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Abstract
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PURPOSE: In order to promote suicide prevention activities in the community, a discussion was held based on three cases at the 82nd Japanese Society of Public Health Public Health Symposium.
Method: In Akita Prefecture, which has a particularly high suicide rate in Japan, a model project was conducted to try to implement social prescriptions (creating a place for the community to prevent social isolation) to prevent social isolation among local elderly people. . A qualitative descriptive study was conducted to clarify the implementation of social prescribing and the role of link workers. Next, he introduced urban development that focuses on suicide prevention factors based on field research that explored ''what local factors are associated with suicide'' in the ''most'' suicide-prone area of Tokushima Prefecture. In Kurume City, a collaborative model between family doctors and psychiatric care has been developed, and with the cooperation of many local medical institutions, a large number of follow-up groups have been built to continue medical care for targeted patients, including those who have attempted suicide. Reported.
Activities A model project in Akita Prefecture showed that the local resource map and link worker functions were useful as social prescriptions, but it became clear that there were cost obstacles to implementation. The local factors that prevent suicide observed in field research in Tokushima are (1) emphasizing and maintaining diversity, (2) fostering a sense of self-affirmation, and (3) being connected but not binding, not binding. (4) Tolerance for mistakes - a chance to try again, and (5) Appropriate help-seeking behavior - being able to ask for help and complain. The relationship between the number of alleys and the suicide rate is also being investigated as a spatial structural characteristic of a town that promotes aid-giving behavior. In addition, a cohort consisting of children and their parents was formed, and the survey was conducted while reporting research results that were considered to be favorable for children's growth. In Kurume City's activities, Kurume University Hospital plays a central role in holding regular regional collaboration meetings among multiple medical institutions, achieving collaboration among medical institutions that would be difficult under the free access system, and reducing the number of suicides. A decrease was confirmed.
Conclusion: Countermeasures against suicide, which are multi-factorial, need to be taken from multiple perspectives, going beyond the medical and health sectors. The scope of suicide prevention has been extended to activities that support children's growth, and it has been shown that measures include community development as well as collaboration between people and organizations.
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目的 地域における自殺予防活動を進めるために，第82回日本公衆衛生学会公募シンポジウムにおいて，3つの事例を基にディスカッションした。
方法 わが国でもとくに自殺率の高い秋田県では地域高齢者の社会的孤立を防止するための社会的処方（コミュニティによる社会的孤立を予防するための居場所つくり）の実装を試みるモデル事業が行われた。社会的処方の実装とリンクワーカーの役割を明らかにするため，質的記述的研究が実施された。次に，徳島県の自殺"最"希少地域において「地域にある何が自殺と関連する因子なのか」を探求したフィールド調査に基づく自殺予防因子に着目した街づくりが紹介された。久留米市では，かかりつけ医と精神科医療との連携モデルが展開されており，地域の多くの医療機関の協力によって，自殺未遂者等対象患者の医療継続のフォローアップ大勢が構築されていることが報告された。
活動内容 秋田県のモデル事業では，地域資源のマップやリンクワーカーの機能が社会的処方として有用であることがうかがわれたが，実装には費用面の障害があることが明らかになった。徳島のフィールド調査で観察された自殺を予防する地域の因子は，（1）多様性の重視と維持，（2）自己肯定感の醸成，（3）つながっているが縛らない，縛られない，ゆるやかな紐帯，（4）過ちへの寛容―やり直しのチャンス，そして（5）適切な援助希求行動；助けを求める，弱音を吐けること，であった。援助支援行動を促す，町の空間的構造特性として，路地の多寡と自殺率の関係も検討されている。また，子どもと保護者からなるコホートが構成され，子どもの成長に好ましいと思われる研究成果を報告しながらの調査が行われていた。久留米市の活動では，久留米大学病院が中心となって複数の医療機関による定期的な地域連携会議を実施して，フリーアクセス制度の下では困難な医療機関の連携を実現し，自殺者数の減少が確認されていた。
結論 多要因である自殺に対し，その対策も，医療，保健セクターを超えた多方面から，複眼的に行われる必要がある。自殺予防のスコープは，子どもの成長を支援する活動にも敷衍され，方策は，人や組織の連携とともに街づくりも含まれることが示された。
Language: ja |