下列哪些個案自殺風險最高？（選所有適合的）

自殺風險評估是精神科護理中的一項關鍵且高優先級任務。護理師必須能夠識別高風險個案，以便及時採取保護措施，確保病人的安全。自殺風險因素通常是多重且複雜的，包括心理、社會、生物學等多方面因素。在評估時，護理師應綜合考量這些因素，並特別關注那些具有立即危險性的指標。 具體、詳細的自殺計畫、可取得的致命工具，以及過去的自殺嘗試史，都是極高的危險信號。此外，憂鬱症病人剛開始服用抗憂鬱劑，情緒可能稍有改善，但此時因精力回升，反而可能增加執行自殺計畫的行動力，這是一個常被忽略但風險極高的階段。護理師應始終將病人安全置於首位，對任何自殺意念或行為傾向保持高度警覺，並立即採取適當的介入措施，如密切監護、移除危險物品或轉介精神科醫師評估。

Suicide risk assessment is a critical and high-priority task in psychiatric nursing. The nurse must be able to identify high-risk cases so that protective measures can be taken promptly and the patient's safety ensured. Suicide risk factors are usually multiple and complex, encompassing psychological, social, and biological dimensions. During assessment, the nurse should consider these factors comprehensively, with particular attention to indicators of immediate danger. A specific, detailed suicide plan, access to lethal means, and a past history of suicide attempts are all extremely high warning signs. In addition, a depressed patient who has just begun taking antidepressants may experience some improvement in mood, but at this time the increased energy may actually heighten the ability to act on a suicide plan; this is an often-overlooked but very high-risk stage. The nurse must always place patient safety first, maintain a high level of vigilance for any suicidal ideation or behavioral tendency, and immediately take appropriate interventions, such as close observation, removal of dangerous objects, or referral to a psychiatrist for evaluation.

在美國，對於有自殺風險的病人，護理師會更積極地進行環境安全評估，移除所有潛在的危險物品，包括病房內的懸掛物、尖銳物品等，並實施持續監護（constant observation）或每15分鐘巡視一次（15-minute checks）。台灣在自殺防範的措施上與美國相似，但對於環境安全評估的嚴謹程度和監護人力配置，可能因醫療機構政策和資源而略有差異。兩國都強調精神科醫師的緊急評估和藥物介入，以及心理治療的長期支持。