People with Borderline Personality Disorder (BPD) experience intense psychological distress and emotional mood swings, often relying on self-destructive behaviours as way of coping. 60%-90% of people with BPD have histories of self-harm, suicidal thoughts, and multiple suicide attempts. Chronic suicidality, a prominent feature in people with BPD, underscores the urgent need for effective medical and psychotherapeutic interventions. The first presentation in this symposium will describe a study with the Coroner's Court of Victoria that clearly illustrates the prevalence of death by suicide in people diagnosed with BPD. A key takeaway is the near universal experience of help-seeking that people engage in during their final months and weeks, highlighting many opportunities for meaningful intervention across the health sector. The second presentation describes the reliance of our health system on crisis-based responding, placing a heavy impost on emergency services and a clear need to rethink the 'off ramps' so that people experiencing repeated crises can access meaningful interventions and supports to break this exhausting cycle. The final presentation recognises that people with BPD and complex trauma, many of whom experience persistent suicidality, may not receive timely and appropriate interventions. Previous work in the field clearly shows that the best way to reduce suicide in people who experience chronic suicidality is to offer evidence-based psychotherapies. When the consumer panel at the 4th National BPD conference were asked “what is the best way to help people with BPD when they are chronically suicidal?” the panel responded, “Never give up on us”. This presentation will highlight principles underlying all evidence-based therapies, knowledge of which empowers clinicians, systems and services not only to “never give up” on someone who experiences persistent suicidality, but to also support them to live through and beyond these experiences.