Horowitz Lisa M, Ryan Patrick C, Wei August X, Boudreaux Edwin D, Ackerman John P, Bridge Jeffrey A
Office of the Clinical Director, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland (Horowitz, Ryan, Wei); Department of Emergency Medicine, Department of Psychiatry, and Department of Population and Quantitative Health Sciences, Chan Medical School, University of Massachusetts, Worcester (Boudreaux); Center for Suicide Prevention and Research, Big Lots Behavioral Health Pavilion, Nationwide Children's Hospital, Columbus, Ohio (Ackerman, Bridge); Department of Psychiatry and Behavioral Health (Ackerman, Bridge) and Department of Pediatrics (Bridge), College of Medicine, The Ohio State University, Columbus.
Focus (Am Psychiatr Publ). 2023 Apr;21(2):145-151. doi: 10.1176/appi.focus.20220086. Epub 2023 Apr 14.
Early detection of risk is a key suicide prevention strategy. Given that most individuals who die by suicide visit a health care provider in the year leading up to their death, medical settings are ideal venues for identifying those at elevated risk and bridging them to life-saving care. Clinicians are presented with an opportunity to engage in proactive suicide prevention efforts through practical and adaptable suicide risk screening, assessment, and management processes. Psychiatrists and mental health clinicians are well positioned to assist nonpsychiatric clinicians on the frontlines of this public health problem. This article discusses the importance of identifying people at elevated suicide risk through screening, differentiates screening from assessment procedures, and presents practical strategies for implementing evidence-based screening and assessment tools into practice as part of a three-tiered clinical pathway. Specifically, this article discusses key components that guide embedding suicide prevention strategies into the workflows of busy medical settings.
早期发现风险是预防自杀的关键策略。鉴于大多数自杀身亡者在死前一年会去看医疗服务提供者,医疗机构是识别高危人群并为其提供挽救生命护理的理想场所。临床医生有机会通过切实可行且可调整的自杀风险筛查、评估和管理流程,积极参与自杀预防工作。精神科医生和心理健康临床医生能够很好地协助处于这一公共卫生问题一线的非精神科临床医生。本文讨论了通过筛查识别自杀风险较高人群的重要性,区分了筛查与评估程序,并介绍了作为三层临床路径的一部分,将循证筛查和评估工具应用于实践的实用策略。具体而言,本文讨论了将自杀预防策略融入繁忙医疗机构工作流程的关键组成部分。