Department of Emergency Medical Science, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.
Department of Mathematics and Physics, Faculty of Applied Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.
Psychol Health Med. 2024 Apr;29(4):743-753. doi: 10.1080/13548506.2023.2214867. Epub 2023 May 18.
Escalation in Deliberate Self-Harm (DSH) is indicative of a rise in poor mental health and/or a failure of social and health services. The phenomenon of DSH exacerbates mental illness sequela, while being an essential indicator of suicide risk. Globally, about 800 000 people commit suicide yearly, averaging almost one suicide every 40 s. Based on a Retrospective Cross-Sectional Study, the aim sought to establish the scope of the DSH, suicidality and suicide case-load from a Western Cape Emergency Medical Services (EMS) prehospital perspective. A census of 3 years of EMS Incident Management Records (IMR) from a large rural district with seven local municipalities was undertaken using a novel data collection instrument. The 2976 (N) mental health-related incidents that met the inclusion criteria (from 413 712 cases) suggest a presentation rate of 7 per 1000 EMS calls. Sixty percent ( = 1776) were regarded to have deliberately self-harmed, attempted suicide or committed suicide. Overdose/deliberate self-poisoning accounted for 52% ( = 1550) of all the DSH caseload of the study. Attempted suicide accounted for 2.7% ( = 83) and Suicide for 3.4% ( = 102) of the suicidality case-load from the study, respectively. Suicide averaged 2.8. suicides per month in the Garden Route District over the 3-year period. Men were five times more likely to commit suicide than women, commonly using strangulation, while women mostly ingested household detergents and poison, and overdosed on chronic medication. Understandably, the EMS needs to assess its own capability to respond, treat, and transport health-care users with DSH and suicidality. This study demonstrates the EMS 'everyday' exposure to DSH, suicidality and suicide case-load. It represents a critical first step in the problem-space definition upon which a determination of the need for EMS responses can be based, to interrupt suicidality by removing methods of harm and strengthening the mental health economy through social capital investment.
自伤行为升级表明心理健康状况恶化和/或社会和卫生服务失败。自伤行为现象会加重精神疾病的后果，同时也是自杀风险的重要指标。全球每年约有 80 万人自杀，平均每 40 秒就有一人自杀。基于一项回顾性横断面研究，本研究旨在从西开普省紧急医疗服务（EMS）院前角度确定自伤行为、自杀意念和自杀病例的范围。使用一种新颖的数据收集工具，对一个拥有七个地方市政当局的大型农村地区的 EMS 事件管理记录（IMR）进行了为期 3 年的普查。符合纳入标准的 2976 例（N）与心理健康相关的事件（来自 413712 例）表明，每 1000 次 EMS 呼叫中有 7 次呈现率。60%（=1776）被认为故意自伤、自杀未遂或自杀。过量用药/故意自我中毒占研究中所有自伤行为病例的 52%（=1550）。自杀未遂占研究中自杀意念病例的 2.7%（=83），自杀占 3.4%（=102）。在过去的 3 年里，花园路线地区平均每月有 2.8 人自杀。男性自杀的可能性是女性的五倍，通常使用绞杀，而女性大多吞食家用清洁剂和毒药，以及过量服用慢性药物。可以理解的是，EMS 需要评估自己应对、治疗和转运有自伤行为和自杀意念的卫生保健用户的能力。这项研究展示了 EMS 日常接触到的自伤行为、自杀意念和自杀病例。这是在问题空间定义方面迈出的关键第一步，可以根据需要确定 EMS 的反应，通过消除伤害方法和通过社会资本投资加强精神卫生经济来中断自杀意念。
