自殺死亡者求助熱線，末通來電之情緒困擾與自殺風險程度初探

Emotional Distress and Suicide Risk in Suicide Completers' Last Phone Calls to the Hotline

本研究旨在瞭解自殺死亡者生前表現出來的情緒困擾和自殺風險程度。研究資料為16名自殺死亡者的最後一通熱線電話協談錄音，分別以情緒狀態評量表和自殺風險評量表檢核他們在通話開始及通話結束時的心理狀態，再與對照組100位自殺企圖進行中案主、100位自殺意念案主、100位無自殺意念案主進行比較。研究發現如下：（一）即將因為人際關係、經濟壓力、生理或心理疾病而自殺死亡者，其情緒困擾和自殺風險程度皆相同；（二）即將自殺死亡者的情緒困擾程度明顯高於三組對照組；（三）即將自殺死亡者和對照組自殺企圖進行中案主的自殺風險程度相同，並列最危急；（四）另項研究證實熱線服務可以降低三組對照組的情緒困擾和自殺風險程度，相較之下，即將自殺死亡者即便求助熱線也無法獲得舒緩，符合自殺學理論所述自殺者僵化固執的特殊心理狀態。最後，研究針對自殺風險評估、危機處預和未來研究等進行相關討論和建議。

This study explored the levels of emotional distress and suicide risk of those who were about to end their lives by suicide. A total of 16 completed suicides among those who called the National Suicide Prevention Hotline were identified, and their last telephone sessions were coded using (1) the modified mental state rating scale (MSRS) for measuring the levels of emotional distress, and (2) the modified suicide risk scale (SRS) for measuring the levels of suicide risk. The coded data would then be compared with data from the author's previous study, which includes coded telephone sessions of 100 acute suicidals (with an ongoing attempt), 100 suicidals (having suicidal thoughts only), and 100 non-suicidals (without suicidal thoughts). Among callers who ended their lives because of relational problem, economic stain, and somatic or psychiatric illness, results showed no significant differences in the MSRS and SRS scores at the beginning of the calls, neither at the end of the calls. There were also no significant changes in the MSRS and SRS scores from the beginning to the end of the calls. Among suicide completers, acute suicidals, suicidals, and non-suicidals, results revealed significant main effect and interaction effect in the MSRS and SRS scores. Individuals prior to suicide death exhibited the highest level of emotional distress than others. They also showed higher levels of suicide risk than suicidals and non-suicidals, but equal to acute suicidals. The hotline services were able to help almost all callers feel less disturbed and lower their suicidal urgency in just one telephone call, but not for those who were about to end their lives. The high level of emotional distress alongside the rigid thinking of a suicide mind may help practitioners identify people at high risk for suicide death.