School of Rural Medicine, University of New England, Armidale, NSW, Australia.
School of Education, University of New England, Armidale, NSW, Australia.
J Intellect Disabil Res. 2018 Jan;62(1):1-9. doi: 10.1111/jir.12442. Epub 2017 Nov 8.
Individuals with intellectual disability (ID) have a higher likelihood of exposure to identified risk factors for suicide when compared with the general community and have been recognised as being both capable of forming intent for suicide and acting on this intent. However, in spite of research outlining these concerns from the 1970s, there remains a dearth of studies that examine suicide amongst the population of people with ID.
An online cross-sectional survey was purposively developed, with questions aimed at identifying both the experiences and current practices of support staff who assist people with ID in relation to suicide, suicidal behaviour and suicide assessment. It was undertaken across both rural and metropolitan areas in Australia. The survey was open for a period of 12 months. A total of 139 respondents (109 female/30 male), with a mean age of 41 and an average 12 years of experience in supporting people with ID, completed the tool.
A total of nine suicides by people with ID were reported. Seventy-seven per cent of the respondents reported that they had individuals with ID display suicidal behaviours, and 76% noted that a person had specifically talked about wishing to end their life. Only four participants (3%) noted that they did not support individuals with a dual diagnosis of ID and mental health concern. Sixty per cent of participants reported that no one in their organisation had ever completed a suicide risk assessment, and only 28% reported that they would do a suicide risk assessment if an individual that they supported was diagnosed with a mental health issue.
The current findings indicate that support staff recognise the capacity of people with ID to conceptualise suicide, note the existence of suicidal discussions and behaviours and report on actual suicides. This represents one of the few Australian studies that has specifically considered suicide amongst this cohort of people and reinforces the fact that suicide is not unknown in this population. The data indicate a possible divide between the reports of people with ID actively talking about and acting on suicidal thoughts and the lack of any proactive use of any tools to assess for this risk.
与普通人群相比，智力障碍（ID）个体更有可能接触到已确定的自杀风险因素，并且已经认识到他们既有自杀意图的形成能力，也有实施自杀意图的能力。然而，尽管从 20 世纪 70 年代开始就有研究概述了这些问题，但仍然缺乏研究关注 ID 人群中的自杀问题。
本研究采用在线横断面调查方法，设计了旨在识别帮助 ID 个体的支持人员在自杀、自杀行为和自杀评估方面的经验和当前实践的问题。该调查在澳大利亚的农村和城市地区进行。调查开放了 12 个月。共有 139 名（109 名女性/30 名男性）受访者完成了该工具，平均年龄为 41 岁，平均支持 ID 个体的经验为 12 年。
报告了 9 例 ID 个体的自杀。77%的受访者报告称，他们的 ID 个体有过自杀行为，76%的受访者注意到有人明确表示希望结束自己的生命。只有 4 名参与者（3%）表示他们不支持 ID 和精神健康双重诊断的个体。60%的参与者报告称，他们所在组织中没有人进行过自杀风险评估，只有 28%的人表示如果他们支持的个体被诊断出患有精神健康问题，他们会进行自杀风险评估。
目前的研究结果表明，支持人员认识到 ID 个体有自杀的概念能力，注意到存在自杀讨论和行为，并报告了实际的自杀事件。这是为数不多的专门考虑该人群中自杀问题的澳大利亚研究之一，这再次证实了自杀在该人群中并非不为人知。数据表明，在 ID 个体主动谈论和实施自杀念头的报告与缺乏任何主动使用工具评估自杀风险之间存在一定差距。
