【摘要】 目的 总结在大型城市试点开展“家庭-学校-医院-社区”（“家-校-医-社”）中小学学生心理危机分类预警干预的经验。方法 2017—2020年（3个学年），在上海市长宁区初步形成由政府部门及街镇提供社会支持，市级专业机构和高校提供技术支撑，疾病预防控制精神卫生分中心、未成年人心理健康辅导中心组成多学科服务团队提供专业干预和指导，家长、心理教师、精神科医护人员、心理咨询师等共同参与的“家-校-医-社”模式；初步建立四级响应体系和三级网络，提供主动及被动监测、专科医师进校园、心理危机事件分类预警和干预以及心理教师、班主任和家长支持性服务等为一体的综合干预。结果 2017年上半年形成干预架构、组建队伍并对相关人员进行培训，同年9月开始运作“家-校-医-社”中小学学生心理危机分类预警干预模式实施干预至2020年8月。3个学年，长宁区累计处置分类预警事件共218件次，其中，重大心理高危事件24件次（占11.0%）、严重心理危机事件42件次（占19.3%）、一般心理事件152件次（占69.7%）；年均服务超过21 000人次，接受服务者抽样满意度从最初的96.7%提高至99.3%；校园重大危机事件联合干预率为100%，预防自杀和自伤行为成功率100%。结论 “家-校-医-社”中小学学生心理危机分类预警干预模式在一定程度上完善了中小学学生心理危机干预体系功能，整合了有效资源，丰富了服务形式和内容，提升了干预效能，为疫情常态化阶段满足城市中小学学生多元心理服务需求提供了实证依据。更多还原

【Abstract】 Objective To summarize the experience of carrying out classified early warning intervention of “familyschool-hospital-community” psychological crisis for primary and secondary school students in large cities. Methods From 2017 to 2020, the “family-school-hospital-community” model was initially formed in Changning district, Shanghai. In the whole pattern, social support was provided by government departments and sub-districts, technical support was provided by municipal professional institutions and universities, and intervention and guidance were provided by multi-disciplinary service team consisting of mental health sub-center of center of disease prevention and control and counseling center for adolescent mental health; parents, psychological teachers, psychiatric medical staff, and psychological counselors participated togeher.A four-level response system and a three-level network were established to provide active and passive monitoring, specialist entering the campus, classified early warning and intervention of psychological crisis events, and comprehensive interventions integrating psychological teachers, class teachers, and parental support services. Results Initially, in the first half of 2017, intervention framework and team were formed and relevant personnel received training. After that, from September 2017 to August 2020, the model of classified early warning intervention of “family-school-hospital-community” psychological crisis for primary and secondary school students was implemented. Through the three academic years, 218 classified early warning events have been handled in the Changning district, which included 24 high-risk(11.0%), 42 serious(19.3%), and 152 general(69.7%) psychological crisis events. The average annual service exceeded 21 000 person-times. The satisfaction of service recipients increased from 96.7% to 99.3%. The joint intervention rate of major crisis events on campus was 100%, and the success rate of preventing suicide and self-injury was also 100%. Conclusion To a certain extent, classified early warning intervention of “family-school-hospital-community” psychological crisis for primary and secondary school students improved the function of school psychological crisis intervention system, integrated effective resources,enriched service forms and contents, and promoted intervention efficiency. It provides an empirical basis for satisfying the multiple psychological service needs of urban primary and secondary school students in the normalization stage of the COVID-19 pandemic.更多还原