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Abstract
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BACKGROUND: Not only psychiatry but also all non-psychiatric departments in the hospital are facing patients at high risk of suicide. For hospital-based suicide prevention (SP), the Taiwanese Society of Sucidology and the Taiwan Suicide Prevention Center (TSPC) have compiled a ＂Hospital Suicide Prevention Work Manual＂ to assist hospitals in establishing in-hospital SP for quality care of the individuals at risk. The study aimed to explore the current status of SP in hospitals in Taiwan.
METHOD: All hospitals were invited to participate in the on-line survey. The surveyed questions comprised three dimensions with17 items: 1) organization for suicide prevention (SP); 2) identification, intervention and follow-up for the individuals at risk of suicide; and 3) SP educational training. Those who completed the surveyed questions through Google online were recruited for analysis.
RESULTS: In total, 314 hospitals (66.5%) completed the questionnaire. The results of the first dimension revealed that the psychiatric hospitals generally presented a significantly higher rate in this part and the level of the chairperson of the special unit was low for all categorized hospitals (37.6%-73.3%). The non-psychiatric hospitals had a relatively low rate of setting up a special unit and a lower level of the convener, although most of the different categories of hospitals displayed higher rates in high-risk case referral, management, review, and reporting to the central government. For the second dimension, the rates of adopting suicide assessment as a routine work in managing patients at-risk in five clinical settings (emergency, inpatients, outpatients, and discharge time-point) and having a mechanism and treatment for psychiatric referrals were significantly higher (around 100%) among the medical centers. The district hospital generally had significantly lower rates (61.9-76.3%) in all items. Except for psychiatric hospitals, the rate of routine assessment for the outpatients at high-risk was generally low in the hospitals. For the third dimension, over 80% of hospitals held regular SP education about working guidelines, suicide risk identification and referrals, and requirement of the hospital to attend educational programs. Moreover, hospitals with special SP units generally have a significantly higher rate to implement the survey items than hospitals without dedicated units.
CONCLUSION: The establishment of a special unit with a higher rank of convener was the most important issue for non-psychiatric hospitals. The district hospitals have a large room for improvement in the implementation of SP. The study provides important information to build up the model of hospital suicide prevention in Taiwan.
Language: zh |