Hatcher Simon, Crawford Allison, Coupe Nicole
aDepartment of Psychiatry and The University of Ottawa Brain and Mind Research Institute, The University of Ottawa, Ottawa bNorthern Psychiatric Outreach Program and Telepsychiatry Centre for Addiction and Mental Health, Toronto, Ontario, Canada cMental Health and Addiction Service, Northland District Health Board, Northland, New Zealand.
Curr Opin Psychiatry. 2017 Jan;30(1):21-25. doi: 10.1097/YCO.0000000000000295.
To provide an update on recent studies on suicide prevention in indigenous populations with a focus on recently colonised indigenous peoples in Canada, the United States, Australia and New Zealand.
There have been several recent reviews on suicide prevention in indigenous populations with high suicide rates. However most of them describe the problem and there is little new that is available on effective interventions. One randomized controlled trial of a package of measures focusing on cultural identity in Maori who had recently self-harmed compared to usual care found little effect on suicidal behavior but it did significantly reduce presentations to hospital for any reason after one year.
The reasons for the limited evidence include a lack of ring fenced funding and a lack of research infrastructure; the problem of high rates of suicide but small numbers; and the difficulty in creating effective collaborations between researchers and communities. Potential solutions include identifying specific research funding; improving capacity in indigenous research; putting effort into accurate identification and recording of ethnicity; and thinking about the problem of suicide in recently colonised populations as a global problem to enable large scale high quality studies to take place.
提供关于原住民自杀预防近期研究的最新情况,重点关注加拿大、美国、澳大利亚和新西兰新近被殖民的原住民群体。
近期有几篇关于自杀率高的原住民群体自杀预防的综述。然而,其中大多数只是描述了问题,关于有效干预措施几乎没有新的内容。一项针对近期有过自残行为的毛利人开展的、聚焦文化认同的一揽子措施的随机对照试验,与常规护理相比,发现对自杀行为影响不大,但确实在一年后显著减少了因任何原因前往医院就诊的次数。
证据有限的原因包括缺乏专项资助和研究基础设施;自杀率高但人数少的问题;以及研究人员与社区之间难以建立有效的合作关系。潜在的解决方案包括确定特定研究资金;提高原住民研究能力;努力准确识别和记录种族;并将新近被殖民群体的自杀问题视为全球问题,以便能够开展大规模高质量研究。