Faculty of Medicine and Health, University of Sydney, Australia; and Faculty of Medicine, University of New South Wales, Australia.
NSW Health Education and Training Institute, North Parramatta, NSW, Australia.
Australas Psychiatry. 2022 Jun;30(3):290-293. doi: 10.1177/10398562211054034. Epub 2021 Nov 27.
The Zero Suicide (ZS) framework is increasingly used in Australia, but without published adaptations for older people, and limited access by older people when implemented. The aim of this paper is to inform Towards Zero Suicide (TZS) implementations to benefit older adults by considering the key differences in older adults at risk of suicide according to each clinical component of the ZS framework.
TZS aspires to reduce deaths by suicide for people within healthcare by refocusing interventions on suicidality rather than diagnosis alone, emphasising evidence-based practices and cultural change. For TZS to be effective for older people, it is essential to ensure practices are based upon evidence relevant to older people and to ensure ageism is effectively counteracted. Older adults have distinct patterns of help seeking and service use, accompanied by differences in risk factors, presentations, and outcomes of suicidal behaviours. Ageism affects assessment, decision-making and actions to address self-harm and suicide for older people. Immediate and longer-term actions are essential to effectively implement TZS in this population.
零自杀（ZS）框架在澳大利亚越来越多地被使用，但没有针对老年人的已发表的适应性调整，而且在实施时老年人获得的机会有限。本文旨在通过考虑 ZS 框架每个临床部分中与有自杀风险的老年人相关的关键差异，为迈向零自杀（TZS）的实施提供信息，以造福老年人。
TZS 通过将干预措施重新聚焦于自杀意念，而不仅仅是诊断，强调基于证据的实践和文化变革，以期减少医疗保健范围内的自杀死亡人数。为了使 TZS 对老年人有效，必须确保实践基于与老年人相关的证据，并有效地克服年龄歧视。老年人的寻求帮助和使用服务的模式明显不同，同时伴有自杀行为的风险因素、表现和结果的差异。年龄歧视会影响对老年人的自我伤害和自杀的评估、决策和应对行动。要在这一人群中有效地实施 TZS，必须立即采取并着眼于长期行动。
