Tværsektoriel opfølgning for børn og unge efter et selvmordsforsøg - en samarbejdsmodel fra Region Syddanmark
DOI:
https://doi.org/10.5617/suicidologi.2389Abstract
ABSTRACT
I Danmark er børn og unge, der har forsøgt at begå selvmord, ikke
sikre på at modtage efterfølgende støtte og behandling. Det er på
trods af, at selvmordsforsøget er udløst af akkumulerede psykosociale problemstillinger og på trods af, at opfølgning kan forebygge recidiv. Selvmordstruede børn og unge har således brug for tværfaglig og tværsektoriel hjælp. Tværsektorielle forløb er dog ofte karakteriseret ved en uklar og tvetydig opgavedeling mellem sektorerne. Dette kan føre til fragmenterede behandlingsforløb. I Region Syddanmark er der etableret et tværsektorielt samarbejde kaldet Behandlingskæden. Prioritering af dette samarbejde på flere beslutningsniveauer sikrer opfølgning på tværs af somatik, psykiatri og kommune til børn og unge, der har haft et selvmordsforsøg. Ud over at sikre kvalificeret opfølgning, muliggør strategien og organiseringen en større grad af forebyggelse og medvirker til afklaring af sektoropdelte ansvarsområder.
In Denmark children and adolescents who have attempted suicide are not guaranteed follow-up. A suicide attempt is often due to accumulated psychosocial challenges and follow-up reduces risk of relapse. Suicidal children and adolescents are in need of interdisciplinary and inter-sectoral help. Inter-sectoral pathways are often characterized by uncertain and ambiguous areas of responsibility between the different sectors which may lead to fragmented treatment courses. In the Region of Southern Denmark an inter-sectoral collaboration, called the Treatment Chain, is established to ensure follow-up across somatic, psychiatric and municipality departments for children and adolescents who have attempted suicide. The priority of this collaboration ensures a qualified follow-up and contributes to clarification of areas of responsibility across sectors.
References
REFERENCELISTE
Ahgren, B. (2010). Dissolving the Patient Bermuda Triangle. International Journal
of Care Coordination, 14(4), 137-141.
Angst, F., Stassen, H.H., Clayton, P. J., & Angst, J. (2002). Mortality of patients
with mood disorders: follow-up over 34-38 years. J Affect Disord, 68(2-3), 167-181.
Beautrais, A.L., Joyce, P.R., Mulder, R.T. (2010). Personality Traits and Cognitive
Styles as Risk Factors for Serious Suicide Attempts among Young People. Suicide
and Life-Threatening Behavior, 29(1), 37-47.
Bille-Brahe, U. (1982). Levekårene i Fyns Amt. Odense: Psykiatrisk Institut.
Odense Universitet.
Christiansen, E., & Larsen, K. J. (2012). Young people's risk of suicide attempts after
contact with a psychiatric department – a nested case-control design using
Danish register data. J Child Psychol Psychiatry, 53(1), 16-25. doi: 10.1111/j.1469-
2011.02405.x
Christiansen, E., Larsen, K.J., Agerbo, E., Bilenberg, N., & Stenager, E. (2013). Incidence
and risk factors for suicide attempts in a general population of young
people: a Danish register-based study. Aust N Z J Psychiatry, 47(3), 259-270. doi:
1177/0004867412463737
Danske Regioner, Kommunernes Landsorganisation, Økonomi- og Indenrigsministeriet,
Finansministeriet, Ministeriet for Sundhed og Forebyggelse. (2013). Bedre
incitamenter i sundhedsvæsenet. København: Danske Regioner, Kommunernes
Landsorganisation, Økonomi- og Indenrigsministeriet, Finansministeriet, Ministeriet
for Sundhed og Forebyggelse.
Dieserud, G., Loeb, M., & Ekeberg, O. (2000). Suicidal behavior in the municipality
of Baerum, Norway: a 12-year prospective study of parasuicide and suicide. Suicide
Life Threat Behav, 30(1), 61-73.
Erlangsen, A., Lind, B.D., Stuart, E.A., Qin, P., Stenager, E., Larsen, K.J., Wang, A.G.,
Hvid, M., Nielsen, A.C., Pedersen, C.M., Winsløv, J., Langhoff, C., Mühlmann, C.,
Nordentoft, M. (2014). Short-term and long-term effects of psychosocial therapy for
people after deliberate self-harm: a register-based, nationwide multicentre study
using propensity score matching. Lancet Psychiatry.
Fyns Amt. (2003). Evalueringsrapport Selvmordsforebyggelse for Børn og Unge på
Vestfyn – Selvfo. Odense: Fyns Amt.
Goldacre, M., Seagroatt, V., & Hawton, K. (1993). Suicide after discharge from
psychiatric inpatient care. Lancet, 342(8866), 283-286.
Grone, O., Garcia-Barbero, M., & Services, W.H.O. European Office for Integrated
Health Care. (2001). Integrated care: a position paper of the WHO European Office
for Integrated Health Care Services. Int J Integr Care, 1, e21.
Haw, C., Bergen, H., Casey, D., & Hawton, K. (2007). Repetition of deliberate selfharm:
a study of the characteristics and subsequent deaths in patients presenting
to a general hospital according to extent of repetition. Suicide Life Threat Behav,
(4), 379-396. doi: 10.1521/suli.2007.37.4.379
Indenrigs- og Sundhedsministeriet. (2005). Kommunalreformen – Kort fortalt.
København: Indenrigs- og Sundhedsministeriet.
Johannessen, H.A., Dieserud, G., De Leo, D., Claussen, B., & Zahl, P.H. (2011). Chain
of care for patients who have attempted suicide: a follow-up study from Baerum,
Norway. BMC Public Health, 11, 81. doi: 10.1186/1471-2458-11-81
Jørgensen, J., & Clausen, B. (2009). Behandlingsforløb og opfølgningsrutiner for
børn og unge med selvmordsforsøg. København: Velfærdsministeriet.
King, C.A., & Merchant, C.R. (2008). Social and interpersonal factors relating to
adolescent suicidality: a review of the literature. Arch Suicide Res, 12(3), 181-196.
doi: 10.1080/13811110802101203
Kommunernes Landsorganisation (KL), Danske Regioner og Indenrigs- og Socialministeriet.
(2009). Status for kommunalreformens gennemførelse – 2009. København:KL, Danske Regioner og Indenrigs- og Socialministeriet.
Knesper, D.J., American Association of Suicidology & Suicide Prevention Resource
Center. (2010). Continuity of care for suicide prevention and research: Suicide attempts
and suicide deaths subsequent to discharge from the emergency department
or psychiatry inpatient unit. Newton, MA: Education Development Center, Inc.
Konieczna, A. (2012). Selvmordsforsøg i Danmark – rateudvikling for perioden
–2011. Odense: Center for Selvmordsforskning.
Krag, A.M., Gut, R., Freil, M. (2007). POPS Patienters oplevelser i Overgange mellem
Primær og Sekundær sektor. København: Enheden for Brugerundersøgelser, Region
Hovedstaden.
Larsen, K.J., Clausen, B. (2006). Kommunepakken. Forebyggelse af selvmordsadfærd
hos børn og unge. Vejledning til personale i socialsektoren. Odense: Center for
Selvmordsforskning.
Livslinjen. (2015). Om selvmord. Retrieved 20. januar, 2015, from www.livslinjen.dk
Mann, J.J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., . . . Hendin,
H. (2005). Suicide prevention strategies: a systematic review. JAMA, 294(16), 2064-
doi: 10.1001/jama.294.16.2064
Mehlum, L. & Ramberg, M. (2010). Continuity of care in the treatment of
suicide attempters – current challenges. Arch Suicide Res, 14(2), 105-108. doi:
1080/13811111003704472
Ministeriet for Børn, Ligestilling, Integration og Sociale Forhold. (2014). Serviceloven
(LBK nr 1023 af 23/09/2014, Gældende).
Morthorst, B., Krogh, J., Erlangsen, A., Alberdi, F., & Nordentoft, M. (2012). Effect of
assertive outreach after suicide attempt in the AID (assertive intervention for deliberate
self harm) trial: randomised controlled trial. BMJ, 345, e4972. doi: 10.1136/
bmj.e4972
Nordentoft, M., Rubin, P., Welcher, B. (1993). Suicide and suicide attempts among
young persons in Copenhagen. Nordic Journal of Psychiatry, 47(1), 61-69.
Plochg, T., & Klazinga, N.S. (2002). Community-based integrated care: myth or
must? Int J Qual Health Care, 14(2), 91-101.
Schmidtke, A., Bille-Brahe, U., DeLeo, D., Kerkhof, A., Bjerke, T., Crepet, P., . . . Sampaio-
Faria, J. G. (1996). Attempted suicide in Europe: rates, trends and sociodemographic
characteristics of suicide attempters during the period 1989-1992. Results
of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatr Scand, 93(5),
-338.
Seemann, J., Johansen, M. (2013). Unge i organisatorisk grænseland – organisering,
samarbejdsstrategier, tillid og ledelse. Uden For Nummer, 14(27), 12-21.
Sundhedsstyrelsen. (2005). Kronisk sygdom. Patient, sundhedsvæsen og samfund.
Forudsætninger for det gode forløb København: Sundhedsstyrelsen, Enhed for Planlægning
Suominen, K., Isometsa, E., Suokas, J., Haukka, J., Achte, K., & Lonnqvist, J. (2004).
Completed suicide after a suicide attempt: a 37-year follow-up study. Am J Psychiatry,
(3), 562-563.
Valentijn, P. P., Schepman, S.M., Opheij, W., & Bruijnzeels, M.A. (2013). Understanding
integrated care: a comprehensive conceptual framework based on the integrative
functions of primary care. Int J Integr Care, 13, e010.
World Health Organization (WHO). (2014). Preventing suicide: a global imperative.
Luxembourg: World Health Organization.
Ølsgaard, G. (2010). Hvordan sikrer vi kvaliteten i sektorovergange? Afrapportering
om KVIS-delprojekt om kvalitetssikring af sektorovergange. København: Danske
Regioner & Foreningen af Speciallæger.
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