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美軍自殺防治風險管理初探

A Preliminary Study on the Risk Management of Suicide Prevention in the US Army

摘要


「世界衛生組織」(World Health Organization, WHO)將每年的9月10日定為「世界自殺防治日」(World Suicide Prevention Day),並以高分貝向全世界吶喊:「『自殺問題』已成為人類當代文明社會遺留的負面資產。」呼籲先進國家亟需正視21世紀這個嚴重的公共衛生課題。而美國要居「世界衛生組織」的重要成員,自然對自殺防治工作極度重視;尤其美國國防部對各軍種單位強力要求,必須依照單位特性訂定軍種自殺預防計畫。因此,本研究深入美軍軍事情境脈絡,探討「美軍是如何預防軍人發生自殺行為之風險管理」的實務作為,藉助他山之石,找尋可以提供國軍降低官兵發生自我傷害危險因子的有效策略,達成「未雨綢繆,防範未然」的政策指導效果。 研究過程發現,近八年來(2001年至2008年),美軍各軍種自殺人口依然逐年攀升。儘管美軍自殺人口比率較一般平民來的低,但推估每年美軍自殺人數約一個連的兵力,想見軍人自殺的嚴重性依然存在,所以,美國國防部不得不正視「軍人自殺問題」而發出嚴重警訊,要求各單位提出有效對策。正因如此,各軍種紛紛依照單位特性和自殺防治理念,制定各種「自殺防治計畫」。舉凡美國陸軍以「整體性防治」為基礎,強調全方位的自殺預防;美國海軍暨海陸則以「挑戰性防治」為理念,將預防官兵自殺行為當作一項備戰任務,隨時積極迎戰;美國空軍以「安全性防治」為觀念,認為自殺不是醫療問題,而是社會問題,只要降低自殺風險,達到安全維護即是好的自殺防治。 最後,本研究以美軍各軍種自殺防治風險管理計畫與實務操作為討論的基礎,從政策與實務兩個面向,提出具體的建議。在政策面:1. 加強網路資訊公告;2. 善用自殺統計資料庫;3. 依軍種特性製定自殺防治計畫;4. 創造軍民合作體系。在實務面:1. 落實自殺防治培訓計畫;2. 發展多元文宣廣告策略。

並列摘要


The World Health Organization (WHO) announces the September 10(superscript th) of every year as the World Suicide Prevention Day, and strongly urges the advanced countries around the world to face this most serious public health issue in the 21(superscript st) century as ”(the suicide problem) has become the negative asset of the contemporary civil society of humans”. Since the US is an important member of the WHO, it pays considerable attention to suicide prevention, especially the US Department of Defense has demanded all military units to formulate the suicide prevention plans according to the characteristics of the armed services. Therefore, this study aims to probe into the scenario context of the US army, and discuss the risk management of suicide prevention in the US army, in order to provide practical experiences to find effective strategies for reducing the risk factors of self-harm in the armed services of Taiwan, thus achieving the policy goal of ”early precautions”. This study finds that over the past eight years (2001~2008), the suicide population in various armed services of the US is still increasing. Although the suicide population in the US army is lower than that of the civilians, it is estimated that the number of suicides in the US army is equivalent to the armed forces of a company, which indicates the seriousness of the suicide of military men. Therefore, facing the suicide issue, the US Department of Defense has issued serious warnings and commanded all military units to propose effective strategies. As a result, various suicide prevention plans were formulated according to the characteristics of each service unit and the suicide prevention concepts. For example, the Army stresses on all-faceted suicide prevention based on ”comprehensive prevention”, the Navy and Marine Corps, based on the concept of ”challenging prevention”, treat suicide prevention as a task of preparation against war, and face the task aggressively; according to the concept of ”safety prevention”, the Air Force believes that suicide is not a medical problem but a social problem, and achieving safety maintenance by reducing the suicide risks is the best suicide prevention. Lastly, based on the risk management plans for suicide prevention and practical experiences in the US army, this study proposes concrete suggestions from two aspects, policy and practice. In terms of policy, this study suggests to: 1) improve the Internet information announcement; 2) utilize suicide statistical database; 3) formulate suicide prevention plans based on the characteristics of each armed unit; 4) create military-civilian cooperation system. In terms of practice, it is suggested to: 1) realize the suicide prevention training program; 2) develop diverse propaganda strategies.

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