急诊科为自杀未遂患者提供精神卫生服务的障碍

Survey on the barriers in providing the mental health services to the suicide attempters in ED

目的 了解综合医院急诊科处理自杀未遂患者时很少提供精神卫生服务的可能原因.方法 对北京市2所大型三甲综合医院（北京协和医院和北京朝阳医院）的急诊科和精神心理科以及1所三甲精神专科医院（北京大学第六医院）的门诊医生及联络会诊科医生开展问卷调查,分析两组医生对于自杀未遂患者的态度及其工作可能存在的障碍.结果 问卷回收率分别为68.7％（急诊科医生）和87.0％（精神科医生）.急诊科医生在态度量表上多项评分低于精神科医生（P ＜0.001）,但两组都认为患者应当得到精神卫生服务（两组中位数均为10分,P=0.059）.医生们对工作中障碍的评价可以归纳出某些共识.结论 综合医院急诊科医生已能普遍认可自杀未遂患者应该得到精神卫生服务.现存障碍复杂但仍有望解决.

Objective The purpose of this study was to explore the barriers existing in medical settings behind the phenomenon that few suicide attempters were provided by mental health services when they got treatment in the general hospital ED.Methods An anonymous and voluntary survey was administered among two groups：ED physicians and psychiatrists.Two tertiary general hospitals and one psychiatric hospital were chosen through convenience sampling.Suicide Behavior Attitude Questionnaire and a self-made questionnaire to evaluate barriers were used.Results The response rate was 68.7% for ED physicians,and 87.0% for psychiatrists.ED physicians generally scored unfavorably than psychiatrists on many items in SBAQ（P 〈0.001）,but on the item about whether the suicide attempters should have access to mental health services,the median of the scores =10 for both group （P =0.059）,meaning highly agree.Some consistent barriers.could be summarized from the self-made questionnaire.Conclusions The majority of ED physicians in general hospitals still hold some misunderstanding about the suicide attempters,but they fully agree that the suicide attempters should have access to mental health services.The barriers for psychiatrists are clear.The barriers for ED physicians are complicated but workable.