從社會工作方案介入探討自殺防治策略：以自殺通報單資料分析為例

本研究使用某地方政府衛生局心理衛生中心，三年內所接獲自殺通報單資料進行分析；運用次級資料，以量化的方法，分析通報對象自殺人口特徵，檢視通報來源。自殺防治工作分為全面性、選擇性、目標性，同社會服務的分級（初級、次級及第三級）。本文提出以社工方案界定服務對象人口群方式，分析基本資料即通報對象的社會資料屬性，從自殺者「危機人口群」（population at risk）中探討「標的人口群」（target population）的概念，討論自殺防治的策略。研究分析發現：（1）自殺通報制度侷限在善後處置，而非事前阻止；（2）不同性別壓力來源差異，顯示生命週期危機與自殺行為；（3）精神疾病就診諮詢經驗，對於緩和自殺相關行為具有意義；（4）老年體能與診治經驗因素，自殺預後狀況不佳；（5）列案輔導和手冊證明持有者，是可掌握的對象；（6）性別與自殺手段差異，影響自殺後的身體結果；（7）四項社會特徵因子，可以預測自殺出現動作行為；（8）年齡、性別的不同，預測自殺後身體影響的嚴重程度。最後，本研究提供建議包括：（1）重新界定現行自殺通報對象制度，比照家暴保護性預防通報：（2）檢視政府暨民間部門職責，落實守門人通報系統；（3）規劃不同性別暨年齡階段需求的社會服務方案；（4）關注曾就診及列管之標的人口群，提供次級預防服務；（5）持有身心障礙第一類證明者，應優先提供關懷處遇。

關鍵字

自殺防治策略與分級預防；標的人口群

並列摘要

This study is a secondary data analysis of suicide cases during three years period since 2013-2015, accessing suicide prevention institution of local government. Suicide prevention work is discriminated into universal, selective and indicative levels as usual; it is same as the social work concept of primary, secondary and tertiary prevention service. The content in this paper, author address the perspective of social work program design, and define about welfare service population, such as general population, population at risk, target population and client population. Through the analyzing social attribute of demography, it investigates suicide prevention of clinic work. The research findings include: (1) The prevention and cure of notification system, is variant of treatment after the event, not in advance; (2) The crisis of life period reflects the particular suicide behavior with the pressure of gender; (3) With the experience of seeking medical advice, it may alleviates the suicide behavior and consequence; (4) With physical capability and lack of seeking medical advice, the aged health are not stable being of suicide behavior; (5) The clients by case management and the disable with identification document, whom are accessible to grasp, are high risk population of suicide; (6) Means of difference by the gender, the consequence of suicide behavior is diverse; (7) There are four variations of the characteristic population, can be forecasted the appearing action of suicide behavior; (8) Age and gender variations can be forecasted the suicide behavior consequence with harm. The research conclusions include: (1) Redefine suicide notification system, and regard the same as the protection administration of domestic violence; (2) Make overall review about responsibility of government and non-government institutions, fulfill the crisis hotline system of gate-keeper; (3) Authority should more concern and push forward psycho-social subject service program of career development; (4) Paying attention to those with the experience of seeking medical advice and the clients by case management, provide service with secondary prevention; (5) Those clients whom are mental disorder with identification document, have high priority to deal with.