Abstract:
BACKGROUND: Nowadays, we find ourselves in very unexpected and challenging circumstances facing the COVID-19 pandemic. The impact of the new coronavirus pandemic probably affected everyone\'s mental health, and people with pre-existing mental disorders may have an aggravated disease condition, leading to a suicide attempt. Pandemic also increased the use of direct-to-consumer telemedicine (TM) exponentially, and consequently, it was expected that cases of attempted suicide could be evaluated remotely. Some TM centers have adapted safety protocols from psychiatric guidelines for managing these patients. However, there is a lack of evidence of the effectiveness of follow-up by TM for patients at high risk for suicide, and there is no consensus on what action should be taken vis-à-vis the patient who requests immediate help remotely.
METHODS: Here, we reported a case of a TM evaluation of a patient\'s suicidal ideation in a direct-to-consumer telemedicine emergency center, describing the conduct taken in the face of this situation. We also discuss the importance of planning the emergency telemedicine center for situations of risk of suicide.
CONCLUSIONS: Telemedicine centers should be prepared for direct consumer assessment of suicidal ideation. Current management suggestions include recognizing the risk profile through institutional training and software skills and immediate referral for face-to-face assessment, encouraging continuous monitoring until the admission and active recruitment of family members or closest friends.
摘要:
背景:如今,我们发现自己处于非常意想不到和具有挑战性的环境中,面临着COVID-19大流行。新冠状病毒大流行的影响可能会影响每个人的心理健康,患有精神疾病的人可能患有加重的疾病,导致自杀未遂.大流行还成倍增加了直接面向消费者的远程医疗(TM)的使用,因此,预计自杀未遂病例可以远程评估。一些TM中心已经调整了来自精神病学指南的安全协议来管理这些患者。然而,缺乏证据证明TM对高自杀风险患者的随访效果,对于远程请求立即帮助的患者应采取什么行动,目前尚无共识。
方法:这里,我们报告了一例在直接面向消费者的远程医疗急救中心对患者的自杀意念进行TM评估的病例,描述了面对这种情况所采取的行为。我们还讨论了针对自杀风险情况规划紧急远程医学中心的重要性。
结论:远程医学中心应做好准备,以直接评估消费者的自杀意念。当前的管理建议包括通过机构培训和软件技能识别风险状况,并立即转诊进行面对面评估,鼓励持续监测,直到入学和积极招募家庭成员或最亲密的朋友。