通过提供心理支持和解决经济困难的心理社会干预预防男性自杀：混合方法评估。
Preventing male suicide through a psychosocial intervention that provides psychological support and tackles financial difficulties: a mixed method evaluation.
机构信息
The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Medical School, University of Bristol, 9th floor Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
出版信息
BMC Psychiatry. 2022 May 13;22(1):333. doi: 10.1186/s12888-022-03973-5.
BACKGROUND
To help resolve high suicide rates in Bristol, North Somerset and South Gloucestershire, the charity Second Step was commissioned to roll-out the Hope service offering a psychosocial intervention for men, supporting them through acute distress and addressing financial difficulties. This study evaluated the impact of the Hope service on men at risk of suicide experiencing financial and other difficulties.
METHODS
Mixed methods study using: (i) a prospective cohort study design to compare depression, suicidal ideation and financial self-efficacy scores of men aged 30-64, referred to the service between October 2018 and July 2020, at baseline and 6 months follow-up and between low and moderate to high-intensity service users; and (ii) a qualitative interview study to evaluate the acceptability and impact of the Hope service to Hope service users.
RESULTS
There was a 49% reduction in depression score (mean reduction - 10.0, 95% CI - 11.7 to - 8.3) and in the proportion of service users with suicidal ideation (percent reduction - 52.5, 95% CI - 64.1% to - 40.9%) at 6 months follow-up compared to baseline. Financial self-efficacy scores increased by 26% (mean increase 2.9, 95% CI 1.8 to 3.9). Qualitative accounts illustrated how 'Hope saved my life' for several men interviewed; most respondents described being able to move forward and tackle challenges with more confidence following the Hope intervention. Professional advice to tackle financial and other difficulties such as housing helped to relieve anxiety and stress and enable practical issues to be resolved.
CONCLUSIONS
The Hope service offered practical and emotional support to men who have experienced suicidal feelings, redundancy, homelessness and poverty and occupies an important space between mental health and social care provision. Hope demonstrates the value of an intervention which cuts across traditional boundaries between psychiatric care and social advice agencies to provide, what is, in effect, an integrated care service.
背景
为帮助解决布里斯托尔、北萨默塞特和南格洛斯特郡的高自杀率问题，慈善机构 Second Step 受委托推出 Hope 服务，为男性提供心理社会干预，帮助他们度过急性困境并解决财务困难。本研究评估了 Hope 服务对有自杀风险、面临财务和其他困难的男性的影响。
方法
混合方法研究，使用：（i）前瞻性队列研究设计，比较 2018 年 10 月至 2020 年 7 月期间，年龄在 30-64 岁之间、向该服务机构转诊的男性的抑郁、自杀意念和财务自我效能评分，在基线和 6 个月随访时以及在低和中高强度服务使用者之间进行比较；（ii）定性访谈研究，评估 Hope 服务对 Hope 服务使用者的可接受性和影响。
结果
与基线相比，在 6 个月随访时，抑郁评分降低了 49%（平均降低 -10.0，95%CI-11.7 至 -8.3），有自杀意念的服务使用者比例降低了 52.5%（百分比降低 -52.5，95%CI-64.1%至-40.9%）。财务自我效能评分提高了 26%（平均提高 2.9，95%CI 1.8 至 3.9）。定性描述说明了几位接受访谈的男性如何“Hope 救了我的命”；大多数受访者表示，在接受 Hope 干预后，他们能够更有信心地向前迈进并应对挑战。提供解决财务和其他困难（如住房）的专业建议有助于缓解焦虑和压力，并能够解决实际问题。
结论
Hope 服务为经历过自杀念头、失业、无家可归和贫困的男性提供了实际和情感支持，在精神卫生和社会保健服务之间占据了重要的位置。Hope 证明了一种干预措施的价值，这种干预措施跨越了精神保健和社会咨询机构之间的传统界限，提供了一种实际上是综合保健服务。
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