It sounds as though the Mental Health Services in your area are not offering the level of support they should be. It is unreasonable, that after all this time, your daughter is still not officially diagnosed with any condition - her behaviour certainly sounds like classic BPD! Obviously, without a diagnosis, it is difficult to offer treatment, as treatments vary for every mental illness. It sounds as though you, as a family, together with the like of A&E staff, are simply trying to put out every small fire as it occurs, but without the correct tools! I simply can’t believe that the mental health team have not fully assessed your daughter sufficiently to give her a diagnosis!
We hear all of the time that mental health services and provision is somewhat of a postcode lottery in the UK, and this has been the case for far too long now. I think it is time to start complaining to be honest. There are PALS services in most hospitals, alternatively you could put a complaint in directly to the NHS Foundation Trust for the service concerned. Within your complaint, you need to demand that your daughter be seen, properly assessed, diagnosed and given a treatment plan as soon as possible. If necessary, get your MP involved too.
Things simply can not go on as they are, as you and the rest of your family will continue to suffer in the end (both physically and mentally). With this in mind, you should also register yourself as a carer with your GP and be sure to make an appointment to see if there is any support available to you (this could be support groups for carers, like yourself, dealing with an adult with mental health problems - it’s often surprising how these things can help you, and it will also demand that you have some time set aside where you are away from your daughter, with some space to think and be.)
We are currently struggling with my cousin (36) who has BPD. She had been ill for some time, but it seemed the mental health services where she was living were useless. Around 6 years ago, she moved back to her parents, and fortunately the mental health team here were brilliant - she had a confirmed diagnosis within weeks of becoming involved with them. Her psychiatrist prescribed medication and the difference was unbelievable and fast! There were a few bumps in the road, but on the whole things improved massively and were looking good.
She was actually very stable for a couple of years, in which time she became involved with her current husband, and had a baby. About a year ago things began to fall apart again! The little one is now 2, and we all feel as though we have gone back to square one with it all. In my cousin’s case, she drinks to ‘numb the mental pain and distress’, but alcohol brings out the real nastiness and aggression. A couple of weeks ago, on a visit back to her parents, she ended up being physically aggressive to her older sister (strangled and bit her) and the police were called.
Unfortunately, I believe that, had she re-engaged with mental health services in her current home city (my understanding is that mental health provision is, again, excellent there!), things would not have progressed to where we are now. However, she was afraid of doing so in case they called Social Services with there being a baby involved. This has now happened anyway due to the police intervention the other week!
Her husband works and they can’t afford for him to lose his job, but she can’t be trusted not to drink when he is at work - hence she is often in no fit state to be looking after a toddler on her own. We’ve been trying to manage this by her coming home to her parents’ during the week, but now her mother’s mental health is too fragile since the incident with her sister, and does not feel strong enough to even see her - let alone have her stay there. As a result, my Mum and I have had her stay with us a couple of times, and at other times, either her father or I have stayed at her house. (My cousin and her husband live almost 2 hours drive away from us).
I am very aware that things can not go on as they are, and my cousin has (so far) agreed to see her GP to discuss medication to stop her drinking (it actually stops the patient feeling any effects from any alcohol they consume!). However, I am already at the point where I have decided that, should she change her mind about either going to the GP to discuss the possibilities or trying this medications if it is suitable for her, I will walk away. She has to start to take some responsibility for herself and her actions.
This is the same for your daughter - she is an adult and must begin to start to take some responsibility for herself. If she continues to refuse to engage with any services (GP / psychiatrist etc), she is not showing that she has any desire to get better. You and your husband have to start asking some difficult questions of what you are and are not prepared to put up with, and then stick to it. While your daughter may well be acting like a child, she is not, and she can not be allowed to manipulate things the ways it seems she has. At some point in the future, you may well have to throw her out of your home and turn your back on her for the sake of your own sanity and for the well-being of the rest of your family. Also, sometimes those who are refusing to help themselves, (even when they have lots of support from a loving family - as yours sounds like) need to hit rock bottom before they realise that they have to face up to things and take some responsibility. It might sound harsh, but it might be what she needs in the end.
Whatever you decide, remember not to let things continue to such a point that you (or anyone else in your family) suffer. Believe me, I have seen the physical and mental health of my Aunt and Uncle deteriorate rapidly over these last 6-7 years, and am desperately worried that the stress of it all will kill them!
Take care, and remember you are not alone. There are many of us who understand and are fighting a similar battle.