BulletPoints Project.
University of California Firearm Violence Research Center.
Curr Opin Psychiatry. 2021 May 1;34(3):299-305. doi: 10.1097/YCO.0000000000000682.
Suicide is a serious public health problem in the United States, and suicide rates have been increasing for more than a decade. Rural areas are more impacted than urban areas, reinforcing that social, cultural, and economic factors contribute to risk. This article reviews recent work about these contributors to suicide and how they may inform prevention efforts.
Current research has shown that suicide is more than a mental health problem with a psychiatric or medical solution. Universal screening and referral by gatekeepers target a large group with a low baseline risk, and there are few treatments proven to reduce death by suicide, as well as a severe shortage of mental health providers in the United States to provide them. Instead, suicide prevention polices can target various other factors that contribute to elevated suicide risk at the population level, including reducing socioeconomic deprivation and access to firearms, both of which are often higher in rural areas. Internet-based interventions also hold promise as they are highly scalable, accessible almost anywhere, and often anonymous.
Understanding factors that increase suicide risk guide development of evidence-based policies targeted at high-risk groups. Population-level interventions should be developed in collaboration with the target audience for cultural appropriateness.
自杀是美国一个严重的公共卫生问题，其发生率在十余年里不断上升。农村地区比城市地区受影响更大，这进一步证实了社会、文化和经济因素会增加自杀风险。本文回顾了近期有关这些自杀风险因素的研究，以及它们如何为预防工作提供信息。
目前的研究表明，自杀不仅仅是一个具有精神科或医疗解决方案的心理健康问题。把关者进行普遍筛查和转介针对的是风险基线较低的一大人群，而被证明可以降低自杀死亡风险的治疗方法很少，而且美国的精神卫生服务提供者严重短缺，无法提供这些治疗方法。相反，预防自杀政策可以针对在人群层面增加自杀风险的各种其他因素，包括减少社会经济贫困和获得枪支的机会，而这些因素在农村地区往往更为普遍。基于互联网的干预措施也很有前景，因为它们具有高度的可扩展性，几乎在任何地方都可以使用，而且通常是匿名的。
了解增加自杀风险的因素有助于制定针对高风险人群的循证政策。针对特定文化背景的目标人群，应制定基于人口水平的干预措施。
