Bismark Marie, Smallwood Natasha, Jain Ria, Willis Karen
Centre for Health Policy, The University of Melbourne, Australia.
Department of Respiratory Medicine, The Alfred Hospital, Australia; and Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital and Monash University, Australia.
BJPsych Open. 2022 Jun 14;8(4):e113. doi: 10.1192/bjo.2022.509.
Healthcare workers are at higher risk of suicide than other occupations, and suicidal thoughts appear to have increased during the COVID-19 pandemic.
To understand the experiences of healthcare workers with frequent thoughts of suicide or self-harm during the pandemic, including factors that contributed to their distress, and the supports that they found helpful.
We used content analysis to analyse free-text responses to the Australian COVID-19 Frontline Healthcare Workers Study, from healthcare workers who reported frequent thoughts that they would be better off dead or of hurting themselves, on the Patient Health Questionnaire-9.
A total of 262 out of 7795 healthcare workers (3.4%) reported frequent thoughts of suicide or self-harm in the preceding 2 weeks. They described how the pandemic exacerbated pre-existing challenges in their lives, such as living with a mental illness, working in an unsupportive environment and facing personal stressors like relationship violence or unwell family members. Further deterioration in their mental health was triggered by heavier obligations at home and work, amid painful feelings of loneliness. They reported that workplace demands rose without additional resources, social and emotional isolation increased and many healthful activities became inaccessible. Tokenistic offers of support fell flat in the face of multiple barriers to taking leave or accessing professional help. Validation of distress, improved access to healthcare and a stronger sense of belonging were identified as helpful supports.
These findings highlight the need for better recognition of predisposing, precipitating, perpetuating and protective factors for thoughts of suicide and self-harm among healthcare workers.
医护人员自杀风险高于其他职业，且在新冠疫情期间自杀念头似乎有所增加。
了解疫情期间有频繁自杀或自伤念头的医护人员的经历，包括导致他们痛苦的因素以及他们认为有帮助的支持措施。
我们采用内容分析法，对澳大利亚新冠一线医护人员研究中的自由文本回复进行分析，这些回复来自在患者健康问卷-9中报告频繁有自己死了会更好或伤害自己想法的医护人员。
在7795名医护人员中，共有262人（3.4%）报告在过去两周内有频繁的自杀或自伤念头。他们描述了疫情如何加剧了他们生活中先前存在的挑战，比如患有精神疾病、在缺乏支持的环境中工作以及面临诸如关系暴力或家人患病等个人压力源。在家务和工作责任加重的情况下，孤独带来的痛苦情绪引发了他们心理健康的进一步恶化。他们报告称，工作场所的需求增加但没有额外资源，社交和情感孤立加剧，许多有益健康的活动无法开展。面对请假或获得专业帮助的多重障碍，象征性的支持提议毫无作用。对痛苦的认可、改善医疗服务的可及性以及更强的归属感被认为是有帮助的支持措施。
这些发现凸显了更好地识别医护人员自杀和自伤念头的诱发、促发、持续和保护因素的必要性。
