Hershman Emily, Fernandes Sara, Ceulemans Sophia, Platt Dylan
Genetic Counseling, Augustana University, Sioux Falls, South Dakota, USA.
Phoenix Children's, Pathology & Laboratory Medicine, Phoenix, Arizona, USA.
J Genet Couns. 2025 Apr;34(2):e1956. doi: 10.1002/jgc4.1956. Epub 2024 Aug 1.
While the heritability of suicidal tendencies is debated, receipt of various genetic diagnoses has shown an increased risk of suicidal ideation and behavior while simultaneously conferring risk to mental health concerns that may further increase this risk. However, the role of genetic counselors (GCs) in assessing and addressing suicide risk remains underutilized. A 15-item recruitment survey was distributed via the National Society of Genetic Counselors Student Research Survey Listserv, and interested individuals could opt to be contacted for an interview after completion. The data analysis included 107 survey responses and 15 semi-structured interviews, which were conducted to explore whether GCs feel that formal suicide risk assessment (SRA) falls within their scope of practice and the frequency with which it is employed during counseling sessions. Additionally, the study examined GCs' experiences, comfort levels, and training in assessing for suicide risk. All interviews were transcribed verbatim and independently coded by two researchers. The coding scheme was systematically constructed, integrating both deductive and inductive coding methods to inform the authors' interpretive description of SRA in the clinic, with four major themes identified by content analysis. Most respondents reported that they had worried about a patient harming themselves or having suicidal thoughts. Most respondents agreed or strongly agreed that SRA is within a GC's scope of practice. Lack of training emerged as the primary barrier to assessing suicide risk and conducting risk assessments. Other barriers included low self-efficacy, societal stigma, and personal discomfort, while access to social workers, natural inclination, and standardized screening tools served as facilitators. Despite encountering patients at risk of self-harm and suicide, most GCs do not utilize SRA tools. Furthermore, GCs expressed a strong desire for additional training to enhance their skills in identifying and managing at-risk patients. A multifocal approach to suicide risk reduction and education is required.
虽然自杀倾向的遗传性存在争议，但接受各种基因诊断已显示出自杀意念和行为的风险增加，同时还会带来心理健康问题的风险，而这可能会进一步增加这种风险。然而，遗传咨询师在评估和解决自杀风险方面的作用仍未得到充分利用。通过美国国家遗传咨询师协会学生研究调查邮件列表分发了一份包含15个项目的招募调查问卷，感兴趣的个人在完成后可以选择接受访谈。数据分析包括107份调查问卷回复和15次半结构化访谈，旨在探讨遗传咨询师是否认为正式的自杀风险评估属于他们的执业范围，以及在咨询过程中进行评估的频率。此外，该研究还考察了遗传咨询师在评估自杀风险方面的经验、舒适度和培训情况。所有访谈均逐字转录，并由两名研究人员独立编码。编码方案经过系统构建，整合了演绎和归纳编码方法，以便作者对临床中的自杀风险评估进行解释性描述，通过内容分析确定了四个主要主题。大多数受访者表示，他们曾担心患者会伤害自己或有自杀念头。大多数受访者同意或强烈同意自杀风险评估属于遗传咨询师的执业范围。缺乏培训成为评估自杀风险和进行风险评估的主要障碍。其他障碍包括自我效能感低、社会污名化和个人不适感，而能够接触到社会工作者、自然倾向和标准化筛查工具则起到了促进作用。尽管遇到有自我伤害和自杀风险的患者，但大多数遗传咨询师并未使用自杀风险评估工具。此外，遗传咨询师强烈希望获得更多培训，以提高他们识别和管理高危患者的技能。需要采取多方面的方法来降低自杀风险和开展教育。
