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首页> 美国卫生研究院文献>Frontiers in Psychiatry >The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care
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The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care

机译：零自杀模式：将循证自杀预防实践应用于临床护理

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摘要

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.
机译：自杀正在达到流行的程度，美国自杀死亡人数超过44,000，2015年全球自杀死亡人数为80万。尽管已研发出直接针对自杀行为的循证干预措施，但自杀率仍在上升。预防自杀的工作需要一种综合的方法，并且研究必须导致在公共和精神卫生系统中的有效实施。对自杀预防的循证研究进行了为期10年的系统回顾，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，人口筛查与护理链相结合，监测和随访。在本文中，我们回顾了自杀预防研究如何为临床环境中实施风险最高的人提供信息。基于证据的最佳实践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，全国预防自杀行动联盟提出了零自杀（ZS）模型，该框架旨在协调实施循证实践的多层次方法。我们提出自杀预防评估，干预和监测模型（AIM-SP），作为在临床环境中实施ZS循证和最佳实践的指南。通过案例插图将描述和说明临床管理模型的十个基本步骤。这些步骤旨在轻松地纳入标准临床实践中，以增强自杀风险评估，进行简短干预以提高安全性和教导应对策略，并改善在护理和高风险时期过渡期间对高风险个体的持续联系和监测。

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