The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care.
The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care.
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DOI：
10.3389/fpsyt.2018.00033
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发表时间：
2018
影响因子：
4.7
通讯作者：
Stanley B
中科院分区：
文献类型：
--
作者：
Brodsky BS;Spruch-Feiner A;Stanley B
自杀正在达到流行病的程度，2015年美国有超过44，000人死于自杀，全球有80万人。尽管有直接针对自杀行为的循证干预措施的研究和开发。自杀预防工作需要一个全面的方法，研究必须导致在公共和精神卫生系统的有效实施。一项为期10年的自杀预防循证调查结果的系统回顾总结了将研究转化为实践所需的领域。这些措施包括风险评估，手段限制，循证治疗，人口筛查结合护理链，监测和随访。在这篇文章中，我们回顾了自杀预防研究如何在临床环境中告知实施，这些风险最高的护理。基于证据的最佳做法解决了自杀风险的波动性，这需要持续的风险评估、直接干预和监测。在美国，国家预防自杀行动联盟提出了零自杀（ZS）模式，这是一个协调实施循证实践的多层次方法的框架。我们提出了评估，干预和监测自杀预防模型（AIM-SP）作为在临床环境中实施ZS循证和最佳实践的指南。临床管理模式的10个基本步骤将通过案例描述和说明。这些步骤的目的是很容易纳入标准的临床实践，以加强自杀风险评估，简短的干预措施，以提高安全性和教应对策略，并改善持续的接触和监测的高风险个人在过渡期间的护理和高风险时期。
Suicide is reaching epidemic proportions, with over 44,000 deaths by suicide in the US, and 800,000 worldwide in 2015. This, despite research and development of evidence-based interventions that target suicidal behavior directly. Suicide prevention efforts need a comprehensive approach, and research must lead to effective implementation across public and mental health systems. A 10-year systematic review of evidence-based findings in suicide prevention summarized the areas necessary for translating research into practice. These include risk assessment, means restriction, evidence-based treatments, population screening combined with chain of care, monitoring, and follow-up. In this article, we review how suicide prevention research informs implementation in clinical settings where those most at risk present for care. Evidence-based and best practices address the fluctuating nature of suicide risk, which requires ongoing risk assessment, direct intervention and monitoring. In the US, the National Action Alliance for Suicide Prevention has put forth the Zero Suicide (ZS) Model, a framework to coordinate a multilevel approach to implementing evidence-based practices. We present the Assess, Intervene and Monitor for Suicide Prevention model (AIM-SP) as a guide for implementation of ZS evidence-based and best practices in clinical settings. Ten basic steps for clinical management model will be described and illustrated through case vignette. These steps are designed to be easily incorporated into standard clinical practice to enhance suicide risk assessment, brief interventions to increase safety and teach coping strategies and to improve ongoing contact and monitoring of high-risk individuals during transitions in care and high risk periods.
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