目的:许多国家的自杀预防策略发生了变化,从国家方法到区域定制并响应当地社区需求的方法。以前的澳大利亚研究支持这种方法。然而,大多数研究都集中在自杀死亡,这些自杀死亡可能无法完全了解预防需求,很少有人关注青年的优先群体。这是第一项全国性研究,旨在研究澳大利亚年轻人自残患病率和相关因素的区域变异性。
方法:招募了澳大利亚青少年(12-17岁)的随机样本,作为YMM(YMM)调查的一部分。参与者完成了关于自我伤害的自我报告问题(即,非自杀性自残和自杀未遂)前12个月。使用混合效果回归,使用YMM和Census数据建立了区域级模型,以产生样本外的小区域自残患病率预测.分析的空间单位是统计区域一级(平均人口400人),所有患病率估计值均更新至2019年.
结果:整个澳大利亚,青少年自我伤害患病率估计值差异较大.北领地,西澳大利亚,南澳大利亚州的患病率估计最高。心理困扰和抑郁是最能预测个体自我伤害的因素。在区域一级,最强的预测因素是单身失业父母的比例很高,在一个≥30%的父母出生在海外的地区,自我伤害的几率降低。
结论:本研究确定了青年自我伤害风险较低和较高的地区的特征。这些发现应有助于政府和社区制定和实施适合区域的青年自杀预防干预措施和举措。
OBJECTIVE: Suicide prevention strategies have shifted in many countries, from a national approach to one that is regionally tailored and responsive to local community needs. Previous Australian studies support this approach. However, most studies have focused on
suicide deaths which may not fully capture a complete understanding of prevention needs, and few have focused on the priority population of youth. This was the first nationwide study to examine regional variability of self-harm prevalence and related factors in Australian young people.
METHODS: A random sample of Australian adolescents (12-17-year-olds) were recruited as part of the Young Minds Matter (YMM) survey. Participants completed self-report questions on self-harm (i.e., non-suicidal self-harm and
suicide attempts) in the previous 12 months. Using mixed effects regressions, an area-level model was built with YMM and Census data to produce out-of-sample small area predictions for self-harm prevalence. Spatial unit of analysis was Statistical Area Level 1 (average population 400 people), and all prevalence estimates were updated to 2019.
RESULTS: Across Australia, there was large variability in youth self-harm prevalence estimates. Northern Territory, Western Australia, and South Australia had the highest estimated state prevalence. Psychological distress and depression were factors which best predicted self-harm at an individual level. At an area-level, the strongest predictor was a high percentage of single unemployed parents, while being in an area where ≥30% of parents were born overseas was associated with reduced odds of self-harm.
CONCLUSIONS: This study identified characteristics of regions with lower and higher youth self-harm risk. These findings should assist governments and communities with developing and implementing regionally appropriate youth
suicide prevention interventions and initiatives.