아동⋅청소년 자살고위험군 자살예방평가 및 프로그램
Development of Suicide Prevention Programs for Mental Health Professionals Working with Children and Adolescens at High Risk of Suicide
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초록
우리나라 자살률은 Organization for Economic Cooperation and Development 국가 중 압도적 1위이며, 특히 아동⋅청소년들은 삶의 만족도가 낮고, 자살률 또한 매년 증가하고 있다. 아동⋅청소년 시기는 어느 발달단계보다 격동적이고 충동적인 시기로 자살 그 자체가 치명적이고, 전염성이 높다. 또한 의미 있는 작업을 잃어버렸을 경우에도 자살률이 높은데, 이는 자살고위험군 아동⋅청소년도 마찬가지이다. 정신건강복지법이 개정되고, 정신건강전문요원에 작업치료사가 포함되기 시작하면서 정신건강서비스에 있어 작업치료를 포함한 다학제적 접근이 강조되고 있다. 아동⋅청소년 자살을 막기 위한 선별도구로 자살사고척도(Suicidal Ideation Questionnaire), Beck의 자살사고척도(Beck Scale for Suicide Ideation), 콜롬비아 대학 자살 심각성 평가 척도(Columbia-Suicide Severity Rating Scale), 청소년용 삶의 이유 척도(The Reasons for Living Inventory for Adolescents), 학생 정서⋅행동 특성검사(Student Emotional and Behavioral Screening Test)가 사용되었고, 작업치료평가도구인 Canadian Occupational Performance Measure도 사용되었다. 또한 다양한 학문과 기관에서 다양한 자살예방프로그램이 제시되고 있다. 하지만 자살고위험군 현실적 특성상 신속하고 적기에 서비스를 제공해야 하기 때문에 다른 자살예방프로그램보다 상대적으로 그 수가 적으며 이 또한 대부분 인지행동적 측면에 초점이 맞춰져 있다. 따라서 본 연구는아동⋅청소년 자살고위험군을 대상으로 정신건강서비스를 제공하는 전문가들에게 다양한 자살예방프로그램을 소개하고, 각기 처해 있는 실정에 맞게 현장에서 활용할 수 있도록 하는 데 목적이 있다.
Abstract
Korea has the highest suicide rate among Organization for Economic Cooperation and Development countries, with increasing rates observed among children and adolescents with low levels of life satisfaction. Patients in these age groups exhibit particularly turbulent and impulsive behaviors, which make suicide highly contagious and fatal. The loss of meaningful work or activities increases the risk of suicide, especially in young people. Following revisions to the Mental Health Welfare Act (2016), which has included occupational therapists among mental health professionals, a multidisciplinary approach including occupational therapy has been emphasized upon in mental health services. Screening tools for preventing suicide in children and adolescents include the Suicidal Ideation Scale, Beck's Suicidal Ideation Scale, Columbia-Suicide Severity Rating Scale, Reasons for Living Scale for Adolescents, and the Student Emotional and Behavioral Characteristics Test. The Canadian Occupational Performance Measure, which is an occupational therapy evaluation tool, is also used. Various suicide prevention programs have been proposed across academic disciplines; however, due to the urgent nature of high-risk groups, there is a need for timely services. Currently, most existing programs focus primarily on the cognitive-behavioral aspects. In this study, we aimed to introduce diverse suicide prevention programs for mental health professionals working with high-risk children and adolescents in order to equip them with the relevant information and help apply their learnings effectively in different situations.
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