as followed: With people labeled BPD, the lost productivity related to inability to work full-time, inability to get better degrees/job training, cost of federal-state disability programs for related diagnoses which cost taxpayers, hospitalizations, medications, etc.... all of these things which result from severe borderline symptoms have to be measured over a lifespan for each person of decades. These lost productivity costs and the disability costs for BPD must be enormous, perhaps hundreds of thousands of dollars per person over a life-span.

However, if intensive 2-3x weekly psychotherapy could be provided for 3-5 years to BPD patients, much of these lost productivity and disability costs could be avoided. But, for short-sighted political reasons, and for reasons related to drug companies' need to profit from managing emotional problems via palliative pills rather than by providing emotional help that can cure... for these reasons, it is somewhat unlikely, at least in America, that things will change.

Here is an example of the cost analysis:

JAMA Network | JAMA Psychiatry | Outpatient Psychotherapy for Borderline Personality Disorder: Randomized Trial of Schema-Focused Therapy vs Transference-Focused Psychotherapy

This study shows how, when a large group of about 90 borderline patients were given free twice-weekly psychodynamic psychotherapy for three years, a majority of them no longer met criteria for BPD by the end of the study, many considered themselves "recovered", and society actually saved money compared to "treatment as usual" (meaning brief hospitalizations, medications, and no intensive therapy).

(Quote below is from this link) Major Outcome Study

The authors said, "Although the treatment involves many sessions over three years, schema therapy is nevertheless cost-effective. An economic analysis conducted by the authors of the study (not included in the Archives article) indicated that, for each year schema therapy patients were in the study, Dutch society benefited from a net gain of 4,500 Euros per patient (the equivalent of about 5,700 US dollars), despite the cost-intensive treatment. The savings over the course of several years after the completion of treatment could actually prove to be higher.

Schema therapists and researchers are hoping that this validation of the effectiveness of Schema Therapy for patients with Borderline Personality Disorder -- that for so many years has been considered intractable - will lead to more research studies and will encourage more clinicians to learn Schema Therapy. They also hope that this study will convince healthcare insurers to reimburse for the costs of effective longer-term psychotherapy for this painful and costly illness."

I hope that people will start asking their elected representatives to do something about this, whether or not it makes a difference right away. In my opinion we are lagging behind some northern European countries which are starting to provide more intensive treatment for "borderline" conditions, and are both helping people and saving money as a result.