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Intentions to Help People at Risk of Suicide and Associated Factors: A National Telephone Survey in Taiwan. 协助自杀者之意愿及相关因素:台湾地区电话调查。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2023-11-20 DOI: 10.1080/13811118.2023.2280231
I-Ting Hwang, Yu-Mei Gao, Shu-Sen Chang, Ying-Chen Chi, Kevin Chien-Chang Wu, Ying-Yeh Chen

Objective: Many people at risk of suicide do not actively seek help. Suicide prevention efforts need to involve the general public to provide appropriate support to those in need. It is important to investigate the intention to help those at risk of suicide and the factors associated with helping intentions in the general population. We aimed to assess the intention to help people at risk and associated factors using a national representative sample.

Method: We conducted a national telephone survey of 1,087 Taiwanese adults and collected data regarding participants' socio-demographic characteristics, mental health status, helping intentions, misconceptions about suicide, and attitudes toward suicide and suicide prevention.

Results: The prevalence of high intentions to help people at risk of suicide was 56.5%. Helping intentions did not differ by sex, educational level, employment status, marital status, or mental health status. Those with high helping intentions were younger, less likely to have misconceptions about suicide or agree that suicide is a personal choice, and more likely to believe that suicide is preventable and support suicide prevention measures.

Conclusions: Suicide prevention education programs aimed to enhance helping intentions may usefully target debunking misconceptions about suicide and cultivating positive attitudes toward suicide prevention.

目的:许多有自杀风险的人不会主动寻求帮助。预防自杀的努力需要公众参与,为有需要的人提供适当的支持。在一般人群中调查帮助有自杀危险的人的意愿以及与帮助意愿相关的因素是很重要的。我们的目的是通过一个具有全国代表性的样本来评估帮助高危人群的意愿和相关因素。方法:对1087名台湾成人进行电话调查,收集调查对象的社会人口学特征、心理健康状况、协助意向、对自杀的误解、对自杀和预防自杀的态度等资料。结果:高意愿帮助自杀风险人群的患病率为56.5%。帮助意愿在性别、教育程度、就业状况、婚姻状况或心理健康状况方面没有差异。那些有高度帮助意愿的人更年轻,不太可能对自杀有误解或同意自杀是个人选择,更有可能相信自杀是可以预防的,并支持自杀预防措施。结论:自杀预防教育计划旨在提高帮助意愿,有助于消除对自杀的误解,培养对自杀预防的积极态度。
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引用次数: 0
Risks and Warning Signs for Medical Student Suicide Mortality: A Systematic Review. 医学生自杀死亡的风险和警示信号:系统回顾。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-02-09 DOI: 10.1080/13811118.2024.2310553
Karan Varshney, Hinal Patel, Mansoor Ahmed Panhwar

Introduction: Medical students have been known to face numerous mental health issues at disproportionately high rates. Of pertinence, medical students have been shown to have high rates of suicidal thoughts and behavior. However, little is known about the risks and warning signs for death by suicide in this group. We therefore conducted a systematic review regarding the factors associated with medical student suicide mortality.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted searches in six different databases. Studies with stratified data on at least one suicide death by a medical student were eligible for inclusion.

Results: Searches produced a total of 1744 articles, and of those, 13 articles were eligible for inclusion. There was a pooled total of 362 suicide deaths of medical students across five different countries. 67.6% of deaths occurred among male students, primarily in their early twenties. Students in their later years of medical school were shown to be more likely to die by suicide, as were those with a history of psychiatric issues such as depression. Motivations for suicide were academic stress/failure, harassment/bullying, and relationship issues. Warning signs for suicide among medical students were recent changes in mood/behavior and leaving a suicide note.

Discussion: Numerous risks and warning signs of suicide have been described in our review. Medical schools may have an important role in lowering suicide deaths by medical students; impactful change can occur through better support, changes in curriculum, and appropriate data collection.

导言:众所周知,医学生面临着许多心理健康问题,而且比例过高。与此相关的是,医学生的自杀想法和行为发生率也很高。然而,人们对这一群体自杀死亡的风险和警示信号知之甚少。因此,我们对与医学生自杀死亡率相关的因素进行了系统回顾:按照系统综述和荟萃分析首选报告项目(PRISMA)指南,我们在六个不同的数据库中进行了检索。至少有一项医学生自杀死亡分层数据的研究符合纳入条件:搜索结果共收集到 1744 篇文章,其中 13 篇符合纳入条件。五个不同国家共有 362 名医学生自杀身亡。67.6%的死亡案例发生在男生身上,主要是二十出头的学生。研究表明,医学院晚年学生更有可能死于自杀,有抑郁症等精神病史的学生也更有可能死于自杀。自杀动机包括学业压力/失败、骚扰/欺凌以及人际关系问题。医学生自杀的警示信号是近期情绪/行为的变化和留下遗书:讨论:在我们的综述中描述了许多自杀的风险和警示信号。医学院校在降低医学生自杀死亡率方面可以发挥重要作用;通过提供更好的支持、改变课程设置和收集适当的数据,可以实现有影响力的改变。
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引用次数: 0
The Structural Model of the Effects of Psychological Strain, Defeat, and Thwarted Belongingness on Suicidal Ideation in Adolescents via the Mediation of Depression and Hopelessness. 心理压力、失败和归属感受挫通过抑郁和无望的中介作用对青少年自杀意念影响的结构模型。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-02-13 DOI: 10.1080/13811118.2024.2314518
Mahboobeh Moosivand, Mohammad Javad Bagian Kulemarzi, Zeinab Zaremohzzabieh, Mansoureh Zarean, Moslem Rajabi, Sajad Khanjani

Objective: This study aimed to identify factors associated with suicidal ideation (SI) in adolescents and to explore the mediating role of depression and hopelessness in these predictive relationships.

Method: Employing a cross-sectional research design, this study included adolescents aged 14 to 19 from Lorestan Province in Iran. A total of 623 middle-school students were selected through a multi-stage cluster sampling technique. Data were collected using a series of assessment tools, including the Depressive Symptom Index-Suicidality Subscale (DSI-SS), the Psychological Strain Questionnaire, the Hopelessness Scale, the Defeat Scale, and the Thwarted Belongingness Questionnaire. Structural Equation Modeling (SEM) in AMOS version 26 and SPSS version 26 was utilized to evaluate the proposed model.

Results: The findings revealed that in the context of Iranian adolescents, defeat and psychological strains emerge as significant predictors of SI. Notably, hopelessness was found to mediate the relationship between psychological strains, defeat, and SI.

Conclusion: These insights provide valuable knowledge for addressing the issue of SI in Iranian adolescents and may inform future prevention and intervention strategies.

研究目的本研究旨在确定与青少年自杀意念(SI)相关的因素,并探讨抑郁和绝望在这些预测关系中的中介作用:本研究采用横断面研究设计,纳入了伊朗洛雷斯坦省 14 至 19 岁的青少年。通过多阶段聚类抽样技术,共选取了 623 名中学生。研究使用一系列评估工具收集数据,包括抑郁症状指数-严重性分量表(DSI-SS)、心理压力问卷、无望量表、失败量表和归属感受挫问卷。利用 AMOS 26 版和 SPSS 26 版的结构方程模型(SEM)对提出的模型进行了评估:研究结果表明,在伊朗青少年中,挫败感和心理压力是预测 SI 的重要因素。值得注意的是,绝望被认为是心理压力、挫败和 SI 之间关系的中介:这些见解为解决伊朗青少年的 SI 问题提供了宝贵的知识,并可为未来的预防和干预策略提供参考。
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引用次数: 0
Patterns of Hospital Presenting Suicide-Related Ideation in Older Adults before and during COVID-19: Findings from a National Clinical Service in Ireland 2018-2021. 在 COVID-19 之前和期间,医院出现的老年人自杀相关意念的模式:2018-2021年爱尔兰国家临床服务调查结果》。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-01-25 DOI: 10.1080/13811118.2024.2307882
M Isabela Troya, Paul Corcoran, Ella Arensman, Katerina Kavalidou

Objective: To examine changes in trends of hospital-presenting suicide-related ideation in older adults living in Ireland, during the first 24 months of the COVID-19 pandemic and 2018-2019.

Methods: Data on presentations of patients aged 60 and older from participating hospitals of the National Clinical Programme for Self-Harm and Suicide-related Ideation were used to compare trends during the first two years of the COVID-19 pandemic (2020-2021) with the preceding period (2018-2019). Poisson regression models were used to estimate trends in the pre-pandemic and pandemic periods.

Results: There were 1531 presentations for suicide-related ideation to hospital emergency departments in older adults between January 1, 2018-December 31, 2021, with most presentations involving males (57.2%, n = 876). There was a 27% increase in suicide-related ideation presentations during the pandemic years (2020-2021) when compared to 2018-2019 (RR: 1.27, p = .001, 95%CI: 1.14-1.40), with females showing a 29% increase (RR: 1.29, p = .001, 95%CI: 1.11-1.51) and males a 23% increase (RR: 1.23, p = .002, 95%CI: 1.08-1.40). When examining these trends by years, there were only significant increases in 2021, and no significant increases were observed in 2020.

Conclusions: The study findings show that in the second year following the start of the pandemic, significant increases were observed in suicide-related ideation hospital-presentations in older adults. While immediate changes in trends were not observed in the first year of the pandemic, it is important to consider the pandemic's medium and long-term impact on older adults' mental health, to provide adequate support and reduce suicide risk among those presenting with suicide-related ideation.

目的研究COVID-19大流行的前24个月和2018-2019年期间,居住在爱尔兰的老年人在医院就诊时出现自杀相关意念的趋势变化:使用 "全国自残和自杀相关意念临床计划 "参与医院的 60 岁及以上患者就诊数据,比较 COVID-19 大流行头两年(2020-2021 年)与前一时期(2018-2019 年)的趋势。采用泊松回归模型来估计大流行前和大流行期间的趋势:2018年1月1日至2021年12月31日期间,医院急诊科共接诊了1531例有自杀相关意念的老年人,其中大多数为男性(57.2%,n = 876)。与2018-2019年相比,在大流行年(2020-2021年)期间,自杀相关意念病例增加了27%(RR:1.27,p = .001,95%CI:1.14-1.40),其中女性增加了29%(RR:1.29,p = .001,95%CI:1.11-1.51),男性增加了23%(RR:1.23,p = .002,95%CI:1.08-1.40)。按年份研究这些趋势时,只有 2021 年出现了显著增长,2020 年没有观察到显著增长:研究结果表明,在大流行开始后的第二年,观察到老年人在医院就诊的自杀相关意念显著增加。虽然在大流行的第一年没有观察到趋势的直接变化,但考虑到大流行对老年人心理健康的中长期影响,为有自杀意念的老年人提供足够的支持并降低自杀风险是非常重要的。
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引用次数: 0
Parents' Information Needs in Relation to Adolescent Self-Harm: Perspectives of Parents and Professionals. 与青少年自残有关的父母信息需求:父母与专业人士的观点。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2023-11-11 DOI: 10.1080/13811118.2023.2279524
Áine French, Keith Gaynor, Finiki Nearchou, Sinead Raftery, Bríd O'Dwyer, Eilis Hennessy

Objective: Discovering that an adolescent is self-harming is extremely distressing for parents and this distress can be compounded by lack of easily accessible and well targeted information on what they can do to help. Some research has even suggested that parental distress can be an obstacle to seeking professional help. This paper describes two studies that sought to identify the information needs of parents in the immediacy of discovering self-harm and in ongoing efforts to support their child.

Method: Study 1: on-line survey of 128 parents who had experienced their child's self-harm; study 2: two-round Delphi method with 29 professionals who provide therapeutic interventions to adolescents who self-harm. The primary aim of both studies was to elicit views on parents' information needs in relation to supporting adolescents who self-harm.

Results: There was a high level of agreement between parents and professionals on the needs for information on topics such as: communication, psychoeducation, managing emotional responses, parenting strategies and interventions. The professionals also emphasized the need for parents to practice self-care and the value of teaching alternative coping strategies to adolescents. Parents placed greater emphasis than professionals on the need for information on future therapeutic needs.

Conclusion: Despite the agreement between parents and professionals on most of the information needed, there were sufficient differences in emphasis to confirm the importance of consulting with both groups. The findings can be used to develop information sources that are specifically tailored to the needs of parents at all stages of adolescent self-harm.

目的:发现青少年有自残行为对父母来说是非常痛苦的,而这种痛苦可能会因为缺乏容易获得的和有针对性的信息而加剧,这些信息告诉父母他们可以做些什么来帮助他们。一些研究甚至表明,父母的痛苦可能成为寻求专业帮助的障碍。本文描述了两项研究,旨在确定父母在发现自我伤害和持续努力支持孩子时的信息需求。方法:研究一:对128名经历过孩子自残行为的家长进行在线调查;研究二:采用两轮德尔菲法对29名专业人员进行自我伤害干预。两项研究的主要目的是了解父母在支持自残青少年方面的信息需求。结果:在沟通、心理教育、情绪反应管理、育儿策略和干预等方面,家长和专业人员对信息需求的认同程度很高。专家们还强调了父母需要练习自我照顾,以及向青少年传授替代性应对策略的价值。与专业人士相比,家长更重视对未来治疗需求信息的需求。结论:尽管家长和专业人员对所需的大部分信息达成一致,但在强调重点上存在足够的差异,这证实了向双方咨询的重要性。这些发现可以用来开发专门针对青少年自残各个阶段父母需求的信息来源。
{"title":"Parents' Information Needs in Relation to Adolescent Self-Harm: Perspectives of Parents and Professionals.","authors":"Áine French, Keith Gaynor, Finiki Nearchou, Sinead Raftery, Bríd O'Dwyer, Eilis Hennessy","doi":"10.1080/13811118.2023.2279524","DOIUrl":"10.1080/13811118.2023.2279524","url":null,"abstract":"<p><strong>Objective: </strong>Discovering that an adolescent is self-harming is extremely distressing for parents and this distress can be compounded by lack of easily accessible and well targeted information on what they can do to help. Some research has even suggested that parental distress can be an obstacle to seeking professional help. This paper describes two studies that sought to identify the information needs of parents in the immediacy of discovering self-harm and in ongoing efforts to support their child.</p><p><strong>Method: </strong>Study 1: on-line survey of 128 parents who had experienced their child's self-harm; study 2: two-round Delphi method with 29 professionals who provide therapeutic interventions to adolescents who self-harm. The primary aim of both studies was to elicit views on parents' information needs in relation to supporting adolescents who self-harm.</p><p><strong>Results: </strong>There was a high level of agreement between parents and professionals on the needs for information on topics such as: communication, psychoeducation, managing emotional responses, parenting strategies and interventions. The professionals also emphasized the need for parents to practice self-care and the value of teaching alternative coping strategies to adolescents. Parents placed greater emphasis than professionals on the need for information on future therapeutic needs.</p><p><strong>Conclusion: </strong>Despite the agreement between parents and professionals on most of the information needed, there were sufficient differences in emphasis to confirm the importance of consulting with both groups. The findings can be used to develop information sources that are specifically tailored to the needs of parents at all stages of adolescent self-harm.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1131-1146"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89716780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implicit Identification with Death, Clinician Evaluation and Suicide Ideation among Adolescent Psychiatric Outpatients-The Mediating Role of Depression. 青少年精神科门诊患者死亡内隐认同、临床医师评价与自杀意念:抑郁的中介作用。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2023-11-17 DOI: 10.1080/13811118.2023.2282661
Nermin Toukhy, Yari Gvion, Shira Barzilay, Alan Apter, Liat Haruvi-Catalan, Cendrine Bursztein-Lipsicas, Maya Shilian, Ori Mijiritsky, Noa Benaroya-Milshtein, Silvana Fennig, Sami Hamdan

Implicit identification with death (i.e., subconsciously self-associating oneself with death), measured by the Death-Suicide Implicit Association Test (D/S-IAT), is associated with Suicide Ideation (SI). Our understanding of the mechanisms underlying this association is limited. The current study examined (1) the mediating role of depression between D/S-IAT and recent SI and (2) the association between SI, D/S-IAT, and clinician evaluation of SI among a clinical sample of adolescents. 148 adolescents aged 10-18 years (69.4% female) from two outpatient clinics were assessed at intake. Participants completed D/S-IAT and self-report measures for recent SI and depression during intake. Findings indicate that depression is a mediator between D/S-IAT and recent SI, controlling for gender, site differences, and past suicidal thoughts and behaviors. D/S-IAT and clinician evaluation were correlated with recent SI but not beyond depression. Our findings highlight the importance of examining the underlying psychological mechanisms regarding the association between D/S-IAT and suicide.

死亡-自杀内隐关联测验(D/S-IAT)测量的死亡内隐认同(即潜意识地将自己与死亡联系起来)与自杀意念(SI)相关。我们对这种关联背后的机制的理解是有限的。本研究以青少年为研究对象,考察了抑郁在D/S-IAT与近期自伤之间的中介作用,以及D/S-IAT与临床医生对自伤的评价之间的关系。148名10-18岁的青少年(69.4%为女性)来自两个门诊诊所,在入院时接受评估。参与者在摄入期间完成了D/S-IAT和近期SI和抑郁的自我报告测量。研究结果表明,抑郁是D/S-IAT与近期自杀之间的中介,控制了性别、地点差异和过去的自杀念头和行为。D/S-IAT和临床医生评价与最近的SI相关,但不超过抑郁症。我们的研究结果强调了研究D/S-IAT与自杀之间关联的潜在心理机制的重要性。
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引用次数: 0
Mindfulness-Based Cognitive Therapy for Individuals Who Are Suicidal: A Randomized Controlled Trial. 有自杀倾向的人的正念认知疗法:一项随机对照试验。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2023-11-23 DOI: 10.1080/13811118.2023.2282663
Eva De Jaegere, Eva Dumon, Kees van Heeringen, Renate van Landschoot, Pauline Stas, Gwendolyn Portzky

There is a need for well-described treatments targeting individuals at risk for suicidal behaviors. The present study aims to investigate the effectiveness of MBCT adapted to individuals who are suicidal (MBCT-S) in a randomized controlled trial, comparing an intervention group receiving MBCT-S and treatment as usual (TAU) with a control group receiving TAU only. Participants who were 18 years or older and experienced suicidal ideation were included. Assessments on suicidal ideation and symptoms associated with suicidal behavior were carried out at baseline, post-treatment, and 12 weeks after the end of the training. When comparing the intervention group with the control group, a significant reduction was found at follow-up in suicidal ideation and depressive symptoms. When focusing on the intervention group only, a significant reduction was found in suicidal ideation, depressive symptoms, hopelessness, worrying, defeat, and entrapment, and a significant increase in mindfulness both at post-treatment and at follow-up. The findings suggest that MBCT-S is a promising suicide-specific intervention as it may have the potential to reduce suicidal ideation and suicide-related components.

有必要针对有自杀行为风险的个体制定详细的治疗方案。本研究旨在通过一项随机对照试验,比较接受MBCT- s和常规治疗(TAU)的干预组和只接受TAU治疗的对照组,探讨MBCT适应自杀个体(MBCT- s)的有效性。参与者年龄在18岁以上,有过自杀念头。在基线、治疗后和训练结束后12周对自杀意念和与自杀行为相关的症状进行评估。当将干预组与对照组进行比较时,在随访中发现自杀意念和抑郁症状显著减少。当只关注干预组时,在自杀意念、抑郁症状、绝望、担忧、失败和困住方面都有显著减少,在治疗后和随访中,正念都有显著增加。研究结果表明,MBCT-S是一种有希望的自杀特定干预措施,因为它可能有减少自杀意念和自杀相关成分的潜力。
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引用次数: 0
Facets of Suicidal Ideation. 自杀意念的方方面面。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-01-04 DOI: 10.1080/13811118.2023.2299259
David A Jobes, Abby A Mandel, Evan M Kleiman, Craig J Bryan, Sheri L Johnson, Thomas E Joiner

According to SAMHSA (2023), approximately 16,600,000 American adults and teens reported having serious thoughts of suicide in 2022. While suicide prevention has primarily focused on suicide deaths and attempts, we contend that suicidal ideation (SI) deserves more in-depth investigation and should be an essential intervention target on its own. In support of this point, we provide three examples of ways to improve specificity in understanding of SI through the study of controllability of SI, the language used to assess SI, and measuring SI in real time. We also consider qualitative work on the content of SI, its treatment, and definitional considerations. We thus call for an increased general focus on SI within research, clinical care, and policy.

根据 SAMHSA(2023 年)的报告,2022 年约有 1,660 万美国成年人和青少年表示有严重的自杀念头。虽然自杀预防主要关注的是自杀死亡和自杀未遂,但我们认为自杀意念(SI)值得更深入的研究,其本身也应成为一个重要的干预目标。为了支持这一观点,我们提供了三个例子,说明如何通过研究自杀意念的可控性、评估自杀意念所用的语言以及实时测量自杀意念来提高对自杀意念理解的针对性。我们还考虑了有关 SI 内容、其处理方法和定义考虑因素的定性工作。因此,我们呼吁在研究、临床护理和政策方面加强对 SI 的普遍关注。
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引用次数: 0
The Recovery from Attempting Suicide. 从企图自杀中恢复过来。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2023-11-20 DOI: 10.1080/13811118.2023.2281546
Antoinette Dubruel, Paras Patel, Angela Kennedy

A positive trajectory of life after an attempted suicide is extremely limited in research despite its advantage of aiding salutary outcomes. A systematic review of the qualitative research was conducted to explore the impact the attempt of taking your own life has had on your life and your work, to discover what changes participants have made to move toward a life worth living, and to understand how people can help better support individuals from attempted suicide attempts. A comprehensive search of online articles identified thirteen eligible studies. Three themes emerged: (1) rediscovering a life of meaning (2) contextual factors that facilitate a life worth living (3) internal changes. Limitations were discussed along with recommendations for future research.

自杀未遂后的积极生活轨迹在研究中极为有限,尽管它有助于有益的结果。对定性研究进行了系统的回顾,以探索自杀未遂对你的生活和工作的影响,发现参与者为迈向有价值的生活做出了哪些改变,并了解人们如何更好地帮助那些有自杀企图的人。对在线文章的全面搜索确定了13项符合条件的研究。三个主题出现了:(1)重新发现有意义的生活(2)促进有价值生活的环境因素(3)内部变化。讨论了局限性以及对未来研究的建议。
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引用次数: 0
Centering Community Strengths and Resisting Structural Racism to Prevent Youth Suicide: Learning from American Indian and Alaska Native Communities. 以社区优势为中心,抵制结构性种族主义,预防青少年自杀:向美国印第安人和阿拉斯加原住民社区学习。
IF 2.5 3区 医学 Q2 PSYCHIATRY Pub Date : 2024-10-01 Epub Date: 2024-01-19 DOI: 10.1080/13811118.2023.2300321
Lisa Wexler, Lauren A White, Victoria M O'Keefe, Stacy Rasmus, Emily E Haroz, Mary F Cwik, Allison Barlow, Novalene Goklish, Emma Elliott, Cynthia R Pearson, James Allen

The persistence of extreme suicide disparities in American Indian and Alaska Native (AI/AN) youth signals a severe health inequity with distinct associations to a colonial experience of historical and on-going cultural, social, economic, and political oppression. To address this complex issue, we describe three AI/AN suicide prevention efforts that illustrate how strengths-based community interventions across the prevention spectrum can buffer suicide risk factors associated with structural racism. Developed and implemented in collaboration with tribal partners using participatory methods, the strategies include universal, selective, and indicated prevention elements. Their aim is to enhance systems within communities, institutions, and families by emphasizing supportive relationships, cultural values and practices, and community priorities and preferences. These efforts deploy collaborative, local approaches, that center on the importance of tribal sovereignty and self-determination, disrupting the unequal power distribution inherent in mainstream approaches to suicide prevention. The examples emphasize the centrality of Indigenous intellectual traditions in the co-creation of healthy developmental pathways for AI/AN young people. A central component across all three programs is a deep commitment to an interdependent or collective orientation, in contrast to an individual-based mental health suicide prevention model. This commitment offers novel directions for the entire field of suicide prevention and responds to calls for multilevel, community-driven public health strategies to address the complexity of suicide. Although our focus is on the social determinants of health in AI/AN communities, strategies to address the structural violence of racism as a risk factor in suicide have broad implications for all suicide prevention programming.

美国印第安人和阿拉斯加原住民(AI/AN)青年自杀率的极端差异持续存在,这表明在健康方面存在严重的不公平现象,与历史上持续存在的文化、社会、经济和政治压迫的殖民经历有着明显的关联。为了解决这个复杂的问题,我们介绍了三项美国印第安人/阿拉斯加原住民自杀预防工作,这些工作说明了基于优势的社区干预措施如何在整个预防范围内缓冲与结构性种族主义相关的自杀风险因素。这些战略是与部落伙伴合作,采用参与式方法制定和实施的,包括普遍性、选择性和指示性预防要素。其目的是通过强调支持性关系、文化价值观和做法以及社区优先事项和偏好,加强社区、机构和家庭内部的系统。这些工作采用合作性的地方方法,以部落主权和自决的重要性为中心,打破了主流自杀预防方法中固有的不平等权力分配。这些范例强调了土著知识传统在共同创造阿拉斯加原住民/印第安人青少年健康成长途径中的核心地位。所有这三个项目的核心内容都是对相互依存或集体导向的深刻承诺,与基于个人的心理健康自杀预防模式形成鲜明对比。这一承诺为整个自杀预防领域提供了新的方向,并响应了多层次、社区驱动的公共卫生战略的号召,以应对自杀的复杂性。虽然我们关注的重点是美国原住民/印第安人社区健康的社会决定因素,但解决作为自杀风险因素的种族主义结构性暴力的策略对所有自杀预防计划都有广泛的影响。
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引用次数: 0
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Archives of Suicide Research
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