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現在主席是不是來請我們石部長 又請石部長部長在這個千年審預算的時候我之前提到說這個對於校園學生問題的自殺的人次年年攀升"},{"start":28.514,"end":56.06,"text":"顯示說學齡、年輕族群的年齡層和高風險對象的自殺防治關懷仍然要有待強化但是我們檢視了你們去年全國自殺防治中心的成果報告的數據來看有關於兒童及青少年自殺防治策略建議中有關學齡層自殺死亡及通報數據的分析指出其實這五年來"},{"start":57.04,"end":85.421,"text":"學齡層的自殺通報人次還是在攀升那我們一直是要講說在這種狀況裡面你像國小孩子這麼小的小孩子男性與女性在106年開始就有顯著的上升特別是109年起上升幅度更加明顯而且自殺的死亡率在111年攀升到歷年新高"},{"start":86.872,"end":106.666,"text":"然後之後稍微有回降 但整體而言 國小學齡的自殺防制仍需要高度的關注那就國中學齡層的來看男性女性的通報人次 從106年都呈現上升的趨勢然後到113年已經升到歷年最高"},{"start":107.466,"end":132.059,"text":"那在學齡層裡面女性自殺通報的人次這五年不斷的上升在這種狀況裡面男性就稍微比較平緩所以看得出來性別上的差異女性的曲線真的是也很明顯的上升的曲線那男性大概維持一個平緩的曲線所以這個上升的死亡率在"},{"start":133.6,"end":161.314,"text":"107年就拉升開始拉升到108年就開始超越男性雖然原因很複雜這當然是原因很複雜但我們看到這樣的這個現象那國內研究使用具代表性的樣本發現13歲的孩童有5.4%有自殺的行為粗略的換下來仍有相當比例的學生可能沒有進入通報的系統"},{"start":162.515,"end":188.955,"text":"但是他還是存在校園內的輔資系統後續的介入輔導或未被發現所以國中校園內的輔資輔導系統的健全還有校外的精神醫療的資源的轉介這一些曾有自殺行為重要的統計研究然後大概都應該還是更嚴重的所以他這個研究發現說"},{"start":191.576,"end":203.22,"text":"較長時數的網路使用跟自傷行為的增加也有關那現在我們先來討論一下就是說像國小自殺的主因大部分都是以家庭成員問題學校適應問題同儕相處問題為主"},{"start":208.188,"end":222.387,"text":"同儕的問題啊 這一些 近年來又衍生一種叫做社群關係 社群媒體的關係那社群媒體的關係 這小孩子這麼小的時候其實他還什麼都"},{"start":224.119,"end":243.149,"text":"沒有很健全心理的或者社會價值的這些教育都還不是很健全的時候他就要面臨到社群同儕裡面的這個壓力所以進一步他們就發現說會導致學童自尊低落 危機然後導致憂鬱 自殺的產生所以這個要仰賴什麼校園內的教師 輔資系統"},{"start":249.392,"end":277.558,"text":"然後這個就是要看說能不能成為學生良好發展的場域然後這是很關鍵的所以學校校職員的這個強化的訓練要包含辨識精神疾病提供學生適當的治療或支援減少精神疾病的惡化後續嚴重自殺企圖的發生危險因子的辨識自殺危機的處理或者是包括老師可能要跟這個家長妥善的溝通都是必須要強化的可是"},{"start":279.338,"end":281.4,"text":"我們都知道老師真的也很累你叫老師要會教書還要會這麼多的專業的這些能力真的也是很困難那如果說不要每個孩子我們都叫老師去網接住好了我們來看這一些特殊身份"},{"start":301.095,"end":324.923,"text":"過去精神病史的這一些孩子那已經是高風險群體了我們就鎖定在高風險群體來看以國小和國中學齡層特殊身份來看兒少保護通報的被害人在這三年戰率均為最高然後國外的研究發現兒時稍受虐待的往後對於自殺行為的"},{"start":326.524,"end":337.374,"text":"這個或者是自殺意念的其實是正相關的台灣的健保資料庫研究有發現受虐的孩童在往後罹患精神疾病的風險也比較高在這種狀況裡面針對國小學齡層兒童兒少保護議題的學童"},{"start":345.561,"end":369.631,"text":"那後續要持續連接的精神科的資源評估都是防治的重點但現在我們看到就是說中低收入戶和脆弱家庭在這兩年也佔率比較高他在這特殊身份別裡面佔率比較高就是一樣自殺的意念自殺行為提升但是呢大家在"},{"start":370.491,"end":386.877,"text":"社群網路裡面有很多焦慮但是如果你是中低收入戶或是脆弱家庭的基於社會文化經濟上的弱勢他可能自殺危險的比例風險是更高的特別是經濟危機"},{"start":391.539,"end":408.567,"text":"經濟危機有可能成為兒童自殺危險因子的惡化的因素所以在這種脆弱家庭無論是國小或國中階段自殺通報的人數一直都是近年來位居前三名這是你們的報告指出來的"},{"start":409.307,"end":433.541,"text":"脆弱家庭 中低收入戶 經濟壓力都是自殺通報人數的前三名那針對這一些人都已經是特殊身分別的兒少了大家都已經鎖定是高風險了那我們到底要怎麼樣去採取更具體的防治策略更精準的跨部會 跨體系的防治"},{"start":434.844,"end":460.172,"text":"那為什麼這個很重要呢其實我們都很害怕大家都見數不見零或者是整個行政體系會變成瞎子摸象你知道我們辨識出這些風險的來源那你有沒有一套能夠整合教育 社政 衛生 心理衛生串接起來的介入模式那為什麼要講這個因為這問題都很複雜教育端你看到孩子可能是說沒有來上課缺課"},{"start":462.433,"end":478.854,"text":"適應不良同儕關係衝突不好那是教育看到的可是社政端他看到的可是這個家庭脆弱照顧壓力然後到醫療端處理的就是說這個孩子送到醫療來他有情緒問題我處理他的精神疾病"},{"start":479.875,"end":503.285,"text":"每個部門都看到自己看見的處理自己的屬於自己的權責應該要負責的那部分卻沒有一個整合全貌串接起來這個全面式的這個介入的模式所以我們擔心說這樣的制度安排對高風險而少而言風險大家都看到了而且大家都只看到自己的"},{"start":504.045,"end":529.376,"text":"可是有沒有一個可以串接起來針對這樣的家庭是全面式的關照全面式的這個介入的一個模式呢謝謝委員提到確實在這個全球的報告也是這樣在COVID之後那個Mental Health的問題反映在那個自殺率的上升那台灣也是同樣的問題這也是一種社會不平等"},{"start":530.416,"end":554.922,"text":"這個在青少年也看到這個趨勢這個趨勢跟世界各國的趨勢是對啦那我現在講的重點就是說社政看到社政的問題處理社政的問題教育看到教育的問題處理教育的問題醫療看到醫療界需要的提供的服務他就提供他自己的服務可是大家都沒有看到這個串聯起來你可能要處理的可能就不是某一個部門的問題它是全面式的對"},{"start":560.103,"end":578.253,"text":"所以我們現在先嘗試的讓這些資訊系統可以串接在一起所以跟委員報告就是我們這個社安網的計畫就是把34個系統先串起來讓它這個資訊流至少可以歸人但是確實還沒有那麼優化"},{"start":579.233,"end":595.708,"text":"就是說你串起來到最後你是要判別他的風險因為我們都始終知道預防是最重要的嘛所以在這裡面對反覆出現在各個部門各個統計資料裡面的高風險身分別你要明確的去分級辨識轉型追蹤跨體系協作"},{"start":599.05,"end":624.899,"text":"而且當一名兒少同時具有脆弱家庭兒少保護通報校園適應困難或精神醫療他都已經被看見的多重風險的時候那主責要換誰那誰要負責來整合資訊那誰要來判斷要提高處遇的強度還有就是說我們整個全面式的這個處遇到底誰哪一個部門要負責"},{"start":627.3,"end":652.45,"text":"跟委員說明因為我們剛剛也提到這個一組折然後共同協多方協力 協作對那這個的概念就是說比如說他是從這個翠家進來的那當然他如果是屬於保護個案的那他就是這個保護性社工會組折你們就只處理保護的但是他就要去連結其他因為他就可以看得到他的其他的資訊那也許他是精神個案進來的"},{"start":653.59,"end":658.397,"text":"那可能是以這個我們精神這邊的醫療人員為主但是我們意思是說他可能看到萃家的然後看到醫療的這個精神個案的那其實他的狀況可能來自於多重的多重的"},{"start":669.674,"end":686.464,"text":"它可能是經濟壓力、那父母的家庭功能的失調的那全面性的要介入的所以我們的意思是說這一些要串接在一起然後看到問題要全面式的接觸它這樣子啊所以後端的話就會有網絡會議就是在處理這種比較複雜網絡跨部門的會議你們就這種個案"},{"start":693.508,"end":710.769,"text":"有這麼多的人手可以這樣子經常去網絡會議討論然後經常工作會議檢討經常整合式的全面性的介入嗎跟委員說明大概比較高危機的是每個月會去review"},{"start":711.669,"end":729.28,"text":"對 就是說跨體系支持的機制要把這些新型態的風險一起納入因為我們剛剛講的就是說傳統上我們都以為是家庭功能失調然後校園適應不良 精神醫療需求但對脆弱家庭來講的孩子而言他們新時代比如說網路霸凌 社群媒體成癮"},{"start":730.781,"end":752.726,"text":"這個很多 真的 複合式的自殺資訊的擴散 新興自殺方法的擴散往往會跟既有的家庭壓力 情緒困擾和求助失靈交互作用 然後它會放大那個風險所以你們現在要進入的是已經到一個網路時代裡面的網路社群媒體的這一些"},{"start":755.306,"end":766.98,"text":"現象裡面的負面的作用交織跟傳統的問題交織在一起放大那一些問題那你們其實也都有看到啦"},{"start":768.945,"end":792.541,"text":"所以你們的報告也提到網路社群媒體跟自殺的相關智慧型手機 社群媒體的興起那可能引發了自殺的危機其實國外的系統文獻包括網路使用 網路霸凌都跟自殺 自傷的還有憂鬱的增加有關那台灣的研究也是發現網路成癮跟一週精神症狀包括睡眠困難"},{"start":796.324,"end":806.872,"text":"長期就失眠了,小孩子就在失眠了然後把焦慮、苦惱、憂鬱、感覺比不上別人以及自殺意念之間形成顯著的相關那這種成癮、霸凌就進一步導致自殺的風險其實不要講小孩,連大人都有失眠問題就想自殺了失眠障礙,那失眠障礙年齡層一直往下掉"},{"start":819.582,"end":823.884,"text":"那網路媒體資訊的興起改變也改變了自殺資訊的傳播方式馬街醫院的團隊對2479位青少年調查研究3%的人曾經在網路上接觸過自殺相關的內容特別是每當"},{"start":836.69,"end":864.613,"text":"新興自殺的方法出現新聞傳播了網路媒體的影響更為顯著那台大一個教授張書生他就講在媒體報導某種新興的自殺方法在日本他們就發現網路的搜尋量增加50倍在英國增加9倍然後還有網站上相約自殺這種東西就是這就是真的是進一步的模仿大家都一直模仿那"},{"start":866.604,"end":896.304,"text":"在這種狀況裡面我們也看到你們都看到了你們的報告就全國自殺防治中心成果報告你們都有寫到就是說關於網路社群媒體跟自殺風險的文字年年都有講年年都有報告你們也都看到了但是我們要問的是說可是他還是不斷的在攀升自殺的次數自殺的人數自殺的年齡層下降自殺的人數上升"},{"start":897.084,"end":924.403,"text":"你們都看到了可是他還是問題越來越嚴重所以連續每年你們都這樣警訊可是我們看不到你的報告裡面相應的政策的升級也沒有看到更具體的監測介入和防治的機制所以在這裡我們如果你們都知道了我們要問的就不是研究的結論而是要問你們說你們我們國家政府端出來的相對應的政策到底是什麼因為這種網路風險跟傳統的校園"},{"start":926.684,"end":944.452,"text":"家庭的風險重疊在一起會擴大那它具有擴散快模仿性高接觸無國界隱蔽性強的特色那在學校裡面社群平台匿名論壇影音平台通訊群組大量的散發接觸"},{"start":945.692,"end":971.382,"text":"在這種狀況裡面政府也應該要有新的治理的工具而不是你在報告裡面把這一些現象用舊的文字重複一遍再重複一遍所以呢台灣公共衛生雜誌2023年台灣青少年自殺率上升的相關因素與預防對策的啟發有講到這個青少年因為特定網路內容或使用方式增加心理困擾與自殺風險"},{"start":973.343,"end":987.594,"text":"然後再大概指出青少年在網路上閱讀自殺相關資訊習得的學習到的自殺的方法或模仿的效應特別是名人自殺或是網路上報導的自殺的情節一直在模仿"},{"start":988.374,"end":1005.629,"text":"所以英國研究自殺死亡的青少年裡面在死亡以前他們13%都有搜尋自殺的方法的資訊10%在網路都發表想要自殺那台灣大概還沒有看到這一方面的數據那所以台灣還有一個現象是15到24歲輟學的"},{"start":1009.732,"end":1026.059,"text":"15到24歲學齡層但錯學的自殺的風險跟相關因素也即待研究因為這些人數可能更在於學齡層在學的這個比例所以我們從這些資訊就是說部長網路風險的行為監測還有錯學學生族群的自殺風險研究還有後續支持的資源的建置我們不能夠再這樣子"},{"start":1038.544,"end":1063.873,"text":"只是宣導只是提醒其實風險辨識早期通報校園應變合作平台合作轉介支持這一些都一連串的是要跨部會的我們不想要看到你告訴我有這種風險我們想要看到的是你的政策是升級是upgrade的而且是與時俱進的而且是知道重點你已經不能是傳統式的那些風險辨識了"},{"start":1069.545,"end":1082.129,"text":"確實社群媒體就如同您剛剛提到的越來越多的報告影響到青少年的身心健康還有他的學習能力跟他的社交相對的也會影響剛剛說到的自殺風險"},{"start":1085.47,"end":1104.455,"text":"所以我們現在大概幾個方法我們能做的就是第一個我們有提供這個心理諮商嘛我們從15歲就是第一個那第二個呢我們有iWIN嘛大概協助說一旦申訴了我們就趕快讓他下架處分這個也是做很久我們講的是社群網路上的問題"},{"start":1105.155,"end":1125.96,"text":"那第三個我們也跟速發部合作 透過AI巡查然後即時反應給我們 然後我們判斷之後就讓他遮蔽或下架大概有這幾個做法上在進行那也跟教育部也在合作 教育部在校園裡面他也會限制使用他的自殺風險可能很高"},{"start":1127.826,"end":1142.114,"text":"其實複合式的包括經濟壓力的經濟壓力再加上網路被霸凌的因為社會文化經濟弱勢在網路上更容易被嘲笑在這種同儕團體之間被嘲笑壓力更大想死的對 那這個我們也會跟教育部大家來合作強化這個對於這個網路風險行為的監測"},{"start":1155.174,"end":1173.113,"text":"其實你們 我都跟你們說出來都跟國家一樣我們繼續來研究看看 現在其他有辦法做的 或者是其他的做法上難道沒有可以更精進的 更可以有效的防治的嗎"},{"start":1175.379,"end":1199.699,"text":"我們來繼續研究啦好啦小孩子我們看到小孩子自殺的比例越來越高人數越來越多真的覺得很捨不得而且不應該啦因為他們還那麼小就想要死剛出生就想要死這件事情就是社會的責任國家的責任了啦好謝謝林淑芬委員發言接下來請賴氏寶委員發言"}],"gazette":[{"speaker":"林委員淑芬","start":"2026-04-23T11:23:18.417000+08:00","guessed":false,"end":"2026-04-23T11:23:19.898000+08:00","text":"謝謝主席，是不是有請我們石部長。","quality":0.786},{"speaker":"主席","start":"2026-04-23T11:23:19.919000+08:00","guessed":false,"end":"2026-04-23T11:23:20.099000+08:00","text":"有請石部長。","quality":0.8},{"speaker":"石部長崇良","start":"2026-04-23T11:23:20.099000+08:00","guessed":true,"end":"2026-04-23T11:23:21.099000+08:00","text":"林委員好。","quality":0},{"speaker":"林委員淑芬","start":"2026-04-23T11:23:20.099000+08:00","guessed":false,"end":"2026-04-23T11:23:50.136000+08:00","text":"部長，前年審預算的時候，對於校園的問題我曾經提到，學生自殺的人次年年攀升，顯示學齡層年輕族群和高風險對象的自殺防治關懷仍然有待強化。","quality":0.836},{"speaker":"林委員淑芬","start":"2026-04-23T11:23:51.156000+08:00","guessed":false,"end":"2026-04-23T11:24:14.723000+08:00","text":"但是我們檢視你們去年全國自殺防治中心成果報告的數據來看，關於兒童及青少年自殺防治策略建議中，有關學齡層自殺死亡及通報數據的分析指出，其實這五年來，學齡層的自殺通報人次還是在攀升。","quality":1},{"speaker":"林委員淑芬","start":"2026-04-23T11:24:15.683000+08:00","guessed":false,"end":"2026-04-23T11:24:33.076000+08:00","text":"我們一直講說在這種狀況裡面，像國小的孩子，這麼小的小孩子，男性與女性在106年開始自殺通報人數就有顯著的上升，特別是109年起，上升幅度更加明顯。","quality":0.885},{"speaker":"林委員淑芬","start":"2026-04-23T11:24:33.076000+08:00","guessed":false,"end":"2026-04-23T11:24:47.777000+08:00","text":"而且自殺的死亡率在111年攀升到歷年新高，雖然之後稍微有回降，但整體而言，國小學齡層的自殺防治仍需要高度的關注。","quality":0.939},{"speaker":"林委員淑芬","start":"2026-04-23T11:24:48.697000+08:00","guessed":false,"end":"2026-04-23T11:25:00.646000+08:00","text":"就國中學齡層來看，男性與女性的通報人次從106年都呈現上升的趨勢，然後到113年已經升到歷年最高。","quality":0.975},{"speaker":"林委員淑芬","start":"2026-04-23T11:25:02.787000+08:00","guessed":false,"end":"2026-04-23T11:25:13.752000+08:00","text":"就學齡層裡面的分布，女性自殺通報的人次這五年不斷的上升，就統計狀況來看，男性的曲線就稍微比較平緩，由此看得出來性別上的差異。","quality":0.754},{"speaker":"林委員淑芬","start":"2026-04-23T11:25:13.752000+08:00","guessed":false,"end":"2026-04-23T11:25:33.323000+08:00","text":"女性的曲線真的是很明顯的上升曲線，男性大概維持一個比較平緩的曲線，所以女性自殺的死亡率在107年就開始拉升，到108年就開始超越男性。","quality":0.895},{"speaker":"林委員淑芬","start":"2026-04-23T11:25:34.263000+08:00","guessed":false,"end":"2026-04-23T11:25:38.846000+08:00","text":"雖然原因很複雜，當然這個原因很複雜，但我們看到這樣的現象。","quality":0.923},{"speaker":"林委員淑芬","start":"2026-04-23T11:25:41.067000+08:00","guessed":false,"end":"2026-04-23T11:26:31.098000+08:00","text":"國內研究使用具代表性的樣本發現，13歲的孩童5.4%有自殺的行為，粗略換算下來，仍有相當比例的學生可能沒有進入通報的系統，但是他還是存在校園內的輔支系統和後續的介入輔導或未被發現，所以國中校園內的輔支、輔導系統的健全還有校外精神醫療資源的轉介，這一些曾有自殺行為的重要統計研究應該還是更嚴重的，這個研究發現較長時數的網路使用跟自傷行為的增加也有關。","quality":0.969},{"speaker":"林委員淑芬","start":"2026-04-23T11:26:31.438000+08:00","guessed":false,"end":"2026-04-23T11:26:37.200000+08:00","text":"現在我們先討論一下國小自殺的主因，大部分都是以家庭成員、學校適應及同儕相處問題為主。","quality":0.974},{"speaker":"林委員淑芬","start":"2026-04-23T11:26:42.188000+08:00","guessed":false,"end":"2026-04-23T11:27:16.809000+08:00","text":"同儕的問題近年來又衍生一種叫做社群媒體的關係，在孩子這麼小的時候，其實心理或者社會價值的教育都還不是很健全，他就要面臨到社群同儕裡面的壓力，因此他們進一步發現會導致學童自尊低落與危機感，並導致憂鬱自殺的產生，所以這要仰賴什麼？","quality":0.925},{"speaker":"林委員淑芬","start":"2026-04-23T11:27:16.809000+08:00","guessed":false,"end":"2026-04-23T11:27:51.438000+08:00","text":"就是校園內的教師及輔支系統，然後要看能不能成為學生良好發展的場域是很關鍵的，所以學校教職員的強化訓練要包含：辨識精神疾病、提供學生適當的治療或資源，以減少精神疾病的惡化及後續嚴重企圖自殺的發生、危險因子的辨識、自殺危機的處理，或者包括老師可能要跟家長妥善的溝通，都是必須要強化的。","quality":0.915},{"speaker":"林委員淑芬","start":"2026-04-23T11:27:51.458000+08:00","guessed":false,"end":"2026-04-23T11:27:54.659000+08:00","text":"可是我們都知道老師真的也很累，你要求老師會教書還要會這麼多專業的能力，真的也是很困難。","quality":0.95},{"speaker":"林委員淑芬","start":"2026-04-23T11:27:54.679000+08:00","guessed":false,"end":"2026-04-23T11:28:44.768000+08:00","text":"如果我們不要求老師去網接住每個孩子好了，我們來看這一些特殊身分和過去有精神病史已經是高風險群體的孩子，我們就鎖定在高風險群體來看，以國小和國中學齡層特殊身分為例，兒少保護通報的被害人在這3年占率均為最高，國外的研究發現兒時遭受虐待的孩童，往後對於自殺行為或者是自殺意念其實是正相關的。","quality":0.851},{"speaker":"林委員淑芬","start":"2026-04-23T11:28:45.348000+08:00","guessed":false,"end":"2026-04-23T11:29:20.830000+08:00","text":"臺灣的健保資料庫研究也發現，受虐的孩童在往後罹患精神疾病的風險也比較高，在這種狀況下，針對國小學齡層兒少保護議題的學童，後續要持續連接精神科的資源評估都是防治的重點，但我們看到中低收入戶和脆弱家庭等特殊身分別在這兩年的占率也比較高，就是一樣有自殺意念及自殺行為的提升。","quality":0.89},{"speaker":"林委員淑芬","start":"2026-04-23T11:29:23.271000+08:00","guessed":false,"end":"2026-04-23T11:29:49.921000+08:00","text":"大家在社群網路裡面有很多焦慮，但如果是中低收入戶或是脆弱家庭，基於社會、文化、經濟上的弱勢，可能自殺、危險的風險比例更高，特別是經濟危機，經濟危機有可能成為兒童自殺危險因子的惡化因素。","quality":0.976},{"speaker":"林委員淑芬","start":"2026-04-23T11:29:50.742000+08:00","guessed":false,"end":"2026-04-23T11:29:59.145000+08:00","text":"所以在脆弱家庭無論是國小或國中階段，自殺通報的人數一直都是近年來位居前三名。","quality":1},{"speaker":"林委員淑芬","start":"2026-04-23T11:30:00.106000+08:00","guessed":false,"end":"2026-04-23T11:30:23.939000+08:00","text":"這是你們的報告指出來的，脆弱家庭、中低收入戶、經濟壓力都是自殺通報人數的前三名，針對這一些特殊身分別的兒少都已經鎖定是高風險了，我們到底要怎麼採取更具體的防治策略？","quality":1},{"speaker":"林委員淑芬","start":"2026-04-23T11:30:24.679000+08:00","guessed":false,"end":"2026-04-23T11:30:29.824000+08:00","text":"需要更精準的跨部會、跨體系的防治，為什麼這很重要？","quality":0.909},{"speaker":"林委員淑芬","start":"2026-04-23T11:30:30.725000+08:00","guessed":false,"end":"2026-04-23T11:30:48.250000+08:00","text":"其實我們很害怕大家都見樹不見林，或者是整個行政體系會變成瞎子摸象，當我們辨識出這些風險的來源，有沒有一套能夠整合教育、社政、衛政、心理衛生串接起來的介入模式？","quality":0.944},{"speaker":"林委員淑芬","start":"2026-04-23T11:30:49.290000+08:00","guessed":false,"end":"2026-04-23T11:30:50.450000+08:00","text":"為什麼要講這些？","quality":0.857},{"speaker":"林委員淑芬","start":"2026-04-23T11:30:50.450000+08:00","guessed":false,"end":"2026-04-23T11:31:47.409000+08:00","text":"因為相關問題都很複雜，教育端可能是看到孩子缺課、適應不良、同儕關係衝突不好，那是教育端看到的，可是社政端看到的可能是家庭脆弱、有照顧壓力，之後到醫療端處理的就是這個孩子送來醫療，他有情緒問題就處理他的精神疾病，每個部門都看到自己看見的，處理屬於自己的權責應該要負責的部分，卻沒有一個整合串接全貌的全面介入模式，所以我們擔心這樣的制度安排對高風險兒少而言，風險是大家都看到了，但是大家都只看到自己的，有沒有一個可以串接起來，針對這樣的家庭全面式關照及介入的模式？","quality":0.911},{"speaker":"石部長崇良","start":"2026-04-23T11:31:50.210000+08:00","guessed":false,"end":"2026-04-23T11:32:01.415000+08:00","text":"謝謝委員提到，確實在全球的報告也是這樣，在COVID之後Mental Health的問題反應在自殺率上升，臺灣也是同樣的問題，特別在……","quality":0.934},{"speaker":"林委員淑芬","start":"2026-04-23T11:32:01.415000+08:00","guessed":false,"end":"2026-04-23T11:32:03.356000+08:00","text":"這也是一種社會不平等。","quality":1},{"speaker":"石部長崇良","start":"2026-04-23T11:32:04.416000+08:00","guessed":false,"end":"2026-04-23T11:32:09.437000+08:00","text":"在青少年也看到相同的趨勢，這跟世界各國的趨勢一樣。","quality":0.783},{"speaker":"林委員淑芬：對，我現在講的重點是","start":"2026-04-23T11:32:12.278000+08:00","guessed":false,"end":"2026-04-23T11:32:23.361000+08:00","text":"社政看到社政的問題，處理社政的問題；教育看到教育的問題，處理教育的問題；醫療看到醫療界需要提供的服務，就提供他自己的服務……是。","quality":0.982},{"speaker":"林委員淑芬","start":"2026-04-23T11:32:23.361000+08:00","guessed":false,"end":"2026-04-23T11:32:28.902000+08:00","text":"可是大家都沒有看到這些問題串聯起來，要處理的可能就不只是某一個部門的問題，而是全面式的。","quality":0.878},{"speaker":"石部長崇良","start":"2026-04-23T11:32:28.922000+08:00","guessed":false,"end":"2026-04-23T11:32:52.233000+08:00","text":"對，所以我們現在先嘗試讓這些資訊系統可以串接在一起，跟委員報告，我們社安網的計畫就是把34個系統先串起來，讓這些資訊流至少可以歸人，但是確實還沒有那麼優化。","quality":0.986},{"speaker":"林委員淑芬","start":"2026-04-23T11:32:53.233000+08:00","guessed":false,"end":"2026-04-23T11:32:56.716000+08:00","text":"就是系統串起來，到最後你要判別他的風險……對。","quality":0.842},{"speaker":"林委員淑芬","start":"2026-04-23T11:32:56.716000+08:00","guessed":false,"end":"2026-04-23T11:33:25.014000+08:00","text":"因為我們都始終知道預防是最重要的，所以在面對反覆出現在各個部門統計資料裡面的高風險身分別，你要明確地去分級辨識、轉銜追蹤、跨體系協作，而且當一名兒少同時具有脆弱家庭、兒少保護通報、校園適應困難或精神醫療，他都已經被看見有多重風險的時候，主責要換誰？","quality":0.974},{"speaker":"林委員淑芬","start":"2026-04-23T11:33:25.555000+08:00","guessed":false,"end":"2026-04-23T11:33:27.555000+08:00","text":"誰要負責整合資訊？","quality":1},{"speaker":"林委員淑芬","start":"2026-04-23T11:33:28.336000+08:00","guessed":false,"end":"2026-04-23T11:33:31.197000+08:00","text":"誰來判斷要提高處遇的強度？","quality":1},{"speaker":"林委員淑芬","start":"2026-04-23T11:33:33.918000+08:00","guessed":false,"end":"2026-04-23T11:33:38.899000+08:00","text":"整個全面式的處遇到底由哪一個部門負責？","quality":0.944},{"speaker":"石部長崇良","start":"2026-04-23T11:33:41.300000+08:00","guessed":false,"end":"2026-04-23T11:33:47.983000+08:00","text":"跟委員說明，因為我們剛剛也提到一主責再由多方協力……協作。","quality":0.84},{"speaker":"石部長崇良","start":"2026-04-23T11:33:48.963000+08:00","guessed":false,"end":"2026-04-23T11:33:53.705000+08:00","text":"對，這個概念就是比如他是從脆家進來的……是。","quality":0.889},{"speaker":"石部長崇良","start":"2026-04-23T11:33:54.765000+08:00","guessed":false,"end":"2026-04-23T11:33:58.747000+08:00","text":"他如果是屬於保護個案的，當然就是保護性社工會主責……","quality":0.826},{"speaker":"林委員淑芬","start":"2026-04-23T11:33:59.267000+08:00","guessed":false,"end":"2026-04-23T11:34:00.107000+08:00","text":"你們就只處理保護的。","quality":1},{"speaker":"石部長崇良","start":"2026-04-23T11:34:00.127000+08:00","guessed":false,"end":"2026-04-23T11:34:10.034000+08:00","text":"但是他要去連結其他的單位，因為他就可以看得到個案的其他資訊，也許他是精神個案進來，可能是以我們的精神醫療人員為主……","quality":0.887},{"speaker":"林委員淑芬","start":"2026-04-23T11:34:10.054000+08:00","guessed":false,"end":"2026-04-23T11:34:36.061000+08:00","text":"但我的意思是，他可能看到脆家或醫療的精神個案，其實他的狀況可能來自於多重方面，可能是經濟壓力、父母家庭功能失調，需要全面性介入，所以這一些要串接在一起，我們看到問題要全面式的接住他。對、對。","quality":0.847},{"speaker":"石部長崇良","start":"2026-04-23T11:34:38.143000+08:00","guessed":false,"end":"2026-04-23T11:34:39.804000+08:00","text":"所以後端的話會有網絡會議，就是在處理這種比較複雜、跨……","quality":0.958},{"speaker":"林委員淑芬","start":"2026-04-23T11:34:39.804000+08:00","guessed":false,"end":"2026-04-23T11:34:58.762000+08:00","text":"網絡、跨部門的會議，對於這種個案你們有這麼多的人手可以經常開網絡會議討論、經常工作會議檢討、經常整合式的全面性介入嗎？","quality":0.907},{"speaker":"石部長崇良","start":"2026-04-23T11:34:58.762000+08:00","guessed":false,"end":"2026-04-23T11:35:04.749000+08:00","text":"跟委員說明，比較高危機的大概是每個月會去review……","quality":0.92},{"speaker":"林委員淑芬","start":"2026-04-23T11:35:05.669000+08:00","guessed":false,"end":"2026-04-23T11:35:11.013000+08:00","text":"對，跨體系支持的機制要把這些新型態的風險一起納入……好。","quality":0.958},{"speaker":"林委員淑芬","start":"2026-04-23T11:35:11.373000+08:00","guessed":false,"end":"2026-04-23T11:35:38.484000+08:00","text":"因為剛剛講到，傳統上我們都以為是家庭功能失調、校園適應不良及精神醫療需求，但對脆弱家庭的孩子而言，新時代比如網路霸凌、社群媒體成癮這些真的很多，是複合式的，自殺資訊及新興自殺方法的擴散，往往會跟既有的家庭壓力、情緒困擾和求助失靈交互作用，當然會放大相關風險。","quality":0.915},{"speaker":"林委員淑芬","start":"2026-04-23T11:35:38.484000+08:00","guessed":false,"end":"2026-04-23T11:36:38.830000+08:00","text":"所以你們現在已經進入一個網路時代，一些網路及社群媒體現象的負面作用跟傳統的問題交織在一起，放大那一些問題，你們其實也都有看到，所以你們的報告也提到網路社群媒體跟自殺的相關，智慧型手機、社群媒體的興起可能引發的自殺危機，其實國外的系統文獻包括網路使用、網路霸凌都跟自殺、自傷還有憂鬱的增加有關；臺灣的研究也發現，網路成癮跟週一精神症狀，包括睡眠困難、看到半夜都不睡，當然長久就失眠了，小孩子就在失眠了，包括焦慮、苦惱、憂鬱、感覺比不上別人，以及自殺意念之間形成顯著的相關，這種成癮、霸凌就進一步導致自殺的風險。","quality":0.918},{"speaker":"林委員淑芬","start":"2026-04-23T11:36:38.830000+08:00","guessed":false,"end":"2026-04-23T11:36:40.852000+08:00","text":"其實不要講小孩，連大人有失眠問題就想自殺了，睡眠障礙的年齡層一直往下掉。","quality":0.939},{"speaker":"林委員淑芬","start":"2026-04-23T11:36:54.362000+08:00","guessed":false,"end":"2026-04-23T11:37:16.715000+08:00","text":"網路媒體資訊的興起也改變了自殺資訊的傳播方式，馬偕醫院的團隊對2,479位青少年調查研究，發現有3%的人曾經在網路上接觸過自殺相關內容，特別是每當新興自殺的方法出現時，新聞傳播了，網路媒體的影響更為顯著。","quality":0.934},{"speaker":"林委員淑芬","start":"2026-04-23T11:37:17.536000+08:00","guessed":false,"end":"2026-04-23T11:37:28.765000+08:00","text":"臺大教授張書森就講，在媒體報導某種新興的自殺方法後，在日本他們就發現網路的搜尋量增加50倍，在英國增加9倍。","quality":0.957},{"speaker":"林委員淑芬","start":"2026-04-23T11:37:29.426000+08:00","guessed":false,"end":"2026-04-23T11:37:38.433000+08:00","text":"然後還有網站上相約自殺，這種東西就真的是進一步的模仿，大家都一直模仿。","quality":1},{"speaker":"林委員淑芬","start":"2026-04-23T11:37:40.604000+08:00","guessed":false,"end":"2026-04-23T11:38:25.954000+08:00","text":"在這種狀況裡面，我們也看到你們都看到了，你們在全國自殺防治中心成果報告中都有寫到，就是關於網路社群媒體跟自殺風險的文字連年都有講、連年都有報告，你們也都看到了，但是我們要問的是，可是自殺的次數、自殺的人數還是不斷的在攀升，自殺的年齡層下降、自殺的人數上升，你們都看到了，可是問題還是越來越嚴重，所以每年你們都這樣警示，可是我們在你們的報告裡面看不到相應的政策升級，也沒有看到更具體的監測、介入和防治機制。","quality":0.892},{"speaker":"林委員淑芬","start":"2026-04-23T11:38:26.615000+08:00","guessed":false,"end":"2026-04-23T11:38:38.142000+08:00","text":"所以，如果你們都知道了，我們要問的就不是研究的結論，而是要問你們，我們國家政府端出來的相對應的政策到底是什麼？","quality":1},{"speaker":"林委員淑芬","start":"2026-04-23T11:38:38.142000+08:00","guessed":false,"end":"2026-04-23T11:39:10.456000+08:00","text":"因為這種網路風險跟傳統的校園、家庭的風險重疊在一起會擴大，那它具有擴散快、模仿性高、接觸無國界、隱蔽性強的特色，然後在學校裡面，社群平台、匿名論壇、影音平台、通訊群組大量的散發、接觸，在這種狀況裡面，政府也應該要有新的治理工具，而不是你在報告裡面把這一些現象用舊的文字重複一遍再重複一遍。","quality":0.969},{"speaker":"林委員淑芬","start":"2026-04-23T11:39:11.337000+08:00","guessed":false,"end":"2026-04-23T11:39:41.574000+08:00","text":"所以臺灣公共衛生雜誌2023年「臺灣青少年自殺率上升的相關因素與預防對策的啟發」有講到，青少年因為特定網路內容或使用方式而增加心理困擾與自殺風險，然後還指出，青少年在網路上閱讀自殺相關資訊，學習到的自殺的方法、模仿的效應，特別是名人自殺或網路上報導的自殺情節一直在模仿。","quality":0.984},{"speaker":"林委員淑芬","start":"2026-04-23T11:39:44.216000+08:00","guessed":false,"end":"2026-04-23T11:39:58.208000+08:00","text":"英國研究自殺死亡的青少年，在死亡以前他們13%都有搜尋自殺方法的資訊，10%都在網路上發表想要自殺，臺灣大概還沒有看到這一方面的數據。","quality":0.966},{"speaker":"林委員淑芬","start":"2026-04-23T11:39:59.108000+08:00","guessed":false,"end":"2026-04-23T11:40:16.117000+08:00","text":"臺灣還有一個現象是15到24歲學齡層但輟學的自殺風險跟相關因素也亟待研究，因為這些人數可能更在於學齡層在學的比例。","quality":0.961},{"speaker":"林委員淑芬","start":"2026-04-23T11:40:17.338000+08:00","guessed":false,"end":"2026-04-23T11:40:44.648000+08:00","text":"我們從這些資訊，部長，網路風險的行為監測，還有輟學學生族群的自殺風險研究，還有後續支持的資源建置，我們不能夠再這樣只是宣導、只是提醒，其實風險辨識、早期通報、校園應變、平台合作、轉介支持，這一些都是一連串的，是要跨部會來處理的。","quality":0.94},{"speaker":"林委員淑芬","start":"2026-04-23T11:40:45.809000+08:00","guessed":false,"end":"2026-04-23T11:40:57.853000+08:00","text":"我們不想要看到你告訴我有這種風險，我們想要看到的是你的政策是升級的、是與時俱進的，而且是知道重點，已經不能是傳統式的那一些風險辨識了。","quality":0.984},{"speaker":"石部長崇良","start":"2026-04-23T11:41:03.545000+08:00","guessed":false,"end":"2026-04-23T11:41:16.129000+08:00","text":"跟委員說明，確實社群媒體就如同您剛剛提到的，越來越多的報告顯示，影響到青少年的身心健康、學習能力跟社交，相對的也會影響剛剛說到的自殺風險。","quality":0.889},{"speaker":"林委員淑芬","start":"2026-04-23T11:41:16.129000+08:00","guessed":true,"end":"2026-04-23T11:41:19.470000+08:00","text":"對啦，你們應變的政策要端出來。","quality":0},{"speaker":"石部長崇良","start":"2026-04-23T11:41:19.470000+08:00","guessed":false,"end":"2026-04-23T11:41:27.652000+08:00","text":"所以我們現在大概有幾個方法，我們能做的第一個就是我們有提供心理諮商，從15歲……","quality":0.912},{"speaker":"林委員淑芬","start":"2026-04-23T11:41:27.652000+08:00","guessed":true,"end":"2026-04-23T11:41:29.193000+08:00","text":"這是傳統的，一直都有的。","quality":0.2},{"speaker":"石部長崇良","start":"2026-04-23T11:41:29.193000+08:00","guessed":false,"end":"2026-04-23T11:41:35.494000+08:00","text":"第二個是我們有iWIN協助，有人申訴了，我們就趕快讓它下架處分。","quality":0.862},{"speaker":"林委員淑芬","start":"2026-04-23T11:41:35.934000+08:00","guessed":false,"end":"2026-04-23T11:41:38.455000+08:00","text":"這個也做很久了，你講的是社群網路上的問題。","quality":0.895},{"speaker":"石部長崇良","start":"2026-04-23T11:41:39.355000+08:00","guessed":false,"end":"2026-04-23T11:41:56.259000+08:00","text":"第三、我們也跟數發部合作，透過AI巡查即時反映給我們，然後我們判斷之後，就讓它遮蔽或下架，大概有這幾個做法在進行，另外也跟教育部合作，教育部在校園裡面會去限制使用……","quality":0.919},{"speaker":"林委員淑芬","start":"2026-04-23T11:41:58.459000+08:00","guessed":false,"end":"2026-04-23T11:42:14.933000+08:00","text":"非在學的、輟學的，他們的自殺風險可能很高，其實複合式的包括經濟壓力的，還有經濟壓力再加上網路被霸凌的，因為社會文化、經濟弱勢在網路上更容易被嘲笑，在同儕團體之間被嘲笑，壓力更大，想死的。","quality":0.88},{"speaker":"石部長崇良","start":"2026-04-23T11:42:14.953000+08:00","guessed":false,"end":"2026-04-23T11:42:15.674000+08:00","text":"對，這個我們也會跟教育部來合作，強化對於高……","quality":0.947},{"speaker":"林委員淑芬","start":"2026-04-23T11:42:15.694000+08:00","guessed":false,"end":"2026-04-23T11:42:16.114000+08:00","text":"網路風險行為的監測……","quality":1},{"speaker":"石部長崇良","start":"2026-04-23T11:42:16.114000+08:00","guessed":true,"end":"2026-04-23T11:42:29.174000+08:00","text":"脆弱家庭跟……","quality":0},{"speaker":"林委員淑芬","start":"2026-04-23T11:42:29.174000+08:00","guessed":false,"end":"2026-04-23T11:42:36.542000+08:00","text":"其實我都覺得你們說出來的都跟以前一樣。","quality":0.722},{"speaker":"石部長崇良","start":"2026-04-23T11:42:36.542000+08:00","guessed":false,"end":"2026-04-23T11:42:40.867000+08:00","text":"我們繼續來研究看看還有什麼其他有辦法可以再做的，或者是其他國家的……","quality":0.71},{"speaker":"林委員淑芬","start":"2026-04-23T11:42:41.107000+08:00","guessed":false,"end":"2026-04-23T11:42:47.113000+08:00","text":"做法上難道沒有可以更精進的、更可以有效防治的嗎？","quality":1},{"speaker":"石部長崇良","start":"2026-04-23T11:42:49.379000+08:00","guessed":false,"end":"2026-04-23T11:42:50.360000+08:00","text":"我們來繼續研究。","quality":1},{"speaker":"林委員淑芬","start":"2026-04-23T11:42:51.561000+08:00","guessed":false,"end":"2026-04-23T11:43:08.274000+08:00","text":"好啦，我們看到小孩子自殺的比例越來越高、人數越來越多，真的覺得很捨不得，而且不應該，因為他們還那麼小就想要死，剛出生就想要死，這件事情就是社會的責任、國家的責任了啦。","quality":1},{"speaker":"石部長崇良","start":"2026-04-23T11:43:10.476000+08:00","guessed":false,"end":"2026-04-23T11:43:11.057000+08:00","text":"好，謝謝。","quality":1},{"speaker":"主席","start":"2026-04-23T11:43:11.057000+08:00","guessed":false,"end":"2026-04-23T11:43:12.057000+08:00","text":"謝謝林淑芬委員發言。","quality":0.778},{"speaker":"主席","start":"2026-04-23T11:43:12.318000+08:00","guessed":false,"end":"2026-04-23T11:43:13.679000+08:00","text":"接下來請賴士葆委員發言。","quality":0.818}]}},"supported_relations":[],"relations":[]}