Fortune Sarah, Sinclair Julia, Hawton Keith
University of Oxford Centre for Suicide Research, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK.
BMC Public Health. 2008 Oct 24;8:369. doi: 10.1186/1471-2458-8-369.
Deliberate self-harm in young people is a cause for concern in many countries. The vast majority of episodes of self-harm do not result in presentation to hospital and relatively little is known about to whom or where adolescents who harm themselves go for help.
This school-based survey of 5,293 15-16 year olds in the United Kingdom investigated sources of help and barriers to help seeking before and after an episode of self-harm.
Friends (40%) and family (11%) were the main sources of support. Far fewer adolescents had sought help from formal services or health professionals. Barriers to help seeking include perceptions of self-harm as something done on the spur of the moment and therefore not serious or important or to be dwelt upon. Many adolescents felt they should be able to, or could cope on their own and feared that seeking help would create more problems for them and hurt people they cared about or lead to them being labelled as an 'attention seeker'. The decision to seek help was in some cases hampered by not knowing whom to ask for help. Gender and exposure to self-harm in the peer group influenced perceived barriers to help-seeking.
There are both push and pull factors' acting on young people in their understanding of what leads them to want to harm themselves and potential mechanisms for seeking help. The implications for community based prevention programmes are discussed.
年轻人的蓄意自我伤害在许多国家都是令人担忧的问题。绝大多数自我伤害事件并不会导致患者前往医院就诊,而且对于那些自我伤害的青少年会向谁或去哪里寻求帮助,我们了解得相对较少。
这项针对英国5293名15至16岁青少年的校内调查,研究了自我伤害事件前后的求助来源及寻求帮助的障碍。
朋友(40%)和家人(11%)是主要的支持来源。向正规服务机构或健康专业人士求助的青少年要少得多。寻求帮助的障碍包括认为自我伤害是一时冲动所为,因此不严重、不重要或不值得深究。许多青少年觉得他们应该能够自己应对,或者可以自行处理,担心寻求帮助会给他们带来更多问题,伤害他们关心的人,或者导致他们被贴上“寻求关注者”的标签。在某些情况下,不知道该向谁求助会阻碍寻求帮助的决定。性别以及在同龄人中接触到自我伤害的情况会影响对寻求帮助障碍的认知。
在年轻人对导致他们想要伤害自己的原因以及潜在求助机制的理解方面,存在着“推动因素”和“拉动因素”。文中讨论了对基于社区的预防项目的影响。