曾有自殺意念者對媒體鼓勵求助訊息的感受：調查研究

Abstract

背景：全球每年有超過70萬人自殺死亡，自殺報導的暴露可能增加易感受性族群的自殺風險，而自殺意念者為自殺高風險族群。為降低自殺報導潛在負面影響，以及發揮自殺防治的正面效果，臺灣自殺報導經常於文末提供鼓勵求助訊息，例如：「自殺不能解決問題」、「珍惜生命，生命誠可貴」、「請撥打24小時安心專線」等，然而，這些訊息是否能提升有自殺意念者的求助意願，仍缺乏相關研究。 目的：本研究旨在探討臺灣20-65歲一生當中曾有自殺意念的成年人中，對媒體鼓勵求助訊息的感受與對求助意願之影響。 方法：本研究第一階段搜集與分類臺灣自殺報導文末的鼓勵求助訊息，第二階段進行問卷調查了解研究參與者對七種鼓勵求助訊息的感受，包括五種在臺灣自殺報導中常見的鼓勵求助訊息，以及根據過往研究重新設計的兩種訊息。在線上調查部分，於北部兩家醫學中心的精神科門診、中部某綜合醫院的精神科門診，以及網路平臺發放文宣招募研究者進行網路問卷調查，在紙本調查部分，於北部某醫學中心日間病房招募研究者進行問卷調查。使用單因子相依變異數分析與Cochran's Q檢定比較研究參與者對七種訊息的感受，並使用多元線性迴歸模型分析訊息感受的相關因素。 結果：針對所研究的媒體鼓勵求助訊息，有超過一半的參與者不同意有正面感受或增加求助意願，其中「自殺不能解決問題」在感受與反應總分表現最差，整體表現較好的則是「勇敢求救並非弱者」與「如果您覺得痛苦、似乎沒有出路，您並不孤單，請撥打1925」。有宗教信仰者之感受與反應皆較正向，而有中/重度心理困擾、近一週有自殺意念與曾有求助行為者則較負向。 結論：整體而言媒體鼓勵求助訊息對曾有自殺意念者，產生正面情緒及增加求助意願的影響有限。將來媒體應避免使用會帶來負面感受及降低求助意願的訊息。

Background: More than 700,000 people die by suicide each year in the world. Exposure to media reporting of suicide may increase suicide risk in vulnerable individuals, and people with suicidal ideation are a high-risk group for suicide. To reduce the potential negative impact of suicide reporting and support suicide prevention, Taiwan’s media commonly includes messages aimed to encourage help-seeking at the end of articles of suicide reporting, such as 'Suicide cannot solve the problems,' 'Cherish life, life is precious,' and 'Please call the 24-hour suicide prevention hotline.' However, there is no past research of whether these messages could increase the willingness to seek help among people with suicide ideation. Objective: To investigate the perceptions toward media messages aimed to encourage help-seeking and their influences on help-seeking willingness among adults aged 20-65 years with a history of suicidal ideation in Taiwan. Methods: In the first phase of this study, we collected and categorized Taiwan media’s messages aimed to encourage help-seeking. In the second stage, we conducted a survey to investigate the participants' perceptions toward seven media messages, including five messages commonly used by Taiwan media and two messages crafted by the researchers. Advertisements of the online part of the survey were disseminated at the psychiatric outpatient clinics of two medical centers in north Taiwan and one general hospital in middle Taiwan. In the paper-based part of the survey, we recruited participants at the day care unit of a medical center in north Taiwan. Repeated measured ANOVA and Cochran's Q test were used to compare participants' perceptions toward the seven media messages, and multiple linear regression models were used to identify the factors associated with the perceptions toward media messages. Results: More than half of the participants did not report positive feelings or increased willingness to seek help in response to the media messages investigated. Among the seven messages, 'Suicide cannot solve the problems' received the most negative responses. By contrast, 'Bravely asking for help is not weak' and 'If you feel pain and there seems to be no way out, you are not alone, please call 1925' received relatively better responses. Religious beliefs were associated with more positive responses toward the messages, while having emotional distress and suicidal ideation in the past week and having sought help were associated with more negative responses. Conclusion: Overall, the media messages aimed to encourage help-seeking had a limited effect on triggering positive emotions or increasing willingness to seek help among people with a history of suicidal ideation. The media should avoid including messages that could trigger negative feelings and reduce the willingness to seek help in suicide reporting.