Department of Epidemiology and Health, Nathan S. Kline Institute, 140 Old Orangeburg Rd., Building 37, Orangeburg, NY 10962, USA.
Psychiatr Serv. 2009 Sep;60(9):1214-21. doi: 10.1176/ps.2009.60.9.1214.
Suicide is a devastating public health problem, and research indicates that people with prior attempts are at the greatest risk of completing suicide, followed by persons with depression and other major mental and substance use conditions. Because there has been little direct input from individuals with serious mental illness and a history of suicidal behavior concerning suicide prevention efforts, this study examined how this population copes with suicidal thoughts.
Participants in 14 regional consumer-run Hope Dialogues in New York State (N=198) wrote up to five strategies they use to deal with suicidal thoughts. Strategies were classified according to grounded theory.
First responses included spirituality, talking to someone, positive thinking, using the mental health system, considering consequences of suicide to family and friends, using peer supports, and doing something pleasurable. Although a majority reported that more formal therapeutic supports were available, only 12% indicated that they considered the mental health system a frontline strategy. Instead, respondents more frequently relied on family, friends, peers, and faith as sources of hope and support.
Consumers' reliance on formal therapeutic supports and support from peers and family suggests that education and support for dealing with individuals in despair and crisis should be targeted to the social networks of this high-risk population. The disparity between availability of formal mental health services and reliance on them when consumers are suicidal suggests that suicide prevention efforts should evaluate whether they are effectively engaging high-risk populations as they struggle to cope with despair.
自杀是一个严重的公共卫生问题，研究表明，有过自杀企图的人自杀风险最高，其次是患有抑郁症和其他严重精神和物质使用障碍的人。由于严重精神疾病患者和有自杀行为史的人很少直接参与预防自杀工作，因此本研究探讨了这一人群如何应对自杀念头。
纽约州 14 个地区性消费者运营的希望对话项目的参与者（N=198）写下了他们用来应对自杀念头的最多五种策略。策略根据扎根理论进行分类。
首先想到的策略包括灵性、与他人交谈、积极思考、利用心理健康系统、考虑自杀对家人和朋友的后果、利用同伴支持以及做一些愉快的事情。尽管大多数人表示有更多的正式治疗支持，但只有 12%的人表示他们认为心理健康系统是一线策略。相反，受访者更频繁地依赖家人、朋友、同伴和信仰作为希望和支持的来源。
消费者依赖于正式的治疗支持以及同伴和家人的支持，这表明应该针对高风险人群的社交网络进行有关如何应对绝望和危机个体的教育和支持。正式心理健康服务的可用性与消费者在自杀时对其的依赖之间存在差距，这表明预防自杀工作应评估它们是否有效地让高风险人群参与进来，因为他们正在努力应对绝望。
