Moutier Christine
American Foundation for Suicide Prevention, New York, New York.
JAMA Psychiatry. 2020 Oct 16. doi: 10.1001/jamapsychiatry.2020.3746.
Suicide, a leading cause of death with devastating emotional and societal costs, is a generally preventable cause of death and a critical global public health issue. The coronavirus disease 2019 (COVID-19) pandemic may increase the risk of population suicide through its effects on a number of well-established suicide risk factors.
Prior to the pandemic, many countries were engaging in suicide prevention strategies, and although the overall global burden of suicide deaths has increased, some national efforts were beginning to see positive results. Additionally, the gap between mental health needs and services has been increasing in many nations. With the added physical and mental health, social, and economic burdens imposed by the pandemic, many populations worldwide may experience increased suicide risk. Data and recent events during the first 6 months of the pandemic reveal specific effects on suicide risk. However, increases in suicide rates are not a foregone conclusion even with the negative effects of the pandemic. In fact, emerging suicide data from several countries show no evidence of an increase in suicide during the pandemic thus far. There are actionable steps that policy makers, health care leaders, and organizational leaders can take to mitigate suicide risk during and after the pandemic.
COVID-19 presents a new and urgent opportunity to focus political will, federal investments, and global community on the vital imperative of suicide prevention. Suicide prevention in the COVID-19 era requires addressing not only pandemic-specific suicide risk factors, but also prepandemic risk factors. This Special Communication provides prioritized, evidence-based strategies for clinicians and health care delivery systems, along with national and local policy and educational initiatives tailored to the COVID-19 environment. If implemented to scale, these interventions could significantly mitigate the pandemic's negative effects on suicide risk.
自杀是导致死亡的主要原因之一，会造成毁灭性的情感和社会代价，是一种通常可预防的死因，也是一个关键的全球公共卫生问题。2019年冠状病毒病（COVID-19）大流行可能通过对一些已确定的自杀风险因素产生影响，增加人群自杀风险。
在大流行之前，许多国家就已在实施自杀预防策略，尽管全球自杀死亡的总体负担有所增加，但一些国家的努力已开始取得积极成果。此外，许多国家心理健康需求与服务之间的差距一直在扩大。随着大流行带来的身心健康、社会和经济负担加重，全球许多人群的自杀风险可能会增加。大流行头6个月的数据和近期事件揭示了对自杀风险的具体影响。然而，即使有大流行的负面影响，自杀率上升也并非必然结果。事实上，来自几个国家的最新自杀数据显示，迄今为止在大流行期间没有自杀率上升的迹象。政策制定者、医疗保健领导者和组织领导者可以采取一些可行的措施，以减轻大流行期间及之后的自杀风险。
COVID-19为将政治意愿、联邦投资和全球社会的注意力集中在预防自杀这一至关重要的任务上提供了一个新的紧迫契机。COVID-19时代的自杀预防不仅需要应对特定于大流行的自杀风险因素，还需要应对大流行之前的风险因素。本专题通信为临床医生和医疗保健提供系统提供了按优先级排列的、基于证据的策略，以及针对COVID-19环境量身定制的国家和地方政策及教育举措。如果大规模实施这些干预措施，可能会显著减轻大流行对自杀风险的负面影响。
