Evidence-based clinical practice and ethical implications in the management of nonsuicidal self-injury (NSSI) of women with borderline personality disorder in forensic mental health services

Author : Matthias Wiesmayr, Madeleine Kassar

Abstract : Psychiatry and psychotherapy in forensic mental health services [FMHS] are complex conjoined specialties that seek to balance the approaches of neuropsychological science, law enforcement and ethical consideration disparate in not only their technical languages. The balancing and translating, central tasks of the forensic health care professional, are necessarily fraught with ambiguity often leading to dilemma situations. This seems to especially apply for women offenders with borderline personality disorder [BPD] in FMHS. This article first aims to outline the equally complex and intriguing situation of women with BPD in FMHS, reviewing evidence-based practice and approaching a core aspect concerning women in particular; namely nonsuicidal self-injury [NSSI]. Then relevant methodological, clinical and ethical concerns are briefly analysed, the latter within the framework of traditional bioethics principles. Finally, recommendations for health care providers are offered on three levels as a starting point for implications for practice, research and further discussion.

Keywords : borderline personal disorder, BPD, ethics, evidence-based, forensic mental health, NSSI, self-injury, women

Conference Name : International Conference on Forensic Psychiatry, Psychology and Mental Health Practice (ICFPPMHP-26)

Conference Place : Edinburgh, UK

Conference Date : 9th Oct 2026