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An uncontrolled pre-post study design was utilized examining service user (n = 332) patient-reported outcome measures and hospital service utilization records (6 months before and after Gold Card SA). Mixed-effects negative binomial regression analysis revealed a significant decrease in rates of service utilization across emergency department presentations (63%), mental health-related inpatient admissions (65%), and bed days (82%). Linear mixed-effect regression indicated large reductions in borderline symptoms and nonspecific psychological distress, and small to moderate improvements in psychosocial functioning. People presenting with or experiencing borderline personality disorder symptoms may benefit from a brief crisis intervention embedded within a stepped care model. <\/jats:p>","DOI":"10.1521\/pedi.2024.38.1.87","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T16:21:13Z","timestamp":1707322873000},"page":"87-108","source":"Crossref","is-referenced-by-count":3,"title":["A State-Wide Initiative to Improve Health System Responses to People With Borderline Personality Disorder Symptoms in Crisis: A Retrospective Audit"],"prefix":"10.1521","volume":"38","author":[{"given":"Dianna R.","family":"Bartsch","sequence":"first","affiliation":[{"name":"Borderline Personality Disorder Collaborative, Barossa Hills Fleurieu Local Health Network, SA Health, Adelaide, South Australia, Australia"},{"name":"School of Psychology, The University of Adelaide, Adelaide, South Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"McLeod Everitt","sequence":"additional","affiliation":[{"name":"Borderline Personality Disorder Collaborative, Barossa Hills Fleurieu Local Health Network, SA Health, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Bednarz","sequence":"additional","affiliation":[{"name":"SAHMRI Women and Kids Theme, South Australia Health and Medical Research Institute, Adelaide, South Australia"},{"name":"School of Public Health, The University of Adelaide, South Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Ludbrook","sequence":"additional","affiliation":[{"name":"Borderline Personality Disorder Collaborative, Barossa Hills Fleurieu Local Health Network, SA Health, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Cammell","sequence":"additional","affiliation":[{"name":"Borderline Personality Disorder Collaborative, Barossa Hills Fleurieu Local Health Network, SA Health, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"377","reference":[{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1159\/000173701"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.112.117762"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2020.07.007"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/1742-6723.13970"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.112.1.155"},{"key":"ref8","volume-title":"Understanding the new statistics: Effect sizes, confidence intervals, and meta-analysis","author":"Cumming G.","year":"2012"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2022.1"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-012-9556-4"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1037\/a0022144"},{"key":"ref12","volume-title":"Brief intervention manual for personality disorders","author":"Grenyer B. 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