Crawford M J, Sharpe D, Rutter D, Weaver T
Department of Psychological Medicine, Faculty of Medicine, Imperial College London, Claybrook Centre, St Dunstan's Road, London W6 8RP.
J R Army Med Corps. 2009 Sep;155(3):203-7. doi: 10.1136/jramc-155-03-07.
To examine the context of suicidal behaviour among soldiers in the United Kingdom and identify factors that could reduce the risk of such behaviour.
A series of in-depth interviews with service providers involved in treating soldiers following deliberate self harm. Their responses were compared with those of a small sub-sample of soldiers who presented to Army medical services following self harm.
We interviewed 21 service providers with a range of experience and professional backgrounds and 10 soldiers. Service providers told us that the rarity of suicide among soldiers together with lower levels of mental illness amongst those who end their lives made suicide prevention in the Army a difficult task. However they highlighted concerns about recruitment and retention of young soldiers, and stated that stigmatisation of mental illness in the Army sometimes prevented those with suicidal ideation seeking help. They also highlighted the role of alcohol use in precipitating self-harm. Soldiers who had self-harmed told us that they struggled to balance the demands of work and family life and described harming themselves impulsively often while intoxicated with alcohol. Soldiers look to sources of support outside the Army, and see commanding officers, rather than healthcare professionals, as helping resolve their problems. Neither service providers nor soldiers mentioned helplines and other 'independent' sources of confidential advice and support which are available to soldiers serving with the British Army.
Our findings highlight problems associated with efforts to reduce suicide among soldiers but suggest that these should focus continuing to try to reduce stigmatisation of mental distress and specifically on the role of commanding officers. Greater efforts should also be made to publicise existing sources of help and reduce levels of alcohol misuse.
研究英国士兵自杀行为的背景情况，并确定可降低此类行为风险的因素。
对参与治疗自残士兵的服务提供者进行了一系列深入访谈。将他们的回答与一小部分自残后前往陆军医疗服务部门的士兵的回答进行了比较。
我们采访了21名具有不同经验和专业背景的服务提供者以及10名士兵。服务提供者告诉我们，士兵自杀事件罕见，且自杀者的精神疾病程度较低，这使得陆军中的自杀预防工作成为一项艰巨任务。然而，他们强调了对年轻士兵招募和留用的担忧，并指出陆军中对精神疾病的污名化有时会阻止有自杀念头的人寻求帮助。他们还强调了饮酒在引发自残行为中的作用。自残的士兵告诉我们，他们难以平衡工作和家庭生活的需求，并描述自己经常在醉酒时冲动地伤害自己。士兵们寻求军队以外的支持来源，并将指挥官而非医疗保健专业人员视为帮助解决他们问题的人。服务提供者和士兵均未提及英国陆军士兵可获得的求助热线及其他“独立”的保密建议和支持来源。
我们的研究结果凸显了与减少士兵自杀努力相关的问题，但表明这些努力应继续侧重于减少对精神困扰的污名化，特别是关注指挥官的作用。还应做出更大努力宣传现有的帮助来源，并减少酒精滥用水平。
