I mean...they made it pretty clear that dead in the Borderlands means just plain dead. So I don't see how they could've died and then became citizens. And I don't see them being about helping to cross over either. One half of the face cards were all about reasons for living and how you need to live life your own way, basically instilling the will to live and the other half just liked fucking with people.
Without thinking about it too hard. I think they are dead based on the fact that they made it a point to not show any of the people in the hospital that decided to stay or report their names. They could be "missing", but in life when a body is missing after a catastrophe we still label them as dead. "Helping" also doesn't have to be positive. Regardless of the reason killing people in the borderlands is still helping people pass on to the after life.
Either way, I don't think borderlands is a real place just a place holder for people on the edge of dying.