This may sound like an unreasonable suggestion due to your paranoia, but I continue to suggest (as I did with Eden) that you engage in DBT. It was prescribed after your last IP stay and it must have been for some reason. Maybe it can help you to reframe your thinking and increase your tolerance for your emotions.

Your providers seem to have a long history of not communicating with each other; I wonder if you can look for new ones? You deserve the care you need. I can't imagine that your pdoc would not immediately send you to the hospital from his/her office given your paranoia. Is it difficult for you to describe how you're feeling to him/her?

As I say, maybe the time has come to seek a different treatment team, one that communicates with each other, is more available to you, and is willing to listen to what you do and do not say.