Implementing Evidence-Based Suicide Prevention Strategies for Greatest Impact.
Implementing Evidence-Based Suicide Prevention Strategies for Greatest Impact.
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DOI：
10.1176/appi.focus.20220078
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发表时间：
2023-04
期刊：
影响因子：
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通讯作者：
N. Melhem;C. Moutier;D. Brent
中科院分区：
文献类型：
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作者：
N. Melhem;C. Moutier;D. Brent
自杀仍然是美国乃至全球的主要死亡原因。在本综述中，考虑到COVID-19大流行的影响，介绍了死亡率和自杀风险的流行病学趋势。具有社区和临床框架的自杀预防公共卫生模式，以及科学发现方面的进展，提供了等待广泛实施的新解决办法。提出了具有降低自杀行为风险证据的可操作干预措施，包括社区、公共政策和临床层面的普遍和有针对性的战略。临床干预措施包括筛查和风险评估；可在初级保健、急诊和行为卫生机构进行的简短干预（例如，安全规划、教育和致命手段咨询）；心理治疗（认知行为、辩证行为、心理化治疗）；药物治疗;以及卫生保健组织的全系统程序（培训、政策、工作流程、自杀指标监测、使用健康记录进行筛查、护理步骤）。必须优先考虑自杀预防战略，并大规模实施，以产生最大影响。
Suicide remains a leading cause of death in the United States and globally. In this review, epidemiological trends in mortality and suicide risk are presented, with consideration given to the impact of the COVID-19 pandemic. A public health model of suicide prevention with a community and clinical framework, along with advances in scientific discovery, offer new solutions that await widespread implementation. Actionable interventions with evidence for reducing risk for suicidal behavior are presented, including universal and targeted strategies at community, public policy, and clinical levels. Clinical interventions include screening and risk assessment; brief interventions (e.g., safety planning, education, and lethal means counseling) that can be done in primary care, emergency, and behavioral health settings; psychotherapies (cognitive-behavioral, dialectical behavior, mentalization therapy); pharmacotherapy; and systemwide procedures for health care organizations (training, policies, workflow, surveillance of suicide indicators, use of health records for screening, care steps). Suicide prevention strategies must be prioritized and implemented at scale for greatest impact.