Telethon Kids Institute, Nedlands, WA 6009, Australia.
Centre for Child Health Research, The University of Western Australia, Nedlands, WA 6009, Australia.
Int J Environ Res Public Health. 2022 Apr 7;19(8):4444. doi: 10.3390/ijerph19084444.
Suicide clusters involve an excessive number of suicides, suicide attempts, or both, that occur close in space or time or involve social links between cluster members. Although suicide clusters are rare, evidence documenting the implementation of suicide cluster response activities in communities is required yet remains limited. In this study, we identified the core components of existing suicide cluster response frameworks through a search of the grey literature and conducted an international survey to assess the implementation of the core components by stakeholders with experience responding to a suicide cluster. The following six core components were identified from five cluster response frameworks and were incorporated into a survey assessing stakeholders' experiences of responding to a suicide cluster: (1) Preparing for a suicide cluster; (2) Routine monitoring of suicide, suicide attempts, and cluster detection; (3) Coordination with the media and monitoring social media; (4) Identifying and supporting individuals at risk; (5) Promoting help-seeking and building community resilience; and (6) Long-term follow-up and evaluation. Twenty-six stakeholders completed the online survey. Many of the core components were implemented by stakeholders. However, gaps in practice were reported in terms of cluster surveillance, monitoring of referral uptake among bereaved individuals, and long-term evaluation. Barriers to implementation included the perceived availability and suitability of mental health services, and availability of long-term funding. Strategic policy and planning that addresses the practice-based experiences of communities has the potential to facilitate a more coordinated and timely response to suicide clusters.
自杀集群涉及过多的自杀、自杀未遂或两者兼而有之，这些事件在空间或时间上较为接近，或者涉及集群成员之间的社会联系。虽然自杀集群很少见，但需要有记录证明社区实施了自杀集群应对活动的证据，但目前这方面的证据仍然有限。在这项研究中，我们通过搜索灰色文献确定了现有自杀集群应对框架的核心组成部分，并进行了一项国际调查，以评估有过应对自杀集群经验的利益相关者对核心组成部分的实施情况。从五个集群应对框架中确定了以下六个核心组成部分，并将其纳入评估利益相关者应对自杀集群经验的调查中：（1）为自杀集群做准备；（2）常规监测自杀、自杀未遂和集群检测；（3）与媒体协调并监测社交媒体；（4）识别和支持处于危险中的个人；（5）促进寻求帮助和建立社区复原力；（6）长期随访和评估。26 名利益相关者完成了在线调查。许多核心组成部分都得到了利益相关者的实施。然而，在集群监测、监测丧亲者的转介参与率以及长期评估方面，实践中存在差距。实施方面的障碍包括心理健康服务的可用性和适用性，以及长期资金的可用性。针对社区实践经验的战略政策和规划有可能促进对自杀集群更协调和及时的应对。
