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日本的全国自杀预防、当地精神卫生资源与自杀率

National Suicide Prevention, Local Mental Health Resources, and Suicide Rates in Japan.

机构信息

1 Mental Health and Nursing Research Team, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.

2 Mental Health Promotion Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.

出版信息

Crisis. 2017 Nov;38(6):384-392. doi: 10.1027/0227-5910/a000469. Epub 2017 Jul 27.

DOI:10.1027/0227-5910/a000469
PMID:28748710
Abstract

BACKGROUND

Suicide rates in Japan are relatively high in OECD countries. A national fund to help local authorities implement suicide prevention programs was launched in 2009. The national suicide prevention project was transferred from the Cabinet Office to the Ministry of Health, Labor, and Welfare on April 2016, with a greater focus on mental health promotion by local governments.

AIMS

The aim of the present study was to (a) identify local authorities' implementation of suicide prevention programs in terms of local health policies, and (b) examine the associations between local health resources and suicide rates in Japan.

METHOD

We investigated the types of programs implemented under the fund, and correlations with authorities' sociodemographic characteristics and mental health and welfare resources.

RESULTS

A majority of authorities implemented general suicide prevention programs. More focused programs addressing issues such as mental health in the workplace, alcohol problems, and attempted suicide were less frequently implemented. There were significantly fewer suicides in health regions with a higher ratio of psychiatrists to residents or a lower ratio of psychiatric beds.

LIMITATIONS

A causal relationship between suicide rates and characteristics of local authorities cannot be inferred from the data.

CONCLUSION

A community mental health system that operated in parallel to the current system may result in fewer inpatients and a reduction in Japan's suicide rate.

摘要

背景

在经合组织国家中,日本的自杀率相对较高。2009 年,日本设立了一项国家基金,用于帮助地方当局实施预防自杀计划。2016 年 4 月,国家预防自杀项目从内阁办公室转移到了厚生劳动省,地方政府更加注重促进心理健康。

目的

本研究旨在 (a) 根据地方卫生政策,确定地方当局实施预防自杀计划的情况,以及 (b) 检验日本地方卫生资源与自杀率之间的关系。

方法

我们调查了基金下实施的项目类型,并分析了与当局的社会人口学特征以及心理健康和福利资源的相关性。

结果

大多数地方当局实施了一般性的预防自杀计划。较少实施更有针对性的项目,如解决工作场所的心理健康问题、酒精问题和自杀未遂问题。精神科医生与居民的比例较高或精神科床位比例较低的卫生区域的自杀人数明显较少。

局限性

不能从数据中推断自杀率与地方当局特征之间的因果关系。

结论

建立一个与现行体系并行的社区心理健康体系,可能会减少住院人数,降低日本的自杀率。

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