Suicidal attempts are not rare in the general population (about 4.5%) and the presence of personality disorder aggravates the clinical issue of these patients who also repeat suicidal attempts. Caring for these patients is particularly difficult for physicians and other caregivers, in the means of choice of specific treatment and prevention of relapse. Despite the existence of many psychiatric facilities that can welcome these patients, there is a high rate of treatment failure or drop-out. This constitutes a major issue for systems of care politics. This article describes a specific form of treatment, psychotherapeutic and risk-management oriented, of borderline patients with suicidal attempt admitted at the ER.