大專院校自殺/自傷危機處理之探討：以臺灣北區四所私立大學為例

An Investigation of Crisis Management for Suicide/Self-injury: The Experiences of Foar Private Universities in Northern Taiwan

校園危機處理為心理諮商專業之必要工作，自殺/自傷危機又是學校諮商員最常處理的事件之一。為因應校園自殺/自傷危機日增的局勢，台灣教育當局所頒布之學生憂鬱及自殺/自傷防治處理機制流程圖中，以三級預防的概念明訂校園中相關單位之自殺/自傷危機處理工作。本研究以台灣北區四所不同特色之大學諮商輔導單位及其諮商員為研究對象，探討各校自殺/自傷危機處理之個案管理所遇到的困難與解決方式，期盼透過此研究補充教育部頒訂之危機處理程序，以涵蓋更多元校園文化之處理流程。為此，本研究透過檔案研究與焦點團體的方式，依照緊急個案管理模式中之評估、轉介、聯繫、通報、召開會議、後續輔導等工作層面，收集各校在自殺/自傷危機處理程序中所遭遇的困難與因應策略。結果發現就自殺/自傷處理程序而言，受訪的學校輔導單位部分採取教育部頒布的處理流程並編製具體內部流程。而就諮商員的自殺/自傷危機個案管理實務工作上，訪問結果發現在評估、轉介與就醫方面，各校皆遇到執行的困難並發展相關的行動策略。聯繫與通報之個案管理工作則因校園行政文化發展不同處理策略。本研究依照上述困難中各校的解決策略，擬定一個調整後的自殺/自傷危機處理流程圖。

Campus crisis management has become a necessary aspect of a counselor’s job. Specifically， management of suicide/self-injury crises is one of the most common occurrences faced by university-based counselors. In responding to the increasing suicide/self-injury incidences across campuses， the Ministry of Education in Taiwan stipulated a student depression and suicide/self-injury prevention and management flowchart based on the tertiary prevention concept. By studying the experiences of four university counseling centers in Northern Taiwan， this study explored the obstacles faced and the solutions adopted by each of these universities in managing crises. It is hoped that this study can help supplement the crisis management procedures formulated by the Ministry of Education and that the unique culture of the various universities can be incorporated into the emergency management procedures to help each campus responding to crises. The present study analyzed case files as well as conducted focus groups to collect information related to obstacles encountered during crisis and the corresponding management strategies used in each of the campuses. The specific elements of assessment， referral， liaison， reporting， meeting， and follow-up counseling indicated in the emergency case management model were examined. Results of the study suggest that difficulties in carrying out assessment， referral and medical treatment were found across campuses and each university has developed its own unique responding strategies. Approaches to liaison and reporting were found to be divergent across campuses due to differences in the administrative culture of each university. On the basis of the above results， the current study forwards a modified version of the suicide/self-injury crisis management reference flowchart to help address concerns across campuses.