兒少憂鬱與自殺保護之護理當責－－從校園到醫療場域

Nursing Accountability in Protecting Children and Adolescents at Risk of Depression or Suicide: From Campus to Medical Care

兒童青少年全人健康是家庭與社會共同的責任。近幾年來，兒少保護議題因為數個重大社會事件受到大眾矚目，特別是兒少心理健康或保護性議題（如凌虐、侵害、校園霸凌、殺子後自殺等），亟需全民共同努力防範。臨床專業人員與社區第一線護理師扮演人民的全人健康守護者，若能發揮專業敏感度、早期發現、介入即時之處置或適時轉介，將有助於有特殊需求之兒少及其家庭獲得必要且充分的協助。本文從護理當責之概念分析，整理兒少憂鬱及自殺風險相關因子，再藉由以下三大護理專業領域特色說明護理之角色與功能：（1）校護透過日常互動察覺學生憂鬱或自殺風險並建立跨處室支持網絡，以早期發現與合適處置或轉介；（2）社區護理師透過健康訪視、家庭觀察與跨領域合作，協助高風險兒少獲得適當資源；（3）兒科護理師則利用標準化評估工具及跨專業合作，及時介入兒少心理危機處置，確保安全並提供心理支持。現今變動的醫療環境與社會氛圍下，提升學校護理教育及跨科在職教育之護理當責與創傷知情概念，將優化兒少第一線照護服務品質、促進護理師個人正向改變、並賦予護兒家三方相互溝通了解的管道，利於早期發現兒少心理健康需求，降低憂鬱或自殺的風險。

Ensuring the holistic health of children and adolescents is a responsibility shared by families and society. In recent years, protection issues related to children and adolescents have garnered increasing public attention due to several major social incidents such as abuse, assault, school bullying, and filicide-suicide. These concerns necessitate the implementation of collective prevention efforts. Clinical healthcare professionals and frontline community nurses serve as guardians of holistic health, and their ability to remain vigilant, identify risks early, and provide timely referrals or interventions is crucial to ensuring that children, adolescents, and their families receive adequate and necessary support. In this article, the concept of nursing accountability is analyzed, the key factors associated with depression and suicide risk in adolescents are identified, and the roles and functions of nurses are outlined in three major professional nursing fields: (1) School nurses play a vital role in recognizing signs of depression and suicide risk through daily interactions with students and the establishment of cross-departmental support networks for early identification and proper management or referrals. (2) Community nurses conduct health visits, observing family dynamics and collaborating with interdisciplinary teams to help high-risk children and adolescents access appropriate resources. (3) Pediatric nurses utilize standardized assessment tools and interdisciplinary collaboration to provide timely interventions for adolescent mental health crises, ensuring safety and offering psychological support. In today’s evolving healthcare environment and social landscape, enhancing school nursing education and cross-disciplinary in-service training in nursing accountability and trauma-informed care promise to optimize frontline adolescent healthcare services. This approach fosters positive professional nursing development; strengthens communication among nurses, patients, and families; and ultimately aids in the early detection of young individuals’mental health needs, thereby reducing the risks of depression and suicide.