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监禁成年人在自杀未遂后的医疗保健差距。

Health care disparities for incarcerated adults after a suicide attempt.

机构信息

University of Chicago Crown Family School of Social Work, Policy, and Practice, Chicago, Illinois, USA.

University of Illinois at Urbana-Champaign, School of Social Work, Urbana, Illinois, USA.

出版信息

Suicide Life Threat Behav. 2021 Oct;51(5):931-939. doi: 10.1111/sltb.12776. Epub 2021 Jun 29.

Abstract

OBJECTIVE

Incarcerated adults have high rates of fatal and nonfatal suicidal behaviors. Suicide prevention recommendations stress the need for the provision of health care for incarcerated adults after suicide attempts, yet prison policies and practices often focus instead on punitive responses to suicidal behaviors. Existing research is limited regarding factors that predict the provision of health care to incarcerated adults post-suicide attempt. The current study examined individual, incident, and institutional factors as predictors of health care to incarcerated adults post-suicide attempt.

METHOD

We used data from critical incidents reports for suicide attempts (N = 495) to conduct mixed-effects logistical regression models.

RESULTS

Staff responded to suicide attempts by placing incarcerated adults under direct observation (with no care) or in segregation at odds two and three times higher than of providing health care, particularly in prisons for men. Race was a significant factor; incidents involving Black men were less likely than incidents involving white men to include staff requesting health care, and incidents involving Black women were less likely than incidents involving white women to include requesting and providing health care.

CONCLUSIONS

This study's findings highlight factors predicting health care responses to suicide attempts and the need to address and prevent health care disparities in prisons.

摘要

目的

监禁成年人的致命和非致命自杀行为发生率很高。自杀预防建议强调在试图自杀后为监禁成年人提供医疗保健的必要性,但监狱政策和做法往往侧重于对自杀行为采取惩罚性反应。现有研究对于预测在试图自杀后为监禁成年人提供医疗保健的因素有限。本研究探讨了个体、事件和机构因素作为在试图自杀后为监禁成年人提供医疗保健的预测因素。

方法

我们使用了 495 例自杀未遂的关键事件报告中的数据,进行了混合效应逻辑回归模型分析。

结果

工作人员通过直接观察(不提供护理)或隔离来应对自杀未遂,这种情况的发生几率是提供医疗保健的两倍或三倍,尤其是在男子监狱。种族是一个重要因素;涉及黑人男性的事件比涉及白人男性的事件中,工作人员要求提供医疗保健的可能性要低,而涉及黑人女性的事件比涉及白人女性的事件中,要求和提供医疗保健的可能性要低。

结论

本研究的结果强调了预测对自杀未遂的医疗保健反应的因素,并需要解决和预防监狱中的医疗保健差异。

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