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Suicide is an increasing problem among adolescents. Developmental concerns and inability to resolve problems stemming from feelings of alienation are often at the core of an adolescent's suicide attempt. Nurses can be instrumental in primary prevention by educating the public about persons at risk for suicide, in helping parents deal more effectively with children's growth, and by supporting programs in the school system and other agencies that help young people communicate with others and resolve problems before they become crises. The nurse can also play an important role in secondary prevention through participation in or referral to hotline services, through intervention in the emergency service, or in community mental health programs or inpatient treatment programs. The psychiatric nurse specialist, in particular, can play a very significant role in the treatment of the adolescent in a suicidal crisis and also in consultation with other nurses and professionals who may assess suicidal risk in young people in the community. Finally, tertiary prevention may be necessary to help families and friends resolve their grief over the loss if a family member or close friend has succeeded at a suicide attempt. Feelings of guilt, anxiety, anger, and depression are usually present in the surviving family members of a successful suicide. They need to be given the opportunity to talk about the events leading up to the suicide, their feelings about the persons involved, especially the lost person, and to ventilate their anger, guilt, and sadness. The rising rate of suicide or suicide attempts among this country's adolescents--the third cause of death among adolescents--cries out for stronger support systems for our young people.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of environmental crowding on the behavior of persons in institutional and noninstitutional setting have been studied extensively, but much less frequently with psychiatric patients. The relationship of violent patient behavior, as measured by incidents of seclusion and/or restraint, and population density, as measured by the average census of patients in psychiatric units, was determined in this retrospective study. The results demonstrate a significant and strong positive relationship between number of seclusion and/or restrain incidents and overcapacity.

Medication noncompliance contributes significantly to recurrence of symptoms and readmission to the hospital of schizophrenic patients. The purpose of this study was to determine factors identified by patients, family members, and nurses for patients' noncompliance. The Health Belief Model provided a theoretical framework. The sample consisted of 11 triads with a noncompliant schizophrenic patient, a family member, and a primary nurse in each triad. A structured interview was developed to assess stated reasons for noncompliance and factors relating to the patient's illness, medication practices, stressors, life-style, and support systems. Results showed that many patients stated they did not need medication or needed less than the amount prescribed. Family members and nurses agreed that the majority of patients did not believe that they needed medication. When asked if they thought they had a mental illness, most patients denied that they were ill. Other stated reasons for noncompliance were drug/alcohol use, and, for one patient, medication side effects. Additional findings were patients' low self-esteem; lack of knowledge about medications; inability to identify stressors in patients' lives; inability to identify early symptoms of relapse; patients' need for support from families; and families' stress from patients' abusive, unpredictable behavior. Use of the Health Belief Model is appropriate to study noncompliance in mentally ill patients if perception of illness threat is assessed. Conclusions were that patients and families could benefit from more knowledge of schizophrenia and its treatment, more awareness of stressors and signs of relapse, and improved mutual problem solving. Studies are needed to assess the effects of patients' denial of illness, denial of need for medication, and self-image/self-esteem on medication noncompliance.