교정시설에서의 자살시도 특징 및 정신사회적 위험요인
The Characteristics of Suicide Attempts and Psychosocial Risk Factors in Correctional Institutions
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초록
자살은 교정시설 내 중요한 사망원인의 하나이다. 본 연구는 국내 14개 교정시설에 수감 중인 재소자를 대상으로 자살 위험과 관련된 인구사회학적, 정신의학적 요인들을 규명하고 교정시설에서의 자살시도 특징을 탐색하고자 시행하였다. 본 연구에서는 자살시도의 상당수가 집중적인 감시와 관리가 제공되는 독거실에서 발생하며, 치사도가 높은 교상을 사용하여 시도되고 있고, 자살시도 후 의학적으로 심각한 상태에서 발견되는 것으로 나타났다. 그리고 자살시도 위험 요인인 제1축 정신질환이나 자살시도의 과거력과 재소자의 자살시도 사이의 연관성과 함께 취약한 사회적 지지체계, 과거 수감 경력도 자살시도 위험과 관련되는 것으로 분석되었 다. 따라서 본 연구 결과는 교정시설에서의 자살을 예방하기 위해 수감되어 있는 재소자들에 대한 정신보건 측면에서의 관리를 강화하고, 특히 정신질환자에 대한 치료와 함께 자살 고위험군에 대한 집중적인 관리가 필요할 것을 시사한다.
Abstract
Objectives: Suicide is one of the most common causes of deaths in correctional institutions. This study aimed to examine the characteristics of suicide attempts and its related psycho-social factors in correctional institutions. Methods: This study examined the characteristics of 101 suicide attempts from 2006 to 2007 in the two regional correctional headquarters. Thirty-seven male inmates (43 suicide attempts) and 40 matched controls were included in interviews and reviews of personal records. Psychiatric illnesses were examined using the Structured Clinical Interview for DSM-IV and medical outcomes of their suicide attempts with the Lethality Scale of Diagnostic Interview for Genetic Studies. Results: Over a half of suicide attempts occurred in solitary cells and the most common method was hanging. Medically, 70% of the suicide attempts were more than severe. Poor social support, a lifetime history of suicide attempts, and incarceration were associated with suicide attempts. Additionally, psychiatric illnesses were more likely to increase the risk of suicide. Conclusion: This study implies that mental health issues and monitoring systems are important to reduce suicides in the correctional system. Regular checks and management of suicide risk and mental illness are crucial to prevent suicide in correctional institutions.
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