The findings support the conclusion that constant observation is not just a protective intervention but one that has therapeutic potential. It can be enhanced if observers engage inpatients in actively supportive interventions. However, observers' perceived attitudes and behaviors can cause patients distress, which reaffirms the need for careful supervision of observers.

PURPOSE.  This article identifies the types of environmental safeguards within psychiatric facilities that can be implemented to protect suicidal individuals from harming themselves. The history and variety of safeguards are discussed, as well as recommendations for administrators regarding making their units safer. CONCLUSION.  The use of environmental safeguards is one of the first steps in decreasing inpatient suicides. PRACTICE IMPLICATIONS.  Inpatient nurses need to be aware of the environmental dangers in their units and of the safeguards that should be implemented. Recommendations include training programs, environmental tours, and effecting indicated structural changes.

A thorough understanding of potential signs of malingering vs. genuine psychosis is needed as well as knowledge of legal ramifications.

No abstract