【摘要】 自杀是全球重要的公共卫生问题之一，给人们的身心健康带来了重大影响。零自杀以消除自杀为终极目标，通过七个核心要素，多维度协同调整传统预防体系。目前，零自杀模式已被全球多个医疗机构接受，涵盖精神专科医院、综合医院急诊室及社区健康服务中心等多级诊疗体系。大量证据表明，采用零自杀模式可降低反复自残行为的发生率和自杀死亡率。然而，零自杀模式也存在一些局限：第一，大多数实证证据源自观察性研究，存在选择偏倚及混杂变量干扰；第二，跨文化效度验证多局限于高收入国家；第三，伦理识别困境、资源分配限制和跨文化适应性问题。本研究通过对有关文献的梳理，综合全球实施零自杀模式的经验和评估结果，旨在为其应用和可扩展性提供建议。本文提出了三条在循证实践中可以优化零自杀模式实施效益的策略：（1）建立成本效益比最优的实施方案；（2）构建不同文化情境下的干预效能；（3）将健康公平性指标纳入实施效果评价体系。这些建议可有助于零自杀模式的全球推广及精准化实施。更多还原

【Abstract】 Suicide has been identified as a major public health problem worldwide, affecting both physical and mental health of the individuals. With the ultimate goal of eliminating suicide, zero suicide is a multidimensional and synergistic adjustment of the traditional prevention system through seven core elements. Currently endorsed by numerous global medical institutions—including psychiatric hospitals, emergency departments of general hospitals, and community health centers.Substantial evidence indicates that implementing zero suicide model significantly reduces both recurrent self-harm incidents and suicide mortality rates. However, three critical limitations warrant attention: first, most empirical evidence derives from observational studies susceptible to selection bias and confounding variables; second, cross-cultural validation remains predominantly confined to high-income countries; third, implementation challenges persist regarding ethical identification dilemmas, resource allocation constraints, and cross-cultural adaptability barriers. Through a review of the relevant literature,this study synthesised experiences and evaluations of the global implementation of the zero suicide model, with the aim of providing recommendations for its application and scalability. Through systematic review of relevant literature and synthesis of global implementation experiences, this study proposes three evidence-based optimization strategies:(1) establishing cost-benefit-optimized implementation protocols;(2) constructing culturally contextualized intervention efficacy models; and(3)integrating health equity metrics into implementation evaluation systems. These recommendations can contribute to global dissemination and precise implementation of the zero suicide model.更多还原