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"守护守门人": 心理健康专业人员的自杀问题及预防范围综述。

"Guarding the Gatekeepers": Suicides among Mental Health Professionals and Scope of Prevention, A Review.

机构信息

Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.

Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.

出版信息

Psychiatry Res. 2020 Dec;294:113501. doi: 10.1016/j.psychres.2020.113501. Epub 2020 Oct 8.

DOI:10.1016/j.psychres.2020.113501
PMID:33065373
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7543698/
Abstract

Suicide is a social evil that is considered to be a global epidemic. Mental healthcare professionals (MHP) (psychiatrists, clinical psychologists, psychiatric social work, etc.) are often involved as 'gatekeepers' in the management of suicidality and suicide prevention. Even though the risk of suicide in medical profession has received attention in research, there has been scarcity of literature related to the same in MHPs. They are not immune to the perils of psychological distress and its cascading consequences including suicide, contrary to the popular societal myths. The intrinsic and extrinsic pressures of the profession, persistent discourse in managing the psychological distress of others, professional burnout, self-stigma, societal apathy and easy access to psychotropics are certain factors making the MHPs more vulnerable. This disengagement and stress can contribute to depression, anxiety and complex trauma in the MHPs. The situation is furthermore compounded in developing countries with resource constraints, low MHP: patient ratio and inflexibility of work schedules. This makes tailored interventions, peer counselling, periodic mental health screenings and administrative understanding and accountability necessary at all levels. Keeping this in background, the review glances at the risk factors of suicide related to MHPs, highlights the problem statement and discusses the possible interventions.

摘要

自杀是一种社会恶疾,被认为是一种全球性的流行疾病。精神卫生专业人员(MHP)(精神科医生、临床心理学家、精神科社会工作者等)通常作为“把关人”参与到自杀倾向和自杀预防的管理中。尽管医学专业人员的自杀风险在研究中已经受到关注,但与 MHP 相关的文献却很少。与流行的社会神话相反,他们并非免受心理困扰及其连锁后果(包括自杀)的影响。职业的内在和外在压力、持续不断地处理他人的心理困扰、职业倦怠、自我污名、社会冷漠以及容易获得精神药物,这些都是使 MHP 更容易受到伤害的某些因素。这种脱节和压力会导致 MHP 出现抑郁、焦虑和复杂创伤。在资源有限、MHP 与患者比例低以及工作时间表缺乏灵活性的发展中国家,情况更为复杂。因此,在各个层面都需要进行有针对性的干预、同伴咨询、定期的心理健康筛查以及行政理解和问责。有鉴于此,本综述回顾了与 MHP 相关的自杀风险因素,强调了问题陈述,并讨论了可能的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09db/7543698/807c7f40afd9/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09db/7543698/807c7f40afd9/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09db/7543698/807c7f40afd9/gr1_lrg.jpg

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本文引用的文献

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Indian J Psychiatry. 2020 Mar-Apr;62(2):114-120. doi: 10.4103/psychiatry.IndianJPsychiatry_767_19. Epub 2020 Mar 17.
3
Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review.由于 COVID-19 大流行,医护人员面临的心理健康问题 - 综述。
年轻人如何应对自杀念头?一项关于利益相关者经历的定性研究。
Indian J Psychiatry. 2024 Sep;66(9):796-804. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_488_24. Epub 2024 Sep 19.
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Suicide risk and prevention during the COVID-19 pandemic.2019冠状病毒病大流行期间的自杀风险与预防
Lancet Psychiatry. 2020 Jun;7(6):468-471. doi: 10.1016/S2215-0366(20)30171-1. Epub 2020 Apr 21.
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The National Mental Health Survey of India (2016): Prevalence, socio-demographic correlates and treatment gap of mental morbidity.印度国家心理健康调查(2016):精神疾病的患病率、社会人口学相关性和治疗差距。
Int J Soc Psychiatry. 2020 Jun;66(4):361-372. doi: 10.1177/0020764020907941. Epub 2020 Mar 4.
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Sustainability and Outcomes of a Suicide Prevention Program for Nurses.护士自杀预防计划的可持续性和结果。
Worldviews Evid Based Nurs. 2020 Feb;17(1):24-31. doi: 10.1111/wvn.12418.
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