预防青少年自杀:现有基于学校的项目的潜在“交叉影响”。

Preventing Youth Suicide: Potential "Crossover Effects" of Existing School-Based Programs.

机构信息

RAND Corporation, 1200 South Hayes St., Arlington, 22202, VA, USA.

National Institute of Mental Health (NIMH), Bethesda, USA.

出版信息

Prev Sci. 2023 Feb;24(2):382-392. doi: 10.1007/s11121-022-01473-2. Epub 2022 Dec 9.

Abstract

Notable increases in youth mental health problems combined with strains on the already stretched mental health workforce raise concerns that there will be an ensuing increase in youth suicide thoughts, behaviors, and even deaths. Schools are recognized as crucial settings for youth mental health support and suicide prevention activities, yet schools also face staff shortages and ever-increasing responsibilities for student well-being. Evidence is emerging that prevention programs originally designed to improve problem-solving skills and social-emotional functioning in youth have demonstrated downstream, "crossover effects," that is, unanticipated benefits, on youth suicidal behavior. Relatively little research on crossover effects has been conducted within school settings, despite the strong potential for commonly administered programs to have an impact on later suicide risk. We review key suicide risk factors and their proposed mechanisms of action; we also discuss factors that may protect against suicide risk. We then identify upstream prevention programs targeting the same factors and mechanisms; these programs may hold promise for downstream, crossover effects on youth suicide risk. This paper is intended to provide a framework to help researchers, practitioners, and policymakers as they consider how to prevent youth suicide using existing school-based resources. Rigorous investigation of upstream prevention programs is urgently needed to determine ideal approaches schools and communities can deploy to prevent youth suicide.

摘要

青少年心理健康问题显著增加,加上心理健康工作者已经不堪重负,这让人担忧青少年自杀念头、行为,甚至死亡的人数会随之增加。学校被认为是青少年心理健康支持和自杀预防活动的重要场所,但学校也面临着员工短缺和学生福祉责任不断增加的问题。有证据表明,最初旨在提高青少年解决问题能力和社交情感功能的预防计划已经产生了下游的“交叉效应”,即对青少年自杀行为的意外益处。尽管普遍实施的计划可能会对以后的自杀风险产生影响,但在学校环境中对交叉效应的研究相对较少。我们回顾了关键的自杀风险因素及其拟议的作用机制;我们还讨论了可能预防自杀风险的因素。然后,我们确定了针对相同因素和机制的上游预防计划;这些计划可能对青少年自杀风险产生下游的交叉效应。本文旨在为研究人员、从业人员和政策制定者提供一个框架,帮助他们考虑如何利用现有的学校资源预防青少年自杀。迫切需要对上游预防计划进行严格调查,以确定学校和社区可以采用的理想方法来预防青少年自杀。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b36b/9734872/5c102816e9d2/11121_2022_1473_Fig1_HTML.jpg

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