台灣自殺防治十年回顧檢討與展望

Suicide prevention in Taiwan: a ten-year review

自殺死亡自1997年起進入台灣十大死因之列，並於2006年達到近年高峰，該年自殺粗死亡率為每十萬人19.3人。為因應嚴峻形勢，政府於2005年成立全國自殺防治中心，擔任推動全國性自殺防治工作之整合平臺。我國自殺防治策略，包含全面性、選擇性與指標性策略，以促進醫療及非醫療體系之自殺防治網絡整合為手段，透過臨床研究與資訊分析之實證基礎為策略依據。自2007年起自殺死亡率呈現下降趨勢，至2010年退出十大死因，於2011年由世界衛生組織定義之高自殺死亡率國家進入中度之列。未來除持續推動國家自殺防治策略外，將繼續深植「珍愛生命、希望無限」的精神於各領域，貫徹「思維全球化」、「策略國家化」、「行動在地化」的目標，以達成「自殺防治人人有責」、「人人都是珍愛生命守門人」的理想境界。

Suicide is a tragic outcome of various bio-psycho-social adversities. In Taiwan, suicide had become one of the top-ten leading causes of death in 1997. The crude suicide mortality rate increased rapidly from 10.0 per 100,000 in 1997 to 19.3 per 100,000 in 2006. In response to this situation, the Ministry of Health and Welfare of Taiwan provided grants to implement the National Suicide Prevention Program. The goal was to promote national suicide prevention strategies, support suicide prevention tasks at the local level, and establish a “planning nationally and acting locally” philosophy. The Taiwan Suicide Prevention Center (TSPC) was established in September 2005 to prevent suicide by enhancing the efficiency of care delivery networks in Taiwan. The TSPC is a medium to translate the scientific evidence about suicide, especially epidemiological evidence, into public health policy. The TSPC also serves as a platform to coordinate efforts between governmental and non-governmental organizations. The TSPC is in charge of standardizing the national suicide report system and aftercare delivery system, implementing pilot plans, promoting suicide gatekeeper trainings, and organizing community support networks. Every county in Taiwan has to implement the county-level program of suicide prevention, and TSPC plays a leading role in support and evaluation of each county in dealing with its own issues with suicide. The standardized suicide mortality rate went down from 16.8 per 100,000 in 2006 to 12.0 per 100,000 in 2012. Suicide dropped out the top-ten leading causes of death in 2010 and continues to do so today. In order to promote the sustainable management of suicide prevention strategies in Taiwan, the staff of the TSPC is now actively engaged in drafting the Suicide Prevention Act.