Cristiana N P Araujo, Apollonia Lysandrou, Alexandria Polles, Tish Conwell, Janet Wroblewski, Lisa J Merlo
{"title":"在州医生健康监测项目中实施结构化自杀风险筛查。","authors":"Cristiana N P Araujo, Apollonia Lysandrou, Alexandria Polles, Tish Conwell, Janet Wroblewski, Lisa J Merlo","doi":"10.1080/13811118.2025.2512454","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study examined the implementation of structured suicide risk screening by a large state physician health monitoring program (PHP).</p><p><strong>Methods: </strong>Physicians (<i>n</i> = 363; 87 women; 44.78 years-old, <i>SD</i> = 13.75) were screened for suicide risk with the Columbia Suicide Severity Rating Scale (C-SSRS) at PHP intake and at 2-weeks, 3-months, 1-year, 2-years, 3-years after initiating monitoring, and following any sentinel events. The PHP response was recorded at each timepoint.</p><p><strong>Results: </strong>At intake, female physicians reported higher current (<i>p</i> = .025, Cramer's V = .178) and lifetime suicide risk (<i>p</i> = .010, Cramer's V = .163) compared to male physicians. Physicians monitored for substance use disorders (SUD) were more likely to deny any lifetime suicide risk than those monitored for co-occurring SUD and psychiatric disorders (<i>p</i> = .017, Cramer's V = .171), and had lower rates of \"moderate\" lifetime suicide risk than those monitored for psychiatric disorders only (<i>p</i> = .017, Cramer's V = .171). The PHP offered behavioral health referrals for physicians reporting \"low\" risk (<i>n</i> = 2) plus safety measures for those with \"moderate\" (<i>n</i> = 2) and \"high\" risk (<i>n =</i> 1). One physician reporting \"low\" risk and four physicians reporting \"high\" risk were already in-treatment. At 2-weeks and 3-months into monitoring, suicide risk remained \"very low\" (99.4% and 98.8%) or \"low.\" At 1-year, risk was \"very low\" for 99.3% of physicians, with two at \"moderate\" risk. At 2 and 3 years, 100% reported \"very low\" suicide risk. No suicides occurred among monitored physicians.</p><p><strong>Conclusion: </strong>PHPs offer support to mitigate suicide risk among physicians. The observed decrease in suicide risk across monitoring may reflect the recovery processes that monitoring is intended to support.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-19"},"PeriodicalIF":2.0000,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Implementation of Structured Suicide Risk Screening in a State Physician Health Monitoring Program.\",\"authors\":\"Cristiana N P Araujo, Apollonia Lysandrou, Alexandria Polles, Tish Conwell, Janet Wroblewski, Lisa J Merlo\",\"doi\":\"10.1080/13811118.2025.2512454\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study examined the implementation of structured suicide risk screening by a large state physician health monitoring program (PHP).</p><p><strong>Methods: </strong>Physicians (<i>n</i> = 363; 87 women; 44.78 years-old, <i>SD</i> = 13.75) were screened for suicide risk with the Columbia Suicide Severity Rating Scale (C-SSRS) at PHP intake and at 2-weeks, 3-months, 1-year, 2-years, 3-years after initiating monitoring, and following any sentinel events. The PHP response was recorded at each timepoint.</p><p><strong>Results: </strong>At intake, female physicians reported higher current (<i>p</i> = .025, Cramer's V = .178) and lifetime suicide risk (<i>p</i> = .010, Cramer's V = .163) compared to male physicians. Physicians monitored for substance use disorders (SUD) were more likely to deny any lifetime suicide risk than those monitored for co-occurring SUD and psychiatric disorders (<i>p</i> = .017, Cramer's V = .171), and had lower rates of \\\"moderate\\\" lifetime suicide risk than those monitored for psychiatric disorders only (<i>p</i> = .017, Cramer's V = .171). The PHP offered behavioral health referrals for physicians reporting \\\"low\\\" risk (<i>n</i> = 2) plus safety measures for those with \\\"moderate\\\" (<i>n</i> = 2) and \\\"high\\\" risk (<i>n =</i> 1). One physician reporting \\\"low\\\" risk and four physicians reporting \\\"high\\\" risk were already in-treatment. At 2-weeks and 3-months into monitoring, suicide risk remained \\\"very low\\\" (99.4% and 98.8%) or \\\"low.\\\" At 1-year, risk was \\\"very low\\\" for 99.3% of physicians, with two at \\\"moderate\\\" risk. At 2 and 3 years, 100% reported \\\"very low\\\" suicide risk. No suicides occurred among monitored physicians.</p><p><strong>Conclusion: </strong>PHPs offer support to mitigate suicide risk among physicians. 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引用次数: 0
摘要
背景:本研究考察了一个大型州医生健康监测项目(PHP)对结构化自杀风险筛查的实施情况。方法:医师(n = 363;87名女性;44.78岁,SD = 13.75)在服用PHP时,以及开始监测后2周、3个月、1年、2年、3年,以及在任何哨点事件发生后,用哥伦比亚自杀严重程度评分量表(C-SSRS)筛查自杀风险。在每个时间点记录PHP响应。结果:在摄入时,女性医生报告的电流(p = 0.025, Cramer's V = 0.178)和终生自杀风险(p = 0.010, Cramer's V = 0.163)高于男性医生。监测物质使用障碍(SUD)的医生比同时监测SUD和精神疾病的医生更有可能否认任何终身自杀风险(p = 0.017, Cramer's V = 0.171),并且比仅监测精神疾病的医生有更低的“中度”终身自杀风险(p = 0.017, Cramer's V = 0.171)。PHP为报告“低”风险(n = 2)的医生提供行为健康转诊,并为报告“中等”风险(n = 2)和“高”风险(n = 1)的医生提供安全措施。一名报告“低”风险的医生和四名报告“高”风险的医生已经在接受治疗。在2周和3个月的监测中,自杀风险仍然是“非常低”(99.4%和98.8%)或“低”。在1年的时间里,99.3%的医生的风险“非常低”,两名医生的风险“中等”。在第2年和第3年,100%的人报告“非常低”的自杀风险。受监测的医生中没有发生自杀事件。结论:PHPs为降低医生自杀风险提供了支持。通过监测观察到的自杀风险降低可能反映了监测旨在支持的恢复过程。
Implementation of Structured Suicide Risk Screening in a State Physician Health Monitoring Program.
Background: This study examined the implementation of structured suicide risk screening by a large state physician health monitoring program (PHP).
Methods: Physicians (n = 363; 87 women; 44.78 years-old, SD = 13.75) were screened for suicide risk with the Columbia Suicide Severity Rating Scale (C-SSRS) at PHP intake and at 2-weeks, 3-months, 1-year, 2-years, 3-years after initiating monitoring, and following any sentinel events. The PHP response was recorded at each timepoint.
Results: At intake, female physicians reported higher current (p = .025, Cramer's V = .178) and lifetime suicide risk (p = .010, Cramer's V = .163) compared to male physicians. Physicians monitored for substance use disorders (SUD) were more likely to deny any lifetime suicide risk than those monitored for co-occurring SUD and psychiatric disorders (p = .017, Cramer's V = .171), and had lower rates of "moderate" lifetime suicide risk than those monitored for psychiatric disorders only (p = .017, Cramer's V = .171). The PHP offered behavioral health referrals for physicians reporting "low" risk (n = 2) plus safety measures for those with "moderate" (n = 2) and "high" risk (n = 1). One physician reporting "low" risk and four physicians reporting "high" risk were already in-treatment. At 2-weeks and 3-months into monitoring, suicide risk remained "very low" (99.4% and 98.8%) or "low." At 1-year, risk was "very low" for 99.3% of physicians, with two at "moderate" risk. At 2 and 3 years, 100% reported "very low" suicide risk. No suicides occurred among monitored physicians.
Conclusion: PHPs offer support to mitigate suicide risk among physicians. The observed decrease in suicide risk across monitoring may reflect the recovery processes that monitoring is intended to support.
期刊介绍:
Archives of Suicide Research, the official journal of the International Academy of Suicide Research (IASR), is the international journal in the field of suicidology. The journal features original, refereed contributions on the study of suicide, suicidal behavior, its causes and effects, and techniques for prevention. The journal incorporates research-based and theoretical articles contributed by a diverse range of authors interested in investigating the biological, pharmacological, psychiatric, psychological, and sociological aspects of suicide.