Undiagnosed and untreated people with Borderline Personality Disorder (BPD) create a public health drain on mental health treatment. BPD underlies major public health problems including high incidence of substance abuse, alcoholism, domestic violence, impulse control disorders, incarceration, high utilization of emergency rooms and inpatient hospitalizations. Although BPD has a prevalence rate between 2–5.9%, it generally goes misdiagnosed, undiagnosed, stigmatized and mistreated. Amongst American veterans who are suicide attempters and completers, a recent study found 94% meet criteria for BPD. There is rampant professional stigma exists against BPD patients, seen as patients to be “avoided”, “treatment refractory,” “untreatable” and a “liability” due to increased risk of self-injurious and suicidal behavior. This is a contributing factor to misdiagnosis that is the usual experience for BPD patients, resulting in wasted years, hopelessness, chaos, family crises, and severe personal and economic consequences for patients and families. The need for assessing with validated diagnostic instruments to rule out or diagnose BPD, Bipolar Disorder, ADHD, substance abuse and other co-morbid diagnoses as well as the need to diagnosis children and adolescents at the time symptoms first appear will be discussed. Presentation of the shockingly few studies on BPD versus Bipolar will be presented and the consequences of failing to diagnose will be highlighted. Findings from an on-line survey from TARA4BPD, an American education and advocacy organization, will demonstrate the need for clinical education in evidence based BPD treatments, training, and supervision as well as patient and family psycho-education so as to improve outcome will be presented.