​Read our letter to the next Director of the National Institute of Mental Health (NIMH) with suggestions regarding Borderline Personality Disorder (BPD) research. This letter is in response to the email “Request for Information” from NIMH asking stakeholders to give their perspective on the state of mental illness research.
Families for Borderline Personality Disorder Research June 21, 2016

Introduction Borderline personality disorder (BPD) is a very significant mental disorder present in up to 5.9% of the U.S. population.

  • Noting this broad impact and its past neglect, Congressional House Resolution 1005 designates May as Borderline Personality Disorder Awareness Month.
  • The Resolution states “Whereas, despite its prevalence, enormous public health costs, and the devastating toll it takes on individuals, families, and communities, BPD only recently has begun to command the attention it requires.”

It is imperative that the root cause of BPD be addressed through research to achieve urgently needed advances in prevention, recovery and cure. Background 1. There is a gap between NIMH funding for BPD and the research required.

  • Although BPD is a serious disorder with higher prevalence than any other major mental illness, it receives less funding; BPD funding is <$5M, only 2% of that of depression (~$260M) (Insel, T., The anatomy of NIMH funding.” White paper, 2015: Fig. 4.).
  • Without funding, the pool of BPD researchers is shrinking. Senior investigators are retiring without a new generation of young investigators to replace them or ensure continuing breakthroughs in this disorder — which is still not well understood.

2. Officials at NIMH report they are not receiving enough meritorious applications to warrant more funding. In turn, BPD researchers have an impression that NIMH will not fund BPD research, so they submit grant applications for other illnesses. 3. In 2011 Families for BPD Research (www.FamiliesforBPDresearch) was formed, partnering with the Brain & Behavior Research Foundation (BBRF) to fund grants for young investigators in BPD research.

  • From 2012 to 2015, seven young BPD investigators were selected by the prestigious BBRF Scientific Council to receive grants for research topics that included neurobiological differences between BPD and bipolar disorder, use of magnetic seizure therapy for treatment of suicidality in BPD, and epigenetic effects of Dialetical Behavior Therapy on genes suspected to be involved in BPD.

Suggestions NIMH needs to increase BPD research and better inform the public about this crippling and often undiagnosed disorder.

  • Reach out to BPD young investigators by offering BPD-specific RFAs, encouraging more applications, potentially increasing the number of YI’s in the field, and counteracting the impression that NIMH will not fund BPD research.
  • Work to increase funding of BPD from less than $5M to a level more in line with other major mental illnesses such as PTSD ($50M) or bipolar disorder ($100M).
  • Improve public service and perception by updating NIMH website information on BPD; although BPD is the most viewed health topic on the NIMH website (NIMH webmaster, 2014), the latest scientific articles on the BPD webpage date to 2008.

Summary Millions suffer from BPD. Suicide, self-harm, substance abuse, unemployment, and emotional misery are widespread. Social and mental health services, emergency rooms and the legal system are each heavily impacted. Although there are evidence-based treatments, diagnosis is still difficult and recovery illusive. Only research in BPD will provide answers, leading to prevention, recovery and cure.

Download a copy of this letter.