Nearly all patients with a Borderline Personality Disorder report about chronic suicidality. We know that about 1 of every 10 patients with this severe personality disorder actually commits suicide in the course of the disorder. But clinical experience and ongoing research shows that this fatal outcome is not easily preventable by hospitalisation in a psychiatric ward and might also increase, rather than reduce, the risk for suicide.
In an outpatient psychotherapeutic setting the open conversation about suicidality is very important and often as a way of communication and attempt to ask for help! Very often actual psychosocial problems or interpersonal problems can be identified as a source of real distress that is expressed in this unusual way to get the attention of the therapists or friends. So the best way to handle suicide thoughts is to analyse the origin of these thoughts and to look for actual problems or interpersonal conflicts of the patient.