Suicide attempts and suicides as determinants of quality and safety within hospital system of mental health care services

Autori:

Marko Ćurković, Porin Makarić, Arian Bljakčori, Senka Repovečki, Jasna Mesarić, Petrana Brečić

Sažetak
Bolnički dio sustava skrbi za psihičko zdravlje izložen je svim izazovima sigurnosti kao i drugi dijelovi bolničkoga zdravstvenog sustava, no mimo njih izložen je i dodatnim, jedinstvenim izazovima sigurnosti, od kojih je jedan svakako povezan s pružanjem skrbi za suicidalne bolesnike. Kao krajnja pojavnost kontinuuma suicidalnosti – samoubojstvo, posebice u bolničkom sustavu skrbi, može predstavljati valjani pokazatelj sigurnosti pružene skrbi. To prepoznaje i pravni okvir u Republici Hrvatskoj koji pokušaj samoubojstva i samoubojstvo razvrstava u neočekivani neželjeni događaj. Međutim, nastojanje sprječavanja (prevencije) samoubojstava i pokušaja samoubojstava bremenito je mnogobrojnim izazovima, a koje u ovom preglednom radu prikazujemo kroz nekoliko međusobno isprepletenih (pod)cjelina: procjenu i predviđanje suicidalnosti (to jest, opasnost od samoubojstva), prijam na bolničko liječenje, liječenje i nadzor tijekom bolničkog liječenja, otpust s bolničkog liječenja te daljnje praćenje po otpustu. Unatoč svim izazovima, sprječavanje samoubojstava je središnji izazov sigurnosti bolesnika u bolničkom sustavu skrbi za psihičko zdravlje.
Summary

The hospital part of the mental health care system is exposed to all safety challenges as other parts of the hospital health care system in general, but besides them it is also exposed to additional, rather unique safety challenges, of which one is certainly related to the provision of care for suicidal patients. As the extreme manifestation of the continuum of suicidality – suicide, especially within the hospital part of health care system, can represent a valid indicator of the health care safety. The same is recognized by the legal framework in the Republic of Croatia, which classifies attempted suicide and suicide as an unexpected adverse event. However,efforts to prevent suicide and suicide attempts are fraught with numerous challenges, which we in this review article present through several interwoven (sub)units: assessment and prediction of suicidality (that is, the risk of suicide), admission to hospital, treatment and observation (oversight) during hospital treatment, discharge from hospital and further follow-up arrangements. Despite all the challenges, suicide prevention is a central challenge to patient safety in the hospital system of mental health care.

Volumen: 11-12, 2023

Liječ Vjesn 2023;145:355–361

Preuzmi XML
Preuzmi PDF