Nicoll Gina, Vincent Jacqueline, Gajaria Amy, Zaheer Juveria
Department of Psychology, Faculty of Arts & Science, University of Toronto, Toronto, Ontario, Canada; Institute for Medical Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
St. Michael's Hospital, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Psychiatry Res. 2023 Sep;327:115407. doi: 10.1016/j.psychres.2023.115407. Epub 2023 Aug 6.
During the COVID-19 pandemic, researchers have questioned how the devastation of the pandemic might impact suicide rates. While initial evidence on suicide rates during the early stages of the pandemic is mixed, there are signs we should still remain vigilant. One way of conceptualizing the long-term effects of the pandemic is as a source of multiple traumatic events: the collective trauma of widespread illness and death and social upheaval, individual traumas from the virus itself (e.g., serious illness and disability, traumatic grief, vicarious trauma), traumas from the social and economic consequences (e.g., domestic violence, unemployment), and its intersections with pre-pandemic traumas and oppression. Given trauma is a well-established risk factor for suicide, this carries significant implications for suicide prevention in the wake of the pandemic. Yet access to trauma-informed care, education, and research remains limited. The pandemic presents a unique opportunity to address these gaps and implement a trauma-informed approach to suicide prevention. Building on existing frameworks, we describe how effective suicide prevention for the pandemic must incorporate trauma-informed and trauma-specific services, strategies, and policies; capacity building; collaborative research; and knowledge exchange. Attending to the traumatic effects of the pandemic may reduce the long-term impact on suicide rates.
在新冠疫情期间，研究人员对疫情的破坏可能如何影响自杀率提出了疑问。虽然疫情初期关于自杀率的初步证据喜忧参半，但仍有迹象表明我们应保持警惕。将疫情的长期影响概念化的一种方式是将其视为多种创伤事件的源头：广泛疾病和死亡以及社会动荡带来的集体创伤、病毒本身造成的个人创伤（例如重病和残疾、创伤性悲伤、替代性创伤）、社会和经济后果导致的创伤（例如家庭暴力、失业），以及它与疫情前的创伤和压迫的交叉影响。鉴于创伤是自杀的一个公认风险因素，这对疫情后的自杀预防具有重大影响。然而，获得创伤知情护理、教育和研究的机会仍然有限。疫情提供了一个独特的机会来填补这些空白，并实施一种创伤知情的自杀预防方法。基于现有框架，我们描述了针对疫情的有效自杀预防必须如何纳入创伤知情和针对创伤的服务、策略和政策；能力建设；合作研究；以及知识交流。关注疫情的创伤影响可能会降低对自杀率的长期影响。
