Arch Suicide Res. 2023 Jan-Mar;27(1):29-42. doi: 10.1080/13811118.2021.1965058. Epub 2021 Sep 1.
A suicide audit was pilot implemented in order to generate recommendations on how to improve suicide prevention.
Thirty-nine consecutive suicides that occurred in Montreal, Canada from January to October 2016 were audited. A retrospective analysis of their life trajectory and service utilization was conducted using the psychological autopsy method, which included interviewing suicide-bereaved survivors and examining health and social services records and the coroner's investigation file. A psychosocial and service utilization profile was drawn for each decedent. A multidisciplinary panel reviewed each case summary to identify gaps in terms of individual intervention, provincial public health and social services, and regional programs.
Five main suicide prevention recommendations were made to prevent similar suicides: (1) deploy mobile crisis intervention teams (short-term, high-intensity, home-based treatment) in hospital emergency departments; (2) train primary and specialized mental health care professionals to screen for and manage substance use disorders; and (3) implement public awareness campaigns to encourage help seeking for depression and substance use disorders; (4) access for all, regardless of age, to an effective psychosis treatment program; and (5) provide universal access to a general practitioner, especially for men.
The suicide audit procedure was implemented effectively and targeted recommendations were generated to prevent similar suicides. However, resistance from medical and hospital quality boards arose during the process, though these could be allayed if regional and provincial authorities actively endorsed the multidisciplinary and multi stakeholders suicide audit process. HighlightsA bottom-up approach to generate recommendations for suicide prevention.Implementation was challenging with resistance to our interdisciplinary approach.The audit needs the support of the regional health department to lift barriers.
为了提出有关如何改进自杀预防的建议，试点实施了自杀审核。
对 2016 年 1 月至 10 月期间在加拿大蒙特利尔发生的 39 例连续自杀事件进行了审核。使用心理解剖方法对他们的生命轨迹和服务利用情况进行回顾性分析，包括采访自杀幸存者，并检查健康和社会服务记录以及验尸官的调查档案。为每位死者绘制了一个社会心理和服务利用概况。一个多学科小组审查了每个案例摘要，以确定在个人干预、省级公共卫生和社会服务以及区域计划方面的差距。
为防止类似自杀事件，提出了五项主要的自杀预防建议：（1）在医院急诊部门部署流动危机干预小组（短期、高强度、家庭治疗）；（2）培训初级和专业精神卫生保健专业人员，以筛查和管理物质使用障碍；（3）开展公众宣传活动，鼓励寻求抑郁和物质使用障碍的帮助；（4）所有人，无论年龄大小，都可以获得有效的精神病治疗方案；（5）为所有人，特别是男性，提供普遍获得普通医生的途径。
自杀审核程序实施有效，并提出了有针对性的建议，以防止类似自杀事件的发生。然而，在实施过程中，医疗和医院质量委员会提出了反对意见，但如果区域和省级当局积极支持多学科和多利益攸关方的自杀审核程序，这些反对意见是可以消除的。
提出自杀预防建议的自下而上方法。
实施具有挑战性，存在对我们跨学科方法的抵制。
审核需要区域卫生部门的支持，以消除障碍。
