The study proposed here is designed as a pilot study to provide preliminary information about clients with borderline personality disorder in the public sector. Specifically, this study proposes to compare borderline clients who are and are not high utilizers of inpatient psychiatric services to better understand the clinical and outpatient service factors associated with high utilization. The study would use random selection from all King County mental health clients and a screening process to identify 60 clients in King County, Washington, who meet criteria for borderline personality on the Personality Disorders Examination; 30 who are high utilizers of inpatient psychiatric services and 30 who are not. These clients will be interviewed regarding their history of suicidal behavior, DSM-IV Axis I diagnoses, cognitive impairment, stressful life events, and satisfaction with outpatient psychiatric services as well. Involvement in the involuntary treatment system is also a possible discriminator, and will be assessed by commitment records. Finally, type and amount of outpatient psychiatric services as well as high versus low utilizer status (of inpatient psychiatric services) will be collected in a downloaded data set from the information services department of the King County Regional Support Network which managers public mental health services for the county. This pilot project has three specific aims, (a) to estimate the prevalence of borderline personality disorder in the public sector, (b) to examine the relationship between clinical and standardized research diagnosis of borderline personality disorder in this population, and to (c) provide initial data regarding the clinical and service factors associated with high versus low utilization of inpatient psychiatric services.