以证据为基础的自杀护理是伦理和专业的当务之急:如何减少自杀痛苦并挽救生命。

IF 12.3 1区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY American Psychologist Pub Date : 2024-05-02 DOI:10.1037/amp0001325
David A Jobes, Jeffrey E Barnett
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引用次数: 0

摘要

在美国和全世界,自杀都是一个重大的公共和心理健康问题。根据最近的调查研究,2022 年有 1,660 万美国成年人和青少年表示有严重的自杀念头(药物滥用和心理健康服务管理局,2023 年),这凸显了对有自杀倾向的人提供有效临床护理的巨大需求。然而,有证据表明,临床医疗服务提供者可能会回避有自杀倾向的患者(出于对医疗事故责任的恐惧和担忧),而且有太多的患者依赖于干预措施(即住院治疗和药物治疗),而这些措施几乎没有减少自杀意念和行为的证据(甚至可能会增加自杀风险)。幸运的是,在与自杀相关的评估、急性临床稳定以及通过心理干预实际治疗自杀风险等方面,都出现了大量以证据为基础的临床文献,并得到了重复的随机对照试验的支持。考虑到自杀倾向的普遍性、对生死的影响,以及已有的行之有效的方法,有观点认为,医疗服务提供者应该接受以证据为基础的自杀风险治疗方法,将其作为最佳的风险管理战略。这种做法完全符合专家建议以及专业和道德标准。最后,我们呼吁大家采取行动,提出一系列具体建议,帮助心理学家(以及其他学科)使用循证的、针对自杀的方法,帮助减少与自杀相关的痛苦和死亡。文章认为,现在这样做已经成为一种道德和职业要求。鉴于这一问题的挑战性,这样做也是正确的。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
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Evidence-based care for suicidality as an ethical and professional imperative: How to decrease suicidal suffering and save lives.

Suicide is a major public and mental health problem in the United States and around the world. According to recent survey research, there were 16,600,000 American adults and adolescents in 2022 who reported having serious thoughts of suicide (Substance Abuse and Mental Health Services Administration, 2023), which underscores a profound need for effective clinical care for people who are suicidal. Yet there is evidence that clinical providers may avoid patients who are suicidal (out of fear and perceived concerns about malpractice liability) and that too many rely on interventions (i.e., inpatient hospitalization and medications) that have little to no evidence for decreasing suicidal ideation and behavior (and may even increase risk). Fortunately, there is an emerging and robust evidence-based clinical literature on suicide-related assessment, acute clinical stabilization, and the actual treatment of suicide risk through psychological interventions supported by replicated randomized controlled trials. Considering the pervasiveness of suicidality, the life versus death implications, and the availability of proven approaches, it is argued that providers should embrace evidence-based practices for suicidal risk as their best possible risk management strategy. Such an embrace is entirely consistent with expert recommendations as well as professional and ethical standards. Finally, a call to action is made with a series of specific recommendations to help psychologists (and other disciplines) use evidence-based, suicide-specific, approaches to help decrease suicide-related suffering and deaths. It is argued that doing so has now become both an ethical and professional imperative. Given the challenge of this issue, it is also simply the right thing to do. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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来源期刊
American Psychologist
American Psychologist PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
18.50
自引率
1.20%
发文量
145
期刊介绍: Established in 1946, American Psychologist® is the flagship peer-reviewed scholarly journal of the American Psychological Association. It publishes high-impact papers of broad interest, including empirical reports, meta-analyses, and scholarly reviews, covering psychological science, practice, education, and policy. Articles often address issues of national and international significance within the field of psychology and its relationship to society. Published in an accessible style, contributions in American Psychologist are designed to be understood by both psychologists and the general public.
期刊最新文献
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