Effects of a smoking ban on a general hospital psychiatric service.

After a private general hospital announced plans to ban smoking inside the hospital, the authors initiated a study on the psychiatric units to identify anticipated and actual patient-related problems associated with the ban and to assess staff and patient attitudes toward the ban. Data were obtained through pre- and post-ban surveys of medical and nursing staff and predischarge interviews with patients. The findings showed that staff anticipated more smoking-related problems than actually occurred and that patients who smoked were able to reduce their tobacco use during their hospital stay. No evidence was found to suggest that hospitalized psychiatric patients are less capable of cutting down on smoking than the general population.

Self-inflicted gunshot wounds among Alaska Natives.

Deaths by violence (accidents, homicide, suicide) have increased significantly among Alaska Natives who have a suicide rate three times that of the general U.S. population. Self-inflicted gunshot wounds comprised 75 percent of the suicides among Alaska Natives from 1976 through 1980. A review of psychiatric consultations concerning 34 Alaska Natives who had survived a self-inflicted gunshot wound indicated some common characteristics. Of the group, 28 were male, and 20 had been using alcohol at the time of the shooting. Interpersonal conflicts were cited by most persons as partial motivation for the shooting, and most shootings were impulsive rather than premeditated. Few patients had a psychiatric history or appeared impaired at the time of the consultation. Cultural and intrapsychic factors that might contribute to this high rate of self-destructive behavior were examined. These include a proscription against verbal expression of negative affect and an increase of non-Native influences with subsequent social disorganization and cultural conflict.