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心理健康劳动力供应与青年自杀率高低集群之间的关联:使用 2016 年至 2020 年自杀死亡率数据的澳大利亚研究。

Association between mental health workforce supply and clusters of high and low rates of youth suicide: An Australian study using suicide mortality data from 2016 to 2020.

机构信息

Telethon Kids Institute, Nedlands, WA, Australia.

Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia.

出版信息

Aust N Z J Psychiatry. 2023 Nov;57(11):1465-1474. doi: 10.1177/00048674231192764. Epub 2023 Aug 22.

Abstract

OBJECTIVE

To examine the association between mental health workforce supply and spatial clusters of high versus low incidence of youth suicide.

METHODS

A cross-sectional analysis of spatial suicide clusters in young Australians (aged 10-25) from 2016 to 2020 was conducted using the scan statistic and suicide data from the National Coronial Information System. Mental health workforce was extracted from the 2020 National Health Workforce Dataset by local government areas. The Geographic Index of Relative Supply was used to estimate low and moderate-to-high mental health workforce supply for clusters characterised by a high and low incidence of suicide (termed suicide hotspots and coldspots, respectively). Univariate and multivariate logistic regression was used to determine the association between suicide clusters and a range of sociodemographic characteristics including mental health workforce supply.

RESULTS

Eight suicide hotspots and two suicide coldspots were identified. The multivariate analysis showed low mental health workforce supply was associated with increased odds of being involved in a suicide hotspot (adjusted odds ratio = 8.29; 95% confidence interval = 5.20-13.60), followed by residential remoteness (adjusted odds ratio = 2.85; 95% confidence interval = 1.68-4.89), and illicit drug consumption (adjusted odds ratio = 1.97; 1.24-3.11). Both coldspot clusters occurred in areas with moderate-to-high mental health workforce supply.

CONCLUSION

Findings highlight the potential risk and protective roles that mental health workforce supply may play in the spatial distributions of youth suicide clusters. These findings have important implications for the provision of postvention and the prevention of suicide clusters.

摘要

目的

研究心理健康劳动力供应与青年自杀发生率高低的空间集群之间的关联。

方法

使用扫描统计和国家验尸信息系统的自杀数据,对 2016 年至 2020 年澳大利亚年轻人(10-25 岁)的空间自杀集群进行了横断面分析。从地方政府区域的 2020 年国家卫生劳动力数据集提取心理健康劳动力。使用地理相对供应指数来估计高和低自杀发生率(分别称为自杀热点和冷点)的集群中的低和中高心理健康劳动力供应。使用单变量和多变量逻辑回归来确定自杀集群与一系列社会人口特征(包括心理健康劳动力供应)之间的关联。

结果

确定了 8 个自杀热点和 2 个自杀冷点。多变量分析显示,心理健康劳动力供应低与成为自杀热点的可能性增加有关(调整后的优势比=8.29;95%置信区间=5.20-13.60),其次是居住偏远(调整后的优势比=2.85;95%置信区间=1.68-4.89)和非法药物消费(调整后的优势比=1.97;1.24-3.11)。两个冷点集群都发生在中高心理健康劳动力供应的地区。

结论

研究结果强调了心理健康劳动力供应在青年自杀集群空间分布中可能发挥的潜在风险和保护作用。这些发现对预防和治疗自杀集群具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e2a/10619187/4d8271d04ea5/10.1177_00048674231192764-fig1.jpg

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