Better ways to prevent suicide更有效的自杀预防

Suicide is the 10th-leading cause of death in the United States, overall. For people ages 35 to 54, it ranks fourth, and for 10- to 34-year-olds, second.
自杀是美国总体死亡原因的第 10 位，对于 35 至 54 岁的人群来说，排名第 4，对于 10 至 34 岁的人群来说，排名第 2。

Over the decades, suicide rates have climbed and fallen and climbed again. Between 1999 and 2017, the suicide rate increased 33%, according to the U.S. Centers for Disease Control and Prevention (CDC) (see March Monitor, "Worrying Trends in U.S. Suicide Rates"). Meanwhile, health-care providers still struggle to identify those at risk and to intervene. Yet suicide researchers say that situation is starting to change.
几十年来，自杀率起伏不定。根据美国疾病控制与预防中心（CDC）的数据，1999 年至 2017 年间，自杀率上升了 33%（参见三月监测报告，“美国自杀率令人担忧的趋势”）。同时，医疗保健提供者仍在努力识别风险人群并采取干预措施。然而，自杀研究人员表示，这种情况正在开始改变。

Within the field of psychology, experts are bringing their unique skills to bear on the problem of suicide. Basic scientists are exploring brain changes and risk factors associated with suicidal ideation and behavior. Applied scientists are seeking new ways to identify those at risk. Clinical researchers are testing new therapeutic interventions, and clinicians on the front lines are helping deliver those treatments to people who are struggling. Meanwhile, psychologists working in advocacy roles are drawing from the latest research to educate the public and promote policies proven to reduce suicide rates. And many psychologists in the suicide field have skills that extend across other subfields of psychology, enabling them to act simultaneously as clinicians, researchers and educators.
在心理学领域，专家们正将他们独特的技能应用于自杀问题。基础科学家正在探索与自杀意念和行为相关的脑部变化和风险因素。应用科学家正在寻求新的方法来识别处于风险中的人群。临床研究人员正在测试新的治疗方法，而一线的临床医生正在帮助将这些治疗提供给那些正在挣扎的人们。同时，担任倡导角色的心理学家正在借鉴最新的研究成果来教育公众并推广已被证明能降低自杀率的政策。而且，许多从事自杀研究的心理学家在其他心理学子领域也拥有技能，使他们能够同时担任临床医生、研究人员和教育者。

"Our field is unique in the opportunities it provides to engage in all sorts of activities: research, clinical work, teaching, influencing policy. You can do it all in one lifetime," says psychologist Jill Harkavy-Friedman, PhD, vice president of research at the American Foundation for Suicide Prevention (AFSP).
我们的领域在提供参与各种活动的机会方面独具特色：研究、临床工作、教学、影响政策。你可以在一生中完成所有这些，美国自杀预防基金会（AFSP）研究副总裁、心理学家 Jill Harkavy-Friedman 博士说。

"In the suicide field, psychologists are really partnering across three arms: science, services and policy," adds Joan Asarnow, PhD, a clinical psychologist and professor of psychiatry and biobehavioral sciences at the University of California, Los Angeles’s David Geffen School of Medicine, whose work focuses on suicide prevention and interventions in youth. "We need basic science to inform our treatments. And on the other end, we need to find ways to get these [prevention and treatment] approaches into our communities."
在自杀领域，心理学家实际上正在三个领域进行合作：科学、服务和政策，”加州大学洛杉矶分校大卫·格芬医学院的精神病学和生物行为科学临床心理学家、教授 Joan Asarnow 博士补充道，其工作专注于预防青少年自杀和干预措施。“我们需要基础科学来指导我们的治疗方法。而在另一端，我们需要找到将这些[预防和治疗]方法引入我们社区的方法。”

To be sure, it’s a multidisciplinary effort, involving psychiatrists, emergency room physicians, social workers, public health experts, pediatricians, school counselors, teachers and many others. But psychology is notable for its wide-ranging expertise—and that diverse expertise is a natural fit for the field of suicide prevention.
当然，这是一个涉及精神科医生、急诊室医生、社会工作者、公共卫生专家、儿科医生、学校辅导员、教师以及许多其他人的多学科努力。但心理学因其广泛的专长而引人注目——这种多样化的专长对于预防自杀领域来说是一种自然的契合。

Increasingly, psychologists are banding together with others both inside and outside the field to tackle the problem of suicide prevention, says Cheryl King, PhD, a psychologist at the University of Michigan whose research focuses on improving suicide-risk assessments and evaluating interventions to reduce risk in youth. When she began her work three decades ago, the research was somewhat piecemeal, she says. No longer. "We were always concluding our sample sizes were too small, our statistical power was too limited, further research was needed. Now there are a lot of big teams working on this," she says. "Psychologists who study suicides are members of a growing community of researchers who often collaborate with others on interdisciplinary research teams."
越来越多的心理学家与领域内外的人士联合起来，共同应对自杀预防问题，密歇根大学的心理学家 Cheryl King 博士表示，她的研究专注于改善自杀风险评估和评估降低青少年风险干预措施。她说，当她三十年前开始这项工作时，研究有些零散。不再是了。“我们总是得出结论，样本量太小，统计能力有限，需要进一步研究。现在有很多大型团队在做这项工作，”她说。“研究自杀的心理学家是不断壮大的研究群体的一员，他们经常与其他人合作进行跨学科研究团队。”

Improving suicide-risk prediction 提高自杀风险预测

Suicide is an ancient problem, but within psychology, it’s a fairly young field. Historically, most suicide research has come from psychiatry departments, since people with suicidal thoughts and behaviors are often hospitalized in psychiatric settings, says Joe Franklin, PhD, an assistant professor of psychology at Florida State University who studies interventions for suicide and self-harm. But over the last three decades or so, more and more psychologists have gotten involved.
自殺是一个古老的问题，但在心理学领域，它相对较新。历史上，大多数自杀研究都来自精神病学部门，因为有自杀想法和行为的人通常会在精神病学环境中住院，佛罗里达州立大学心理学助理教授、研究自杀和自我伤害干预措施的 Joe Franklin 博士说。但近三十年来，越来越多的心理学家开始参与其中。

One area in which that teamwork is paying off is in the area of suicide-risk prediction. Many risk factors are associated with increased suicide risk, including depression, anxiety, sociodemographic factors and substance use. But not everyone who has depression or uses drugs or alcohol has suicidal thoughts. To better understand risk, Franklin, with his former postdoctoral adviser Matthew Nock, PhD, a professor of psychology at Harvard University, and colleagues analyzed 365 studies of suicide-risk factors over the last half century. "I’m a big proponent of going back to that basic science to ask, ‘What do we really know about what causes suicide?’" Franklin says.
一个团队协作取得成效的领域是自杀风险预测。许多风险因素与自杀风险增加有关，包括抑郁症、焦虑、社会人口学因素和物质使用。但并非所有患有抑郁症或使用药物或酒精的人都有自杀念头。为了更好地理解风险，Franklin 与他的前博士后导师、哈佛大学心理学教授 Matthew Nock 博士以及同事们分析了过去半个世纪 365 项自杀风险因素的研究。"我非常支持回到基础科学，问‘我们到底知道什么导致自杀？’" Franklin 说。

Not nearly enough, according to their analysis. Franklin and his colleagues found that after 50 years of research, prediction of suicidal behavior was still only slightly better than chance (Psychological Bulletin, Vol. 143, No. 2, 2017). "We’ve been moving in circles in suicide research, and we aren’t where we want to be in terms of suicide prediction," he says.
根据他们的分析，远远不够。富兰克林和他的同事发现，经过 50 年的研究，对自杀行为的预测仍然仅略好于偶然（心理通报，第 143 卷，第 2 期，2017 年）。他说：“我们在自杀研究中一直在原地打转，在自杀预测方面，我们还没有达到我们想要达到的地方。”

Such findings reinforce what clinicians on the ground have long recognized, says King: "Single risk factors just don’t predict suicide well." Still, the analysis has been an important and influential finding for the field, and has given a fresh push to efforts to better predict who is at risk.
此类发现加强了地面临床医生早已认识到的观点，金说：“单一风险因素并不能很好地预测自杀。”然而，这项分析对该领域来说是一项重要且有影响力的发现，并为更好地预测谁处于风险之中提供了新的推动。

To better understand how risk factors interact, Franklin and his colleagues applied machine learning to the electronic health records of more than 5,000 adults who had a history of self-injury. They developed an algorithm that predicted suicide attempts based on combinations of risk factors including demographic data, previous diagnoses, medication history and past health-care utilization (Walsh, C.G., et al., Clinical Psychological Science, Vol. 5, No. 3, 2017). "Machine learning can take us from near-random guessing to a prediction that’s about 80% correct," Franklin says.
为了更好地理解风险因素之间的相互作用，富兰克林及其同事将机器学习应用于超过 5,000 名有自伤史的成年人的电子健康记录。他们开发了一种算法，根据包括人口统计数据、既往诊断、用药史和以往医疗服务利用在内的风险因素组合来预测自杀尝试（沃尔什，C.G. 等，《临床心理学科学》，第 5 卷，第 3 期，2017 年）。富兰克林说：“机器学习可以将我们从近乎随机的猜测转变为大约 80%准确的预测。”

King is also harnessing technology to improve suicide-risk assessment among adolescents. Her team has developed an adaptive screening tool that adjusts to the individual. "The questions posed to youths depend upon their responses to previous questions, so different youths get different sets of questions to get the best prediction possible," she says. In the National Institute of Mental Health (NIMH)-funded Emergency Department Screen for Teens at Risk for Suicide study, King and her collaborators are testing the screening in 14 pediatric emergency departments nationwide. If testing is successful, she plans to work with implementation experts to put the tool into use. "Our interest is in getting this new teen suicide-risk screen out into the field," she says.
金也在利用技术来改善青少年自杀风险评估。她的团队开发了一种适应性筛查工具，该工具会根据个人进行调整。“向青少年提出的问题取决于他们对先前问题的回答，因此不同的青少年会得到不同的问题集，以获得最佳预测，”她说。在国家精神卫生研究所（NIMH）资助的“青少年自杀风险急诊筛查”研究中，金及其合作者在全国 14 个儿科急诊部门进行筛查测试。如果测试成功，她计划与实施专家合作，将此工具投入使用。“我们的目标是让这项新的青少年自杀风险筛查在实地应用，”她说。

From lab to clinic 从实验室到诊所

Basic research is informing our understanding of suicide in other ways as well, including efforts to understand genetic signatures and brain activity associated with suicidal behaviors. For example, psychologists at Carnegie Mellon University are looking for neurocognitive markers associated with suicidal ideation and attempts. The researchers used fMRI to look at the neural patterns of 17 people with and 17 people without suicidal ideation as they thought about concepts including death, cruelty and praise. Using machine-learning techniques to assess the participants’ neural patterns, the researchers were able to determine with 91% accuracy those who had suicidal ideation and those who did not. What’s more, among those with suicidal thoughts, the algorithm differentiated with 94% accuracy those who had made suicide attempts from those who had not (Just, M.A., et al., Nature Human Behaviour, Vol. 1, 2017).
基础研究也在以其他方式丰富我们对自杀的理解，包括努力理解与自杀行为相关的遗传特征和大脑活动。例如，卡内基梅隆大学的心理学家正在寻找与自杀意念和尝试相关的神经认知标记。研究人员使用 fMRI 观察了 17 个有自杀意念的人和 17 个没有自杀意念的人在思考死亡、残忍和赞美等概念时的神经模式。通过使用机器学习技术评估参与者的神经模式，研究人员能够以 91%的准确率确定有自杀意念的人和无自杀意念的人。更重要的是，在那些有自杀想法的人中，算法以 94%的准确率区分了那些有自杀尝试的人和那些没有尝试的人（Just, M.A. 等，《自然人类行为》，第 1 卷，2017 年）。

Elsewhere, psychological scientists are exploring new ways to model suicidal behavior in order to understand what might make someone act on a suicidal impulse. "It’s just hard to do experimental suicide research, logistically and ethically," says Franklin. But he and others are beginning to use virtual reality (VR) to test how various factors might affect the likelihood of self-harm. Franklin developed a VR scenario in which people can virtually jump from a height or shoot themselves, and tested it among participants who did not have a history of suicidal thoughts (Behaviour Research and Therapy, online 2018). He plans to use the system to study how factors such as social rejection might influence the way people behave in those virtual scenarios. "We can’t directly study the causes of suicidal behavior, but we can directly study the causes of virtual suicidal behavior," he says.
其他地方，心理科学家正在探索新的方法来模拟自杀行为，以了解什么可能促使某人采取自杀冲动。富兰克林说：“在逻辑和伦理上，进行实验性自杀研究很难。”但他和其他人开始使用虚拟现实（VR）来测试各种因素可能如何影响自我伤害的可能性。富兰克林开发了一个 VR 场景，人们可以在虚拟中从高处跳下或自杀，并在没有自杀想法史（行为研究与治疗，在线 2018）的参与者中进行测试。他计划使用该系统来研究社会排斥等因素如何影响人们在虚拟场景中的行为方式。他说：“我们无法直接研究自杀行为的原因，但我们可以直接研究虚拟自杀行为的原因。”

At the clinical end of the spectrum, psychologists are also working to improve outcomes for people at risk of suicide. That effort has seen significant advancement in recent years, says psychologist Ivan Miller, PhD, a professor of psychiatry and human behavior at Brown University. "Until about 15 years ago, there really wasn’t an awful lot of empirically oriented research directly focused on suicide," he says. "We now have several types of interventions that have been shown to be effective at reducing suicidal behaviors."
在临床光谱的末端，心理学家也在努力改善有自杀风险人群的预后。心理学家伊万·米勒博士，布朗大学精神病学和人类行为学教授，表示：“直到大约 15 年前，针对自杀的实证性研究并不多。”他说，“我们现在有几种已被证明能有效减少自杀行为的干预措施。”

Among those effective interventions is one tested by Miller and colleagues. The Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) study tested a suicide intervention in eight hospital emergency departments nationwide. Emergency department staff used a brief screening to assess suicide risk among patients. Those who were flagged as at increased risk received a secondary screening, a self-report safety plan, and the Coping Long Term with Active Suicide Program (CLASP), a values-based suicide prevention program delivered by telephone over the following year. Patients who received the intervention had 30% fewer suicide attempts during that year than patients who received standard emergency department care (JAMA Psychiatry, Vol. 74, No. 6, 2017).
在有效干预措施中，包括由 Miller 及其同事进行的一项测试。紧急情况部门安全评估和随访评价（ED-SAFE）研究在全国八个医院的急诊部门测试了自杀干预措施。急诊部门工作人员使用简短筛查来评估患者自杀风险。那些被标记为风险增加的患者接受了二次筛查、自我报告的安全计划以及应对长期活跃自杀计划（CLASP），这是一个基于价值观的自杀预防项目，通过电话在接下来的年份内提供。接受干预的患者在那一年自杀尝试次数比接受标准急诊部门护理的患者少 30%（《美国精神病学杂志》，第 74 卷，第 6 期，2017 年）。

The safety planning intervention used in the ED-SAFE study was a paper-and-pencil version delivered by nurses. Face-to-face safety planning has also been shown to be effective as a suicide intervention. One such face-to-face intervention, developed by psychologists Barbara Stanley, PhD, at Columbia University, and Gregory Brown, PhD, at the University of Pennsylvania, and colleagues, is the Safety Planning Intervention (SPI). The SPI involves several steps, including teaching people at risk of suicide to identify personalized warning signs for an impending suicide crisis, determine coping strategies and pinpoint individuals who can support them in a crisis. Stanley and colleagues tested the SPI in nine emergency departments and found that it reduced suicidal behavior and increased treatment engagement in patients at risk of suicide (JAMA Psychiatry, Vol. 75, No. 9, 2018).
在 ED-SAFE 研究中使用的安全规划干预是一种由护士提供的纸质笔头版本。面对面安全规划也被证明是一种有效的自杀干预措施。其中一种面对面干预措施是由哥伦比亚大学的心理学家 Barbara Stanley 博士和宾夕法尼亚大学的 Gregory Brown 博士及其同事开发的，称为安全规划干预（SPI）。SPI 包括几个步骤，包括教给有自杀风险的人识别即将发生的自杀危机的个性化预警信号，确定应对策略，并确定在危机中可以支持他们的人。Stanley 及其同事在九个急诊科测试了 SPI，发现它减少了自杀行为，并增加了有自杀风险患者的治疗参与度（《美国精神病学杂志》，第 75 卷，第 9 期，2018 年）。

Psychologists have played a leading role in developing other evidence-based frameworks to address suicidal thoughts and behaviors, including dialectical behavior therapy (DBT; Linehan, M.M., et al., JAMA Psychiatry, Vol. 72, No. 5, 2015) and the collaborative assessment and management of suicidality (CAMS; Jobes, D.A., Suicide and Life-Threatening Behavior, Vol. 42, No. 6, 2012). Several versions of cognitive-behavioral therapy (CBT) have also been shown to reduce suicide attempts. Asarnow and colleagues showed that the Safe Alternatives for Teens and Youths (SAFETY) intervention, a family-based treatment informed by CBT and DBT, reduced suicide attempts in high-risk adolescents (Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 56, No. 6, 2017).
心理学家在开发其他基于证据的框架以应对自杀想法和行为方面发挥了主导作用，包括辩证行为疗法（DBT；Linehan, M.M. 等，JAMA Psychiatry，第 72 卷，第 5 期，2015 年）和自杀协作评估与管理（CAMS；Jobes, D.A.，自杀与生命威胁行为，第 42 卷，第 6 期，2012 年）。几种认知行为疗法（CBT）版本也被证明可以减少自杀尝试。Asarnow 及其同事表明，基于认知行为疗法（CBT）和辩证行为疗法（DBT）的家庭治疗干预措施“青少年和青年安全选择”（SAFETY），降低了高风险青少年的自杀尝试（美国儿科学会儿童与青少年精神病学杂志，第 56 卷，第 6 期，2017 年）。

M. David Rudd, PhD, ABPP, and colleagues demonstrated that even a brief CBT intervention can reduce repeat suicide attempts in military personnel by about 60% (American Journal of Psychiatry, Vol. 172, No. 5, 2015). Still, suicide rates among military personnel and veterans have increased over the last decade. One reason, suggests Rudd, is that evidence-based interventions haven’t become established very quickly in the majority of clinical settings. "The clinical and scientific fields have undeniably moved forward in the last two decades. There’s probably been more movement in the last 15 years than in the previous 50," he says. But evidence-based treatments such as his brief CBT intervention still aren’t widely used in clinical settings, he says. "We need more implementation scientists to get involved as well as policy experts."
M. David Rudd，博士，ABPP，及其同事证明，即使是短暂的 CBT 干预也能将军事人员重复自杀尝试减少约 60%（《美国精神病学杂志》，第 172 卷，第 5 期，2015 年）。然而，过去十年中，军事人员和退伍军人的自杀率有所上升。Rudd 认为，其中一个原因是基于证据的干预措施在大多数临床环境中并没有迅速建立。他说：“临床和科学领域在过去二十年里无疑取得了进步。可能在过去 15 年里取得的进展比之前 50 年还要多。”但他表示，像他短暂的 CBT 干预这样的基于证据的治疗方法在临床环境中仍然没有得到广泛应用。“我们需要更多的实施科学家和政策专家参与。”

Influencing policy and funding 影响政策和资金

Though progress in that regard is slower than most psychologists would like, many of those in the field say they’re optimistic that prevention and intervention efforts are gaining momentum. In 2010, the National Action Alliance for Suicide Prevention launched as a public-private partnership to advance and update the National Strategy for Suicide Prevention, which details goals and objectives for reducing deaths by suicide.
尽管在这方面取得的进展比大多数心理学家希望的慢，但该领域的许多人表示，他们对预防和干预措施正在加速感到乐观。2010 年，国家自杀预防行动计划作为一项公私合作项目启动，旨在推进和更新国家自杀预防战略，该战略详细说明了减少自杀死亡的目标和目标。

That alliance includes some 250 partners, including major federal agencies such as NIMH, the Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Defense and the Department of Veterans Affairs. The creation of this partnership and the development of a national strategy have been major steps forward in the effort to reduce deaths by suicide, says Jane L. Pearson, PhD, a psychologist and special adviser to the director on suicide research at NIMH.
该联盟包括约 250 个合作伙伴，其中包括主要联邦机构如美国国立精神卫生研究所（NIMH）、物质滥用与精神健康服务管理局（SAMHSA）、国防部以及退伍军人事务部。Jane L. Pearson 博士，一位心理学家，也是 NIMH 自杀研究主任的特别顾问，表示，创建这一伙伴关系和发展国家战略是减少自杀死亡人数努力中的重大进步。

One important recent development was the expansion of the CDC’s National Violent Death Reporting System, which collects data on deaths by suicide and other violent deaths in the United States. Incredibly, that system wasn’t fully funded to collect data from all 50 states until 2018. Without those numbers, it has been hard to paint a complete picture of U.S. suicides, says Pearson. By gathering data on the characteristics and experiences of everyone who dies by suicide, researchers can better understand who is at risk—and find more effective ways to help them, she says.
一项重要的近期发展是 CDC 国家暴力死亡报告系统的扩展，该系统收集美国自杀和其他暴力死亡的数据。令人难以置信的是，直到 2018 年，该系统才得到充分资金以收集所有 50 个州的数据。Pearson 表示，没有这些数字，很难描绘出美国自杀的完整图景。她说，通过收集所有自杀死亡者的特征和经历数据，研究人员可以更好地了解谁处于风险之中，并找到更有效的帮助他们的方式。

Having a psychologist such as Pearson involved in NIMH’s efforts has been a boon to suicide research, says Asarnow. Meanwhile, psychologists at SAMHSA have been leading the way on suicide prevention services, she adds. That agency oversees the National Suicide Prevention Lifeline, which last year answered more than 2.2 million calls.
有心理学家如 Pearson 参与 NIMH 的努力，对自杀研究来说是一大福音，Asarnow 说。同时，SAMHSA 的心理学家在自杀预防服务方面引领了潮流，她补充道。该机构负责监督全国自杀预防热线，去年接听了 220 多万个电话。

SAMHSA also administers the Garrett Lee Smith State/Tribal Youth Suicide Prevention and Early Intervention Grant Program, which provides funding to states and tribes for implementing youth suicide prevention and early intervention strategies in settings such as schools, juvenile justice systems and foster care programs. Richard McKeon, PhD, MPH, a psychologist and chief of the suicide prevention branch at SAMHSA, has worked with the Garrett Lee Smith program since 2005. During that time, he says, research has shown that the program makes a difference. Evaluation studies have found that counties that received those grants had lower rates of youth suicide attempts and deaths by suicide than matched counties that did not receive funding (Garraza, L.G., et al., JAMA Psychiatry, Vol. 72, No. 11, 2015).
SAMHSA 还管理着加勒特·李·史密斯州/部落青年自杀预防与早期干预补助金项目，该项目为各州和部落提供资金，以在学校、青少年司法系统和寄养计划等环境中实施青年自杀预防和早期干预策略。理查德·麦克劳恩博士，公共卫生硕士，是一位心理学家，也是 SAMHSA 自杀预防部门的负责人，自 2005 年以来一直参与加勒特·李·史密斯项目。他说，在此期间，研究表明该项目产生了影响。评估研究发现，获得这些补助金的县与未获得资金的匹配县相比，青少年自杀尝试和自杀死亡的比例更低（Garraza, L.G. 等，《美国精神病学杂志》，第 72 卷，第 11 期，2015 年）。

McKeon says he and his colleagues keep a close eye on the latest science as they determine how best to provide support. When data showed that the impact of the Garrett Lee Smith–funded programs faded over time, for example, SAMHSA increased the amount of funding and extended the length of the grants, hoping that sustained support would make the benefits last. "We closely monitor the research to try to incorporate as much as we can into all of our suicide prevention activities," McKeon says.
麦凯恩表示，他和他的同事们在确定如何最好地提供支持时，密切关注最新的科学进展。例如，当数据显示由加勒特·李·史密斯资助的项目随着时间的推移影响减弱时，SAMHSA 增加了资助金额并延长了资助期限，希望持续的支持能让好处持续。麦凯恩说：“我们密切监控研究，试图将尽可能多的内容纳入我们所有的自杀预防活动中。”

Outside of government, psychologists such as Harkavy-Friedman at AFSP are advocating for greater research investment and policies that could reduce deaths by suicide. AFSP lobbied for the expanded National Violent Death Reporting System, for instance. And in her role overseeing the organization’s research grant program, Harkavy-Friedman helps support scientists whose work has the potential to inform prevention efforts. "We’re always advocating for increased funding for research, but we also want to show that research is having an impact," she says.
政府之外，AFSP 的 Harkavy-Friedman 等心理学家正在倡导增加研究投资和可能减少自杀死亡的政策。例如，AFSP 游说扩大国家暴力死亡报告系统。在她的监督组织研究资助计划的角色中，Harkavy-Friedman 帮助支持那些工作有可能为预防工作提供信息的研究人员。“我们一直在倡导增加研究资金，但我们也想表明研究正在产生影响，”她说。

Reaching across the divide 跨越分歧

From research labs to hospital corridors, from funding agencies to political rallies, psychologists are deeply embedded in efforts to reduce deaths by suicide. Though their roles and backgrounds differ, many of those experts echo the same two major takeaways when describing the current state of their field: First, suicide research has recently made significant strides.
从研究实验室到医院走廊，从资助机构到政治集会，心理学家在减少自杀死亡的努力中深深扎根。尽管他们的角色和背景不同，许多这些专家在描述他们领域的当前状态时，都重复了同样的两个主要观点：首先，自杀研究最近取得了重大进展。

But second, there’s still a lot of work to be done.
但是第二，还有很多工作要做。

"We’ve found some things that work, and we’re starting to get more clues about how to prevent suicide. But we need more researchers looking at this," Pearson says.
我们找到了一些有效的方法，并且开始获得更多关于如何预防自杀的线索。但我们还需要更多研究人员关注这个问题，Pearson 说。

And the best way to accomplish that? Just start, says psychologist Janis Whitlock, PhD, a research scientist and associate director for teaching and training at the Bronfenbrenner Center for Translational Research at Cornell University. Whitlock’s own research focuses on self-injury, which is a risk factor for suicide. And in her teaching role, she trains other scientists to translate their research into practice. "Exposure is the best teacher. If you’re interested in working across fields of psychology, the best thing you can do is invite in people who are sitting in a different place," she says.
并且实现这一目标最好的方法是什么？就是开始，心理学家 Janis Whitlock 博士，康奈尔大学 Bronfenbrenner 转化研究中心的教学与培训副总监，这样说道。Whitlock 自己的研究专注于自伤，这是自杀的风险因素。在她的教学角色中，她培训其他科学家将他们的研究转化为实践。“暴露是最好的老师。如果你对在心理学各个领域工作感兴趣，你能做的最好的事情就是邀请那些坐在不同位置的人进来，”她说。

Whitlock recommends that when psychologists are reaching out to form those collaborations, they should start with a lot of questions—and be open to hearing the answers. "When researchers want to start working across fields, the biggest mistake is that they assume people think like them. They go in with their road map and start charting things out in a linear way. But the best way to cultivate relationships is to ask questions, listen and integrate everybody’s perspective," she says. "You have to learn to take different perspectives: how to wear the policymaker hat or the practitioner hat. That’s not intuitive for most researchers."
Whitlock 建议，当心理学家在寻求建立合作关系时，他们应该提出很多问题——并乐于倾听答案。“当研究人员想要跨学科工作的时候，最大的错误是他们认为别人和他们想的一样。他们带着自己的路线图，以线性方式开始规划。但培养关系的最好方法是提问、倾听并整合每个人的观点，”她说。“你必须学会采取不同的视角：如何戴上政策制定者的帽子或实践者的帽子。这对大多数研究人员来说并不直观。”

Though it might not come naturally, it’s well worth the effort, says Mitch Prinstein, PhD, ABPP, a distinguished professor of psychology and neuroscience at the University of North Carolina at Chapel Hill who studies adolescent depression and self-injury. "The field of psychology is unique in our ability to move science from the lab to providers’ offices, and even into legislative efforts," he says. "Psychology can make an enormous difference by working together across science, practice and policy. Together, our work can truly save lives." 
尽管这可能不是自然而然的，但值得付出努力，Mitch Prinstein 博士，ABPP，北卡罗来纳大学教堂山分校心理学和神经科学杰出教授，研究青少年抑郁症和自残行为，如此说道。“心理学领域独特之处在于我们能够将科学从实验室转移到提供者办公室，甚至进入立法努力。”他说。“心理学可以通过跨科学、实践和政策合作产生巨大的影响。我们的合作工作可以真正挽救生命。”

Source: https://www.apa.org/monitor/2019/07-08/cover-prevent-suicide