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一种针对青少年心理健康服务中自杀意念和行为的数字方法:观察性研究。

A Digital Approach for Addressing Suicidal Ideation and Behaviors in Youth Mental Health Services: Observational Study.

作者信息

Chong Min K, Hickie Ian B, Ottavio Antonia, Rogers David, Dimitropoulos Gina, LaMonica Haley M, Borgnolo Luke J, McKenna Sarah, Scott Elizabeth M, Iorfino Frank

机构信息

Brain and Mind Centre, The University of Sydney, Camperdown, Australia.

headspace Bondi Junction, Sydney, Australia.

出版信息

J Med Internet Res. 2024 Dec 18;26:e60879. doi: 10.2196/60879.

Abstract

BACKGROUND

Long wait times for mental health treatments may cause delays in early detection and management of suicidal ideation and behaviors, which are crucial for effective mental health care and suicide prevention. The use of digital technology is a potential solution for prompt identification of youth with high suicidality.

OBJECTIVE

The primary aim of this study was to evaluate the use of a digital suicidality notification system designed to detect and respond to suicidal needs in youth mental health services. Second, the study aimed to characterize young people at different levels of suicidal ideation and behaviors.

METHODS

Young people aged between 16 and 25 years completed multidimensional assessments using a digital platform, collecting demographic, clinical, social, functional, and suicidality information. When the suicidality score exceeded a predetermined threshold, established based on clinical expertise and service policies, a rule-based algorithm configured within the platform immediately generated an alert for treating clinicians. Subsequent clinical actions and response times were analyzed.

RESULTS

A total of 2021 individuals participated, of whom 266 (11%) triggered one or more high suicidal ideation and behaviors notification. Of the 292 notifications generated, 76% (222/292) were resolved, with a median response time of 1.9 (range 0-50.8) days. Clinical actions initiated to address suicidality included creating safety plans (60%, 134/222), conducting safety checks (18%, 39/222), psychological therapy (8%, 17/222), transfer to another service (3%, 8/222), and scheduling of new appointments (2%, 4/222). Young people with high levels of suicidality were more likely to present with more severe and comorbid symptoms, including low engagement in work or education, heterogenous psychopathology, substance misuse, and recurrent illness.

CONCLUSIONS

The digital suicidality notification system facilitated prompt clinical actions by alerting clinicians to high levels of suicidal ideation and behaviors detected among youth. Further, the multidimensional assessment revealed complex and comorbid symptoms exhibited in youth with high suicidality. By expediting and personalizing care for those displaying elevated suicidality, the digital notification system can play a pivotal role in preventing rapid symptom progression and its detrimental impacts on young people's mental health.

摘要

背景

心理健康治疗的长时间等待可能会导致自杀意念和行为的早期发现及管理出现延迟,而这对于有效的心理健康护理和自杀预防至关重要。使用数字技术是快速识别高自杀倾向青年的一个潜在解决方案。

目的

本研究的主要目的是评估一种数字自杀倾向通知系统在青少年心理健康服务中用于检测和应对自杀需求的应用情况。其次,该研究旨在描述处于不同自杀意念和行为水平的年轻人的特征。

方法

年龄在16至25岁之间的年轻人使用数字平台完成多维度评估,收集人口统计学、临床、社会、功能和自杀倾向信息。当自杀倾向评分超过基于临床专业知识和服务政策设定的预定阈值时,平台内配置的基于规则的算法会立即为治疗临床医生生成警报。随后对后续的临床行动和响应时间进行了分析。

结果

共有2021人参与,其中266人(11%)触发了一次或多次高自杀意念和行为通知。在生成的292条通知中,76%(222/292)得到解决,中位响应时间为1.9天(范围0 - 50.8天)。为解决自杀倾向而采取的临床行动包括制定安全计划(60%,134/222)、进行安全检查(18%,39/222)、心理治疗(8%,17/222)、转至另一服务机构(3%,8/222)以及安排新预约(2%,4/222)。自杀倾向程度高的年轻人更有可能出现更严重和共病的症状,包括工作或教育参与度低、多种精神病理学症状、药物滥用和反复患病。

结论

数字自杀倾向通知系统通过提醒临床医生注意在青少年中检测到的高自杀意念和行为,促进了及时的临床行动。此外,多维度评估揭示了自杀倾向高的青少年表现出的复杂和共病症状。通过加快并个性化对那些自杀倾向升高者的护理,数字通知系统可以在防止症状快速进展及其对年轻人心理健康的有害影响方面发挥关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463c/11694056/61c55bb9321d/jmir_v26i1e60879_fig1.jpg

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