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在精神卫生服务中,为患有精神病的人实施以自杀为重点的心理治疗时,对服务使用者和工作人员而言,什么是重要的?

What is important to service users and staff when implementing suicide-focused psychological therapies for people with psychosis into mental health services?

作者信息

Peters Sarah, Awenat Yvonne, Gooding Patricia A, Harris Kamelia, Cook Leanne, Huggett Charlotte, Jones Steven, Lobban Fiona, Pratt Daniel, Haddock Gillian

机构信息

Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.

Manchester Academic Health Science Centre (MAHSC), Manchester, United Kingdom.

出版信息

Front Psychiatry. 2023 May 12;14:1154092. doi: 10.3389/fpsyt.2023.1154092. eCollection 2023.

Abstract

INTRODUCTION

Suicide is a leading cause of death globally. People with psychosis are at increased risk of suicide death and up to half experience suicidal thoughts and/or engage in suicidal behaviors in their lifetime. Talking therapies can be effective in alleviating suicidal experiences. However, research is yet to be translated into practice, demonstrating a gap in service provision. The barriers and facilitators in therapy implementation require a thorough investigation including the perspectives of different stakeholders such as service users and mental health professionals. This study aimed to investigate stakeholders' (health professionals and service users) perspectives of implementing a suicide-focused psychological therapy for people experiencing psychosis in mental health services.

METHODS

Face-to-face, semi-structured interviews with 20 healthcare professionals and 18 service users were conducted. Interviews were audio recorded and transcribed verbatim. Data were analyzed and managed using reflexive thematic analysis and NVivo software.

RESULTS

For suicide-focused therapy to be successfully implemented in services for people with psychosis, there are four key aspects that need to be considered: (i) Creating safe spaces to be understood; (ii) Gaining a voice; (iii) Accessing therapy at the right time; and (iv) Ensuring a straightforward pathway to accessing therapy.

DISCUSSION

Whilst all stakeholders viewed a suicide-focused therapy as valuable for people experiencing psychosis, they also recognize that enabling successful implementation of such interventions will require additional training, flexibility, and resources to existing services.

摘要

引言

自杀是全球主要的死亡原因之一。患有精神病的人自杀死亡风险增加,多达一半的人在一生中会有自杀念头和/或实施自杀行为。谈话疗法在减轻自杀经历方面可能有效。然而,研究尚未转化为实践,这表明服务提供方面存在差距。治疗实施中的障碍和促进因素需要进行全面调查,包括服务使用者和心理健康专业人员等不同利益相关者的观点。本研究旨在调查利益相关者(卫生专业人员和服务使用者)对在心理健康服务中为患有精神病的人实施以自杀为重点的心理治疗的看法。

方法

对20名医疗保健专业人员和18名服务使用者进行了面对面的半结构化访谈。访谈进行了录音并逐字转录。使用反思性主题分析和NVivo软件对数据进行分析和管理。

结果

为了在为患有精神病的人的服务中成功实施以自杀为重点的治疗,需要考虑四个关键方面:(i)创造被理解的安全空间;(ii)获得发言权;(iii)在合适的时间获得治疗;(iv)确保获得治疗的直接途径。

讨论

虽然所有利益相关者都认为以自杀为重点的治疗对患有精神病的人有价值,但他们也认识到,要使此类干预措施成功实施,现有服务需要额外的培训、灵活性和资源。

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