Abstract

Objective

Implementation of evidence-based suicide prevention is critical to prevent death by suicide. Contrary to previously held beliefs, interventions including contracting for safety, no-harm contracts, and no-suicide contracts are not best practices and are considered contraindicated. Little is known about the current use of best practices and contraindicated interventions for suicide prevention in community settings.

Methods

Data were collected from 771 individuals enrolled in a suicide prevention training. Both mental health clinicians (n = 613) and mental health allies (e.g., teachers, first responders) (n = 158) reported which best practices (i.e., safety plan, crisis response plan) and contraindicated interventions (i.e., contracting for safety, no-harm contract, no-suicide contract) they use with individuals who presents with risk for suicide.

Results

The majority of both mental health clinicians (89.7%) and mental health allies (67.1%) endorsed using at least one evidence-based practice. However, of those who endorsed using evidence-based interventions, ∼40% of both mental health clinicians and allies endorsed using contraindicated interventions as well.

Conclusion

Contraindicated interventions are being used at high rates and suicide prevention trainings for evidence-based interventions should include a focus on de-implementation of contraindicated interventions. This study examined only a snapshot of what clinicians and allies endorsed using. Additional in depth information about each intervention and when it is used would provide helpful information and should be considered in future studies. Future research is needed to ensure only evidence-based interventions are being used to help prevent death by suicide.

• Highlights:

• The majority of both mental health clinicians and mental health allies use evidence-based practices for suicide prevention. This indicates good implementation rates of evidence-based interventions for suicide prevention.

• Approximately 40% of both mental health clinicians and mental health allies who endorsed using evidence-based practices for suicide preventions also endorsed using contraindicated interventions.

• A focus on de-implementation of contraindicated suicide interventions is warranted and should be part of the focus on suicide prevention efforts.

中文翻译：

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自杀干预实践：心理健康临床医生和心理健康盟友正在使用什么？

摘要

客观的

实施循证自杀预防对于预防自杀死亡至关重要。与以前的看法相反，包括安全合同、无伤害合同和无自杀合同在内的干预措施不是最佳实践，并且被认为是禁忌的。目前对于社区环境中预防自杀的最佳做法和禁忌干预措施的使用情况知之甚少。

方法

数据收集自 771 名参加自杀预防培训的个人。心理健康临床医生（n  = 613）和心理健康盟友（例如教师、急救人员）（n  = 158）报告了最佳实践（即安全计划、危机应对计划）和禁忌干预措施（即签订安全合同、他们对有自杀风险的个人使用“无伤害合同”、“无自杀合同”。

结果

大多数心理健康临床医生（89.7%）和心理健康盟友（67.1%）都支持使用至少一种循证实践。然而，在那些支持使用循证干预措施的人中，约 40% 的心理健康临床医生和盟友也支持使用禁忌干预措施。

结论

禁忌干预措施的使用率很高，基于证据的干预措施的自杀预防培训应包括重点关注取消禁忌干预措施的实施。这项研究仅检查了临床医生和盟友认可使用的内容的概况。有关每种干预措施及其使用时间的其他深入信息将提供有用的信息，应在未来的研究中予以考虑。未来的研究需要确保仅使用基于证据的干预措施来帮助预防自杀死亡。

• 强调：

• 大多数心理健康临床医生和心理健康盟友都使用循证实践来预防自杀。这表明预防自杀的循证干预措施实施率良好。

• 在支持使用循证实践预防自杀的心理健康临床医生和心理健康盟友中，大约 40% 也支持使用禁忌干预措施。

• 有必要重点关注取消禁忌自杀干预措施的实施，并且应该将其作为重点关注自杀预防工作的一部分。