Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Department of Research & Innovation, GGZinGeest, Amsterdam, The Netherlands.
Suicide Life Threat Behav. 2018 Dec;48(6):745-754. doi: 10.1111/sltb.12396. Epub 2017 Oct 26.
Suicide prevention is a major health care responsibility in need of new perspectives. This study reviews Zero Suicide, an emerging approach to suicide prevention that embraces the aspirational goal of zero suicides among patients treated in health care systems or organizations. Zero Suicide is gaining international momentum while at the same time evoking objections and concerns. Fundamental to Zero Suicide is a multilevel system view on suicide prevention, with three core elements: a direct approach to suicidal behaviors; continual improvement of the quality and safety of care processes; and an organizational commitment to the aspirational goal of zero suicides. The rationale and evidence for these components are clarified and discussed against the backdrop of concerns and objections that focus on possible undesired consequences of the pursuit of zero suicide, in particular for clinicians and for those who are bereaved by suicide. It is concluded that it is rational to pursue zero suicides as an aspirational goal, provided the journey toward zero suicides is undertaken in a systemic and sustained manner, in a way that professionals feel supported, empowered, and protected against blame and inappropriate guilt.
自杀预防是医疗保健的一项重大责任，需要新的视角。本研究回顾了零自杀，这是一种新出现的自杀预防方法，它秉持着在医疗保健系统或机构中治疗的患者零自杀的理想目标。零自杀在获得国际动力的同时，也引起了反对和关注。零自杀的基础是一个多层次的系统视角的自杀预防，有三个核心要素：直接处理自杀行为；不断提高护理过程的质量和安全性；以及对零自杀这一理想目标的组织承诺。这些组成部分的理由和证据，是在关注和反对的背景下得到澄清和讨论的，这些关注和反对主要集中在追求零自杀可能带来的不良后果，特别是对临床医生和自杀身亡者的亲属的影响。结论是，将零自杀作为一个理想目标来追求是合理的，前提是朝着零自杀的方向前进是系统的、持续的，让专业人员感到支持、赋权，并免受指责和不适当的内疚。
