We evaluated the impact of short-term crisis treatment at the general hospital among borderline patients with emotional crisis severe enough to require emergency hospitalisation in a 500.000 inhabitants urban catchment area. Those patients with concurrent bipolar disorder I and severe substance dependence were excluded from the study. Repeated assessment were conducted at intake, 3-month and 1-year follow-up in order to tape adherence to treatment, service utilization and treatment failure over one year. Presence of borderline personality disorder was assessed within acute in-patient treatment with the International Personality Disorder Interview (IPDE). The results indicate that residential treatment is no more a cogent issue of rational treatment plans for acute borderline patients. Among these subjects, psychodynamically informed crisis intervention at the general hospital may be a valuable alternative to classic psychiatric hospitalisation.