From Gendered Diagnosis to Community Care: How Borderline Personality Disorder Organizes Community Mental Health Nursing Practice.
- 1School of Nursing, Trent University, Peterborough, Ontario, Canada.
Abstract
Borderline personality disorder (BPD) is a contested diagnosis that has been criticized for pathologizing women's responses to trauma, adversity, and relational harm. This paper examines how BPD, as a gendered, historically situated, and institutionally mediated diagnostic category, shapes community mental health nursing (CMHN) practice. Using a critical conceptual analysis, it synthesizes historical, feminist, psychiatric, nursing, and Mad studies literature, combining genealogical, critical feminist, and social-structural perspectives. The paper argues that BPD functions not only as a clinical description of symptoms but also as an institutional category that influences documentation, referral pathways, eligibility criteria, and service design. Through these processes, the diagnosis shapes clinical visibility, therapeutic relationships, service access, and continuity of care. Moving beyond explanations of stigma that focus solely on individual clinician attitudes, the analysis demonstrates how diagnostic meanings are reproduced through organizational and health system structures, contributing to forms of structural stigma that constrain relational and trauma-informed care. The paper concludes with implications and recommendations for nursing practice, education, service delivery, and policy, including trauma-informed and relational approaches to assessment, non-stigmatizing documentation practices, transparent referral and eligibility processes, investment in community-based services, and strengthened clinical supervision and workforce supports.
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BibTeX
@article{galea2026from,
title = {{From Gendered Diagnosis to Community Care: How Borderline Personality Disorder Organizes Community Mental Health Nursing Practice.}},
author = {Rachel Galea and Alison Rodgers and Catherine MacDonald and Ayanna Robertson and Alessandra Rooney},
journal = {Nursing inquiry},
year = {2026},
month = oct,
doi = {10.1111/nin.70174},
url = {https://europepmc.org/article/MED/42927650},
note = {CC BY},
}
RIS
TY - JOUR
TI - From Gendered Diagnosis to Community Care: How Borderline Personality Disorder Organizes Community Mental Health Nursing Practice.
AU - Rachel Galea
AU - Alison Rodgers
AU - Catherine MacDonald
AU - Ayanna Robertson
AU - Alessandra Rooney
PY - 2026
DA - 2026/10/01
JO - Nursing inquiry
DO - 10.1111/nin.70174
UR - https://europepmc.org/article/MED/42927650
AB - Borderline personality disorder (BPD) is a contested diagnosis that has been criticized for pathologizing women's responses to trauma, adversity, and relational harm. This paper examines how BPD, as a gendered, historically situated, and institutionally mediated diagnostic category, shapes community mental health nursing (CMHN) practice. Using a critical conceptual analysis, it synthesizes historical, feminist, psychiatric, nursing, and Mad studies literature, combining genealogical, critical feminist, and social-structural perspectives. The paper argues that BPD functions not only as a clinical description of symptoms but also as an institutional category that influences documentation, referral pathways, eligibility criteria, and service design. Through these processes, the diagnosis shapes clinical visibility, therapeutic relationships, service access, and continuity of care. Moving beyond explanations of stigma that focus solely on individual clinician attitudes, the analysis demonstrates how diagnostic meanings are reproduced through organizational and health system structures, contributing to forms of structural stigma that constrain relational and trauma-informed care. The paper concludes with implications and recommendations for nursing practice, education, service delivery, and policy, including trauma-informed and relational approaches to assessment, non-stigmatizing documentation practices, transparent referral and eligibility processes, investment in community-based services, and strengthened clinical supervision and workforce supports.
SN - 1320-7881
SN - 1440-1800
ER -