Risk for suicidal self-injurious behavior

Welcome to this comprehensive exploration of the nursing diagnosis related to 'Risk for Suicidal Self-Injurious Behavior.' This diagnosis underscores the critical importance of recognizing the multifaceted factors contributing to an individual's vulnerability to self-harm and suicidal ideation. By understanding this diagnosis, healthcare professionals can implement targeted interventions that address not only the psychological aspects but also the behavioral, physiological, situational, and social influences that can exacerbate these risks.

In this article, we will delve into the various risk factors associated with suicidal behaviors, including behavioral, physiological, and psychological dimensions. We will also highlight the populations most at risk and discuss the conditions that often accompany these struggles. By establishing a broad overview, we aim to provide a solid foundation for nurses and healthcare providers as they navigate the complexities of mental health care.

We will further examine the expected outcomes (NOC) that can guide nursing practice and the evaluation criteria necessary for assessing the effectiveness of interventions. A detailed outline of nursing interventions (NIC) will also be provided, emphasizing the collaborative and supportive nature of care that encourages individuals to seek help and develop positive coping strategies.

Finally, we will discuss practical suggestions for implementing these nursing approaches effectively, ensuring that caregivers are equipped with the necessary tools and knowledge to support those at risk. Join us as we embark on this vital journey to enhance our understanding and response to suicidal self-injurious behavior within the nursing framework.

Definition of Nursing Diagnosis

Risk for suicidal self-injurious behavior refers to the susceptibility of an individual to act in a harmful manner toward themselves, with an associated intent to die. It involves multiple dimensions, including behavioral, physiological, psychological, situational, social, and other factors that contribute to the individual’s vulnerability to suicide and self-harm. Identifying and addressing these risk factors can aid in preventing suicidal actions and providing adequate care to those at risk.

Risk Factors

Behavioral Factors

Behavioral factors are actions and tendencies that increase the likelihood of self-injury or suicidal behavior. These behaviors often reflect underlying emotional struggles or lack of coping skills.

• Aggressive behaviors: A tendency toward violent or hostile actions may indicate higher risk of harming oneself.
• Difficulty expressing emotion: When individuals cannot effectively communicate their feelings, they may turn to self-harm as a coping mechanism.
• Inadequate health literacy: Poor understanding of health issues can contribute to ineffective management of emotions and behaviors.
• Ineffective impulse control: A lack of control over impulsive actions can result in harmful behaviors without consideration of consequences.
• Ineffective use of coping strategies: Insufficient or maladaptive coping mechanisms increase the risk of turning to self-harm.
• Substance misuse: Abuse of substances such as alcohol or drugs can impair judgment and escalate suicidal tendencies.
• High number of non-suicidal self-harm methods: Frequent engagement in self-injury, even without intent to die, can indicate a higher risk of eventual suicidal behavior.

Physiological Factors

Physiological factors refer to physical health issues and conditions that may contribute to the development of suicidal tendencies.

• Insomnia: Chronic sleep disturbances can lead to mental exhaustion and a sense of hopelessness, increasing suicidal thoughts.
• Recurrent nightmares: Nightmares may exacerbate emotional distress and contribute to feelings of entrapment or despair.
• Significant mobility limitations: Physical disabilities or limitations can lead to isolation and a decreased quality of life, heightening suicidal risk.
• Uncontrolled acute pain: Persistent and severe pain that is not managed properly can lead to feelings of hopelessness and frustration.
• Uncontrolled chronic pain: Chronic pain, when not adequately addressed, can increase emotional suffering and elevate suicide risk.

Psychological Factors

Psychological factors encompass mental and emotional conditions that make an individual more susceptible to suicidal behaviors and self-harm.

• Anxiety: Persistent anxiety can lead to overwhelming feelings that contribute to self-harm or suicidal thoughts.
• Attentional bias toward suicide: A tendency to focus excessively on suicide-related thoughts can increase the likelihood of self-injury.
• Automatic negative thinking: A habitual pattern of negative thoughts about oneself can increase feelings of worthlessness and hopelessness.
• Cognitive inflexibility: Difficulty in adjusting thoughts or responses to new situations may hinder the ability to cope with emotional stress.
• Daily suicidal ideation: Persistent thoughts of suicide on a daily basis significantly heighten the risk of acting on those thoughts.
• Depressive symptoms: Depression often leads to feelings of despair and a loss of hope, which are key factors in suicidal behavior.
• Difficulty regulating emotions: Struggling to manage emotions can lead to impulsive decisions and self-harm.
• Dysfunctional attitudes as measured using standardized, validated instrument: Negative beliefs and attitudes about oneself can increase vulnerability to suicide.
• Emotional dysregulation: Inability to manage intense emotions effectively can lead to emotional outbursts and potentially self-destructive behavior.
• Feelings of entrapment: A sense of being trapped in a situation or life circumstances can contribute to suicidal ideation.
• High level of alexithymia: Difficulty in identifying and expressing emotions can worsen psychological distress and lead to self-harm.
• High level of the personality type intellect/openness: A tendency toward higher levels of introspection and openness may increase vulnerability to existential crises and suicidal thoughts.
• Hopelessness: A pervasive sense of hopelessness often leads to suicidal ideation, as individuals believe that things will never improve.
• Implicit identification with death measured by standardized, validated instrument: Identification with death and suicidal themes is a serious indicator of suicidal risk.
• Inability to generate positive future events: When individuals cannot envision a hopeful future, they may see suicide as the only escape.
• Inability to maintain proper interpersonal-regulation: Difficulties in managing relationships may lead to isolation and exacerbate feelings of worthlessness.
• Inadequate self-control: A lack of self-discipline in managing emotions and behaviors can lead to impulsive suicidal actions.
• Inadequate self-esteem: Low self-worth can contribute to feelings of hopelessness and a desire to escape life.
• Internalized anger: Unresolved anger directed inwardly can manifest in self-destructive behavior.
• Low levels of the personality type extraversion: Social withdrawal, common in low-extraversion individuals, can lead to increased isolation and suicidal thoughts.
• Maladaptive grieving: Poor emotional processing of loss can create prolonged distress, leading to self-harm.
• Negative attributional style: A tendency to attribute negative events to internal, stable, and global causes is linked with depression and suicidal ideation.
• Perceived burdensomeness: The belief that one is a burden to others is a strong predictor of suicidal thoughts.
• Perfectionism: Unrealistic expectations of oneself can create feelings of failure and hopelessness.
• Reduced sense of meaning in life: Lack of purpose or meaning in life often drives individuals toward thoughts of suicide.
• Risk score on standardized, validated suicide risk instrument: A high risk score on a validated suicide assessment tool indicates increased risk of self-harm and suicidal behavior.
• Rumination: Repeatedly dwelling on negative thoughts can enhance feelings of hopelessness and increase the risk of suicide.
• Thwarted belongingness: A lack of meaningful social connections can lead to feelings of alienation and hopelessness, increasing suicide risk.

Situational Factors

Situational factors involve specific life circumstances and events that can trigger or exacerbate suicidal thoughts or self-injurious behavior.

• Difficulty accessing mental health care: Inability to obtain proper mental health support can lead to untreated psychological distress.
• Difficulty with immigration transition: Stress associated with immigration can lead to isolation, cultural dissonance, and mental health struggles.
• Increased access to commonly used high-lethality suicide methods: Easy access to methods like firearms or toxins increases the likelihood of fatal self-harm.
• Loss of independence: Losing autonomy, particularly in older adults, can contribute to feelings of helplessness and increase suicide risk.
• Loss of personal autonomy: The perception of losing control over one's life can lead to feelings of desperation and suicidal ideation.

Social Factors

Social factors include environmental and interpersonal influences that contribute to the individual's emotional distress and risk of self-harm.

• Bullying: Harassment, whether physical or emotional, can severely affect self-esteem and lead to suicidal thoughts.
• Cultural barriers: Cultural differences or a lack of support from one’s cultural community can contribute to isolation and mental health struggles.
• Difficulty establishing interpersonal relations: Problems forming meaningful relationships can lead to loneliness and depression, increasing suicide risk.
• Harsh parenting: An abusive or neglectful upbringing can lead to lasting emotional trauma and suicidal tendencies.
• Inadequate parental social support: Lack of support from parents can contribute to feelings of abandonment and low self-worth.
• Inadequate social support: A lack of close, supportive relationships increases the risk of isolation and despair.
• Loss of intimate partner: The death or loss of a significant partner can cause profound grief, leading to increased suicide risk.
• Low number of positive social ties: A lack of close, supportive relationships increases feelings of loneliness and hopelessness.
• Loss of a family member: Bereavement, especially of someone close, can trigger suicidal thoughts due to overwhelming grief.
• Social exclusion: Feeling excluded from social groups or communities can intensify feelings of isolation and despair.

At Risk Population

• Adolescents: Young individuals, particularly during the tumultuous period of adolescence, face developmental and emotional challenges that may increase their risk for suicidal behaviors.
• Cisgender men: Men who identify with the gender they were assigned at birth may experience societal pressures around masculinity, which can sometimes prevent them from seeking help or expressing vulnerability, increasing their risk.
• Economically disadvantaged individuals: Poverty and financial instability are significant stressors that can contribute to mental health struggles and increase vulnerability to suicidal behaviors.
• Ethnic minority status: Ethnic minorities may experience discrimination, cultural isolation, and higher stress levels, all of which can raise the risk for self-harm and suicide.
• Indigenous peoples: Indigenous individuals often face historical trauma, cultural disconnection, and socio-economic disparities, leading to higher rates of suicide risk within these communities.
• Individuals experiencing death of a parent: Losing a parent can cause profound emotional distress, especially for younger individuals, significantly raising the risk of depression and suicidal thoughts.
• Individuals experiencing economic recessions: Financial downturns can lead to job loss, housing instability, and mental health struggles, all of which contribute to an increased risk of suicidal behavior.
• Individuals experiencing loss of significant interpersonal relations: The loss of key relationships, such as through breakup, divorce, or death, can leave individuals feeling isolated and hopeless, which are risk factors for suicide.
• Individuals experiencing racial conflict: Exposure to racial tensions and systemic inequality can lead to a sense of alienation, depression, and despair, making individuals more vulnerable to suicidal behavior.
• Individuals experiencing situational crisis: Major life events, such as job loss, financial strain, or natural disasters, can lead to emotional overwhelm, pushing individuals into suicidal thoughts or behaviors.
• Individuals exposed to natural disaster: Survivors of natural disasters may experience prolonged trauma, loss of home, and emotional distress, which significantly heighten the risk of self-harm or suicide.
• Individuals exposed to suicide in others: Witnessing or learning about suicides can create a psychological burden and potentially normalize suicide as a way to cope with distress.
• Individuals facing discrimination: Social or institutional discrimination can cause emotional harm, leading to feelings of hopelessness and an increased risk of suicidal behaviors.
• Individuals living in nontraditional settings: Living in environments that are unconventional or isolating (such as group homes or shelters) may increase feelings of alienation and risk of mental health struggles.
• Individuals of younger age relative to classmates: Being younger than peers in a social or educational context may lead to feelings of inadequacy, bullying, or exclusion, increasing the likelihood of suicide risk.
• Individuals separated from parent: Separation from a caregiver, especially during formative years, can lead to emotional instability and feelings of abandonment, both of which are risk factors for suicide.
• Individuals with an increased level of mental health treatment: Individuals who require frequent mental health treatment may have complex and persistent issues that increase their vulnerability to suicide if not adequately supported.
• Individuals with family history of suicide: A family history of suicide can contribute to genetic predispositions or learned behaviors that increase the likelihood of suicidal ideation or attempts.
• Individuals with history of attempted suicide: A prior suicide attempt is one of the strongest predictors of future suicide risk, often indicating unresolved emotional pain or psychological conditions.
• Individuals with history of childhood abuse: Childhood trauma, particularly abuse, can have long-lasting effects on emotional regulation and increase the risk of suicidal behaviors in later life.
• Individuals with history of childhood neglect: Growing up in neglectful environments can impair emotional development and create deep feelings of worthlessness and hopelessness, raising the risk of suicide.
• Individuals with history of exposure to violence: Exposure to violence, whether in the home or community, can have traumatic effects that increase the risk of self-harm or suicidal behaviors.
• Individuals with history of violence: A personal history of violent behavior, whether toward others or oneself, may indicate emotional instability that puts an individual at risk for suicide.
• Individuals with parent who has substance abuse issue: Growing up in an environment where substance abuse is present can lead to emotional neglect and instability, increasing the likelihood of suicidal behavior.
• LGBTQ+ individuals: LGBTQ+ individuals, especially those who face discrimination, rejection, or family conflict, are at a higher risk of suicide due to social and emotional stressors.
• Older adults: Seniors may face social isolation, declining health, and loss of independence, all of which can contribute to feelings of hopelessness and increased suicide risk.
• Young adults: Young adults, particularly in the transitional phase of early adulthood, may struggle with identity, relationships, and career pressures, all of which can lead to an increased risk of suicide.

Associated Conditions

• Addictive behaviors: Substance abuse and other addictive behaviors can be both a coping mechanism and a contributor to mental health issues, including suicidal ideation.
• Mental disorders: Conditions such as depression, anxiety, and bipolar disorder significantly increase the risk of suicidal thoughts and behavior.
• Physical illness: Chronic or severe illness can lead to feelings of helplessness, suffering, and a diminished quality of life, all of which can increase suicide risk.
• Progressive illness: Diseases that worsen over time can create prolonged emotional distress and a sense of hopelessness, which can lead to suicidal behaviors.
• Terminal illness: A terminal diagnosis can trigger feelings of despair and fear, leading some individuals to consider suicide as a way to end their suffering.
• Unpredictability of illness trajectory: Uncertainty about the progression of an illness can cause anxiety and fear, contributing to a higher risk of suicide in patients dealing with long-term health conditions.

NOC Outcomes

NOC outcomes related to the risk for suicidal self-injurious behavior are crucial for guiding nursing interventions and assessing their effectiveness. By focusing on these outcomes, healthcare professionals can better evaluate the progress and well-being of individuals at risk, helping them to cultivate healthier coping mechanisms and improve their overall emotional stability.

Monitoring these outcomes allows for timely adjustments in care plans and interventions, ultimately aiming to reduce suicidal ideation and self-harming behaviors. Through ongoing evaluation, individuals can also build resilience and gain a deeper understanding of their emotional health, facilitating long-term recovery and stability.

• Reduction in suicidal thoughts: This outcome measures a decrease in the frequency and intensity of suicidal ideation, indicating improved mental health and coping strategies.
• Improved coping strategies: Evaluation of the individual’s ability to employ effective coping mechanisms that mitigate emotional distress and reduce the urge for self-injury.
• Enhanced emotional regulation: This assesses the individual’s skills in managing and responding to emotions, which can lower the risk of impulsive actions related to self-harm.
• Increased engagement in treatment: Monitoring how consistently the individual participates in therapeutic interventions and adheres to treatment plans, which is vital for positive health outcomes.
• Developed support networks: This outcome focuses on the individual’s ability to establish and utilize social connections, which can provide emotional support and reduce feelings of isolation.

Goals and Evaluation Criteria

The primary goal in addressing the risk of suicidal self-injurious behavior is to create a comprehensive care plan that targets the multifaceted nature of risk factors. This involves identifying and addressing behavioral, physiological, psychological, situational, and social aspects that contribute to an individual's vulnerability. A robust plan should promote resilience, enhance coping skills, and provide access to necessary resources, ensuring that individuals at risk receive holistic support.

Evaluation criteria should focus on measuring the effectiveness of interventions and improving overall well-being. This includes monitoring progress regularly through validated assessments and encouraging open communication between healthcare providers and individuals in risk management. Ensuring responsive care that can adapt to the changing needs of the individual is crucial in reducing suicide risk and fostering a supportive environment.

• Assess the effectiveness of interventions: Regularly evaluate the impact of therapeutic strategies and support systems in reducing suicidal ideation and self-harming behaviors.
• Monitor changes in risk factors: Continuously assess behavioral, physiological, and psychological factors to identify any shifts that may require adjustments in care plans.
• Promote engagement in treatment: Encourage active participation in mental health programs and therapies, measuring adherence and responsiveness to treatment.
• Facilitate social support networks: Evaluate the individual’s connections with family and community resources to ensure they have adequate emotional support and security.
• Enhance coping skills development: Provide resources and training for effective coping mechanisms, assessing the individual’s ability to manage emotional distress constructively.

NIC Interventions

Nursing interventions for individuals at risk of suicidal self-injurious behavior must be comprehensive and sensitive to the complex interplay of factors contributing to their vulnerability. These interventions prioritize establishing a therapeutic relationship, providing education and resources, and fostering empowerment through skill-building and support. The ultimate goal is to create a supportive environment that encourages open communication and helps individuals navigate their emotional challenges while developing effective coping strategies.

Effective NIC interventions also involve collaborative approaches that engage multidisciplinary teams to ensure holistic care. This includes regular mental health screenings, crisis intervention strategies, and referral to appropriate mental health services. Nurses play a crucial role in promoting safety, addressing immediate needs, and facilitating long-term support for individuals facing suicidal thoughts or behaviors.

• Comprehensive mental health assessment: Conducting thorough evaluations to identify risk factors and establish a baseline understanding of the individual's mental health status, ensuring appropriate interventions are tailored to their unique situation.
• Safety planning: Collaboratively developing a personalized safety plan that outlines specific actions the individual can take when experiencing suicidal thoughts, including identifying triggers, coping strategies, and support contacts.
• Education on coping mechanisms: Providing information on healthy coping strategies, such as mindfulness, relaxation techniques, and problem-solving skills, to help individuals manage distressing emotions and reduce impulsive behaviors.
• Encouraging social support: Facilitating connections with family, friends, or support groups to create a network of positive relationships that can provide emotional support and reduce feelings of isolation.
• Monitoring and follow-up: Regularly checking in on the individual's progress and mental health status to provide ongoing support, adjust interventions as needed, and reinforce the importance of seeking help when necessary.

Nursing Activities

Nursing activities are essential in the assessment, monitoring, and intervention strategies geared towards individuals at risk for suicidal behaviors. These activities not only provide immediate support but also facilitate the long-term stabilization of mental health, improving overall patient outcomes. Nurses play a significant role in identifying risk factors, promoting safe environments, and fostering therapeutic relationships that empower individuals in crisis.

Moreover, an integral part of nursing activities involves educating patients and their families about warning signs and preventive strategies related to self-harm and suicide. This education aims to destigmatize mental health issues, increase awareness, and encourage open communication, ultimately leading to timely interventions to reduce risks and enhance mental wellness.

• Conducting thorough assessments: Nurses should perform comprehensive evaluations including mental health status, risk factors, and any history of suicidal behavior. This helps establish an understanding of the individual's needs and the urgency of interventions.
• Implementing safety plans: Collaborating with patients to develop personalized safety plans that include coping strategies, emergency contacts, and local resources is critical. These plans can help in mitigating potential risks by providing actionable steps during crises.
• Facilitating communication: Encouraging open dialogue between the patient, family members, and the healthcare team is vital. This includes discussing feelings, experiences, and available support systems to foster engagement in the recovery process.
• Providing education and resources: Nursing activities should include educating patients and their families about the signs of suicidal ideation and self-harm, as well as how to seek help. Providing access to mental health resources and information about coping strategies can empower individuals to make informed decisions.
• Monitoring and adjusting care: Continuous observation of the patient's mental health status is necessary to assess changes and adapt care plans. This enables nurses to effectively address emerging needs or crises, ensuring ongoing support tailored to the individual's situation.

Related Nursing Diagnoses

Several nursing diagnoses are closely associated with the diagnosis of risk for suicidal self-injurious behavior. Understanding these interrelated diagnoses is crucial for developing a comprehensive care plan that addresses the multifaceted nature of an individual's mental health and risk factors. Each diagnosis highlights a distinct area that may require targeted interventions to mitigate risk and promote overall well-being.

• Impaired Coping: This diagnosis highlights the individual's struggles with effective coping mechanisms. Patients may resort to self-injurious behaviors when they feel overwhelmed and cannot manage their emotional distress appropriately. Interventions may include teaching adaptive coping strategies and providing support for emotional regulation.
• Risk for Self-Directed Violence: This diagnosis specifically underscores the potential for self-harm or suicidal ideation. It necessitates careful monitoring, safety planning, and implementation of therapeutic interventions aimed at reducing immediate risks while fostering a supportive environment.
• Anxiety: Given that anxiety is a common psychological factor contributing to suicidal ideation, this diagnosis emphasizes the need to address underlying anxious thoughts and behaviors. Interventions may focus on anxiety management techniques, including cognitive-behavioral therapy and relaxation strategies.
• Disturbance in Self-Concept: This diagnosis reflects individuals' negative perceptions of themselves, which can increase vulnerability to suicidal thoughts. Therapeutic interventions should aim to enhance self-esteem, promote self-acceptance, and build a positive self-image through supportive counseling and intervention programs.

Suggestions for Use

Utilizing the nursing diagnosis of 'Risk for suicidal self-injurious behavior' is critical for healthcare providers in various settings, particularly when assessing individuals exhibiting signs of emotional distress. It is imperative to conduct a thorough evaluation of the patient's emotional, psychological, and situational factors that may contribute to their risk of self-harm. This diagnosis not only assists in identifying at-risk individuals but also guides clinicians in developing targeted interventions aimed at mitigating these risks and promoting overall well-being.

Moreover, effective communication with both the patient and their support system is essential in creating a comprehensive care plan. Engaging the patient in discussions regarding their feelings and experiences can provide valuable insights into their mental state. Additionally, establishing a supportive network that includes family members and friends can play a pivotal role in fostering resilience and preventing suicidal ideation. Regular follow-ups and adjustments to the care plan based on the patient’s progress are also crucial for ongoing support and intervention.

• Conduct thorough risk assessments: Regularly evaluate potential behavioral, physiological, psychological, situational, and social risk factors. This comprehensive approach helps in identifying individuals at higher risk and tailoring interventions accordingly.
• Implement therapeutic communication strategies: Use active listening and open-ended questions to encourage patients to express their thoughts and emotions. This can help providers understand the underlying issues leading to self-harm and foster trust in the therapeutic relationship.
• Develop a safety plan: Collaborate with the patient to create a personalized safety plan that includes coping strategies and emergency contacts. This proactive measure equips individuals with tools they can utilize during moments of crisis.
• Involve family and support systems: Educate family members about the risk factors and signs of suicidal behavior. Encouraging family involvement can help build a supportive environment and promote recovery.
• Monitor and adjust treatment plans: Regularly review the effectiveness of ongoing treatments and interventions. Adjust care plans based on the patient’s evolving needs and response to treatment for optimum outcomes.

Examples of Patients for Nursing Diagnosis

This section presents diverse patient profiles that may require careful consideration of nursing diagnosis for the risk of suicidal self-injurious behavior. Each example outlines the unique backgrounds and needs of the patients, highlighting how tailored nursing interventions can support their health journeys.

• Adolescent Female with Depression:

  A 16-year-old girl recently diagnosed with Major Depressive Disorder, who has exhibited self-harming behaviors such as cutting. She comes from a family with a history of mental health conditions and experiences bullying at school, leading to feelings of hopelessness and isolation. Her primary needs include emotional support, a safe space to express feelings, and strategies for coping with peer pressure. Nursing interventions would focus on establishing trust, educating her about coping skills, and engaging her in group therapy to enhance social connections.

• Middle-Aged Man Recovering from Surgery:

  A 45-year-old man who recently underwent surgery for a chronic health condition, now facing challenges with pain management and mobility. He has expressed feelings of worthlessness and frustration about his new limitations. His unique needs include pain management strategies, encouragement for physical rehabilitation, and addressing his emotional distress through counseling. Nurses can tailor interventions by providing pain management education and emotional support, linking him to physical therapy, and helping him set realistic recovery goals.

• Elderly Woman Experiencing Loss:

  A 78-year-old widow who has lost her husband of 50 years, feeling profound grief and hopelessness. She lives alone and has limited social support, exacerbating her feelings of loneliness. Her needs include companionship, engagement in social activities, and mental health resources. Nurses could facilitate connections with local support groups, encourage family visits, and monitor her mental health closely to provide timely interventions if suicidal ideation arises.

• Young Adult in Treatment for Substance Use Disorder:

  A 22-year-old individual undergoing treatment for a severe alcohol use disorder, who has experienced multiple relapses along with suicidal thoughts. They struggle with self-esteem and difficulty managing emotions. Their unique needs involve ongoing mental health support, coping strategies for stress and triggers, and a structured routine post-treatment. Nursing care would focus on implementing a personalized care plan that includes relapse prevention techniques, regular mental health evaluations, and access to counseling services.

• Immigrant Teenager Facing Cultural Isolation:

  A 17-year-old immigrant girl who has recently moved to a new country, experiencing cultural dissonance and high levels of anxiety as she navigates a new education system. She feels disconnected from her peers and has voiced thoughts of self-harm due to stress and identity challenges. Her needs comprise social integration, language support, and counseling for anxiety. Nurses can offer culturally sensitive care, involving family in discussions, connecting her with local youth groups, and providing mental health resources that respect her cultural background.