Mental Health

Cell Phones on Psych Wards – Yea or Nay?

I recently saw a tweet about the issue of cell phones on psych wards, and it stirred up a strong reaction for me.  A man was writing about how he’d been advocating for his child to be able to have their cell phone on the psych ward, but this was flatly denied due to their no cell phones on the ward policy.  As a result, the child was very much disconnected from their social support network.

During my last hospitalization, the ward had a no cell phones policy, and they wouldn’t budge at all on that.  It made me feel even more isolated than I already was, and talking on the phone in the common area with no privacy was not the least bit appealing.  I remember at one point calling my community psychiatrist from the patient phone and leaving a voicemail yelling “I’m stuck in this f*cking hellhole as long as they want to keep me here!”  That kind of thing is really better done in private.

When I used to work as a nurse on an inpatient unit, I don’t recall us having a general rule about cellphones.  Then again, that was before cell phones became as omnipresent as they are now.  We would sometimes take a phone away if, for example, a manic patient was being disruptive by calling people at 3 in the morning, but it was a case by case decision.

Access to support

I believe that one of the arguments made against cell phones relates to the camera function.  I’m not convinced, though, that this is sufficient grounds for an across the board ban.  I completely agree that in some cases it’s not appropriate for certain patients to have access to their phones because of the particular symptoms of illness they’re having at that time. Still, I don’t think that should mean that everyone else has to miss out on access to their support network.

For many of us, having access to our phones is an essential way to connect with our main support people.  Limiting us to talking on the patient phone in front of everyone else significantly impacts the ability to connect to that support network.  The blogging and social media communities can be really important sources of support, and that’s generally inaccessible on a hospital ward without having the use of a smartphone.

Arbitrariness

I think blanket bans on cell phone use demonstrate laziness by hospital staff.  It’s a lot easier to just say no to everyone than to make reasoned, well thought out decisions about what specific patients should not have their phones because of their illness symptoms, and to have to answer questions about those decisions.  I think it also comes down to a culture of having rules for the sake of imposing control.  Forget what’s therapeutic or not; far too often the focus is on establishing a clear hierarchical divide between staff and patient.

As a nurse, this kind of arbitrary rule-setting has always bugged me, and it’s been amplified even further since I got sick myself.  It frustrates me how many mental health professionals lack the empathy to be able to imagine themselves in the place of the patient and consider what they might want/need in that situation.  One of the places I work now is really bad for arbitrary rules, and it drives me bonkers.

Autonomy

Autonomy is a fundamental value held dear by most people.  Sometimes there is genuine therapeutic value in placing judicious limits at certain times and certain situations, but limitations on autonomy should not be the default when it comes to mental health treatment.  When autonomy is arbitrarily stripped away, so is a little bit of our dignity and humanity.

While we may be patients, and we may have mental illnesses, we’re still human.  We deserve to be treated in a way that is therapeutic rather than counter-therapeutic.  We deserve to be treated with respect, and not to have arbitrary restrictions placed on our freedom.  Treatment should be about healing, not about punishment.  It should be patient-centred, not centred around what’s easiest for the staff.

So that’s my rant.  What are your thoughts on the cell phones on psych wards issue?

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41 thoughts on “Cell Phones on Psych Wards – Yea or Nay?”

  1. I think the lack of a smartphone is a part of a bigger issue in hospitals, which is the lack of privacy. Hospitals have to balance allowing patients privacy with monitoring them for unsafe behaviors, and so much of what happens on a patient’s cellphone is hidden. It’s hard because letting everyone have a cellphone is a bad option, and letting no one have a cell phone is also a bad option.
    -Sean
    http://www.nerd-mind.com

  2. I agree to a certain extent. I believe the patient has rights to allowing a mobile phone. However, not to be used as a constant.
    If they had a station in the nurses area, where cell phones could be kept and charged. The patient may use them in a separate room for privacy.
    The reason why I don’t agree to have them on a patients person the whole time in the psych ward is because I feel as if it would take away from the goals that the hospital is providing. ie.. Group therapy, one on one therapy, psychiatrist, and overall break from the outside world in order to get better.
    I do agree that a patients privacy and dignity should be kept private. That is why I thought of the room idea.
    I know I was truly humiliated by other people listening in to my private discussions.

  3. I think that with cell phones, it gets a little tricky. Every patient is different and I agree that it shows a level of unwillingness and laziness to refuse to simply analyze whether or not each specific patient can/should have access to their cell. During my own hospitalization, I felt very isolated as well, but I actually think that having my cell phone would’ve been counterproductive for ME, personally. Though I felt very alone and frustrated that I couldn’t talk to anyone in privacy (we also had a phone we could use but it was in the common room where everyone ate and watched TV when allowed), a lot of my anxieties come from the outside world, and having access to everything on my phone might’ve been triggering. With that being said, however, I think that it should evaluated for all patients, because for some, it can be triggering to NOT have access to outside people. That sense of being alone can be very detrimental to some. The blanket rule is ridiculous to me, even as a person who wasn’t personally effected by it. Some need the communication and contact, and I think that for that reason, it is more therapeutic for them to have it than to not.

  4. I wholeheartedly agree with you. I feel like everyone should have the right to have their cell phones with them (of course, set boundaries and whatnot). I feel like if patients get their cell phones taken away from them, it makes them feel more lonely and it can create more problems (if that makes sense).

    1. I think sometimes taking the phone away is best, at least in short term, but I agree, for a lot of people it can just make things more difficult having the phone taken away.

    2. I fully agree. A mental patient, deprived of his/her cellphone, is helpless no one to talk to or communicate with family members. This is counter productive and it makes a patient more sick with anxieties and depression.

  5. It’s been years since I was in a hospital but we weren’t allowed to have cell phones or use the internet. Completely cut off from the outside world. It was miserable and unhelpful. If they remove you completely from all of your stressors and environment what are they preparing you for when you leave? I agree cell phones should be allowed. Maybe only in rooms or access at certain times only?

  6. I agree! Numerous studies show that solitary confinement (lack of social interaction) can worsen or induce psychosis in prisoners. I imagine taking away methods to connect while voluntarily or involuntarily hospitalized would cause similar distress/harm.

  7. Mmm definitely a tricky one, I can see the for and against sides to having phones on the wards, but also how this varies (ie. it may be a trigger for some patients). I’d be inclined to feel the lack of connection and heightened sense of isolation would be enough reason to warrant flexibility on a ban though. x

  8. They didn’t allow any ‘personal’ items at all when I was hospitalized. And I was on the ‘non-restricted’ side too (meant we weren’t locked in our rooms is all). My own feelings on that – it’s a good policy. Part of the point of therapy or being committed (at least for folks like me) is that we need to learn to communicate – face to face – with others. Learn better boundary setting and conflict resolution and that ain’t gonna happen if one is checking their Facebook or Twitter or whatever mess they like to socialize with. And I happen to be too old to really appreciate the finer aspects of being connected 24/7. It annoys the crap out of me when I see others (young folks mostly) doing that. You can’t talk to them, they aren’t listening. You can’t engage with them on a one on one basis because the electronic device is more compelling I guess. So for me? Keeping the cell phone usage to a bare minimum seems the best policy for people on a psych ward. A compromise might be a set amount of time in the lounge or group gathering room or whatever. If someone is caught taking pictures, the privilege is revoked. Seems simple enough.

    1. Very good points. For me what really mattered was not being able to text message with my good friends. I didn’t really feel like talking on the phone, much less on the ward phone in front of everyone, so I just didn’t communicate with friends, which meant I was cut off from my key support network.

      1. That is a down side. I suspect if cell phones had been more utilized (I was committed in 2011 and not that many people had cell phones…nothing like now), the doctors at that place would have had to deal with the issue. I think they took all personal stuff away from the patients because there was less chance of someone being attacked by someone else who wanted the object in question. And oddly now my biggest support network is on social media, so I’m not sure what I’d do if I were cut off. But I wouldn’t want those people who know me ‘in real life’ to know about it anyway. You have made a very valid point for them allowing cell phones too!

  9. My only concern about patients having cellphones is that they might use them to ruin or damage their existing friendships. Every time that I’ve been hospitalized as an adult, I was so far gone that if I’d talked or communicated with people I know, they would’ve been appalled at my bizarreness and it could’ve been damaging to our relationships. That’s my number-one concern. I probably would’ve been texting people saying things like, “I want to get out of here so I can keep trying to kill myself already,” and a lot of people can’t handle that sort of thing. That concern aside, I definitely see what you’re saying!!

    1. I guess I just figure that’s a decision that should be made on an individualized basis rather than being a blanket ban applied to everybody.

      1. That’s a good point!!! I see what you mean now. And come to think of it, the last time I was in the mental hospital (2006), I was bored senseless. Internet access would’ve helped a huge deal!! You’ve convinced me! I’ll vote for a case-by-case basis!!

  10. I definitely see some benefit from disconnecting from social media during treatment, but the part that bothers me is more that you can’t contact loved ones, have private conversations, or check on important things like bills/responsibilities while inpatient. For instance, where we live, if we don’t pay our rent on time, they will file to have you evicted within a few weeks. I have often wondered what I would do if I were alone and in the hospital for a long period of time and couldn’t pay on time. I’ve also known people who missed important court dates while inpatient and that can’t be good. I do think they should at least have private areas to make personal calls, and public computers or something where you can access important accounts/personal data. The hospital I was in, did not have either. There were phones, but always in the common areas.

      1. About the eviction, yeah, it is scary. I’m not sure if you actually have to leave that quickly, or if it is a longer process and that is just the initial step. Never went through it luckily. I hope they make some exceptions if you communicate with them and let them know what is going on, but not sure. It is kind of a complex situation because we own our house, but rent the property it is on. It is confusing lol.

      1. Agreed. When I was hospitalized, one lady ended up begging to be let out early so she could attend a custody hearing, and then she ended up coming back the same night because she was still so unstable. It didn’t seem right to me.

  11. There are a couple of points to be made here; Public hospital MH ward vs private hospital MH Ward? But the biggest issue of contention with having a phone on a MH ward is pertaining to Stigma.

    Scenario 1: Billy is admitted to private hospital for Mania and decides to takes a photo of Sally, and posts it on social media, here we have a significant breach of Sallys rights and society gets to make a judgment call on Sally because ‘Ahhh she has a mental illness’. Sally was hoping to keep this one between her and the hospital. Sally then claims damages by suing the hospital becuase the hospital shoud be held accountable for allowing someone whose judgment is impaired – to use a phone on the ward.

    We also see that half the problem is with society and the judemental nature of people in general.

    Scenario 2: Secondly. Billy is admitted to a public ward with substance induced psychosis, he is an involuntary patient becuase he is unstable and is not able to make sound decisions. He doesnt realise that using substances enhances his auditory hallucinations and casues more distress. He uses his phone to contact his drug dealer. He uses his leave from the ward to meet his friend, or his friend visists him on the ward – who has picked up the substance for him. He brings the substance onto the ward setting.

    Scenario 3: Sally was admitted to the ward with a manic episode. Her judgment is impaired and she calls everyone on her contact list telling them she is in hospital. She tells them all sorts of grandios ideas that arent neccesarrily true about her. Then once she is stable in her mental health she regrets everything. She commences a lawsuit against the hospital arguing that they should have restricted her access to the phone.

    Its rediculous becuase people should be allowed the basic human right of having their phone. However, if you put yourself in the space of the hospital – there are too many risks for litigation, and/or there is too much detraction from the basic therapeutic nature of what a ward provides. And so to keep it safe and simple, they blanket rule. Though in Australia a person may take their phone off ward when on leave. Its more than likely for the best that hospitals keep it this way until humanity in general evolves or something ….

    Anyway, I hope this helped. 🙂

  12. I can see some incredibly valid reasons for patients to be limited on cell phone usage (engagement, reducing destructive behaviors, disrupting sleep, not stepping out of the world enough) BUT it’s incredibly important to stay in touch with certain people or communities with a significantly higher degree of privacy.

    There are also projects that are good for a person’s MH (such as blogging or working on digital media) that a patient may fall behind on or lose out on by not being allowed access to a phone or tablet.

    If I ran a psych ward—and sometimes I feel like I do!—I would set standard parameters with times allowed and not, then go case by case with what’s accessible and how much monitoring is necessary. Likely getting a feel as part of the intake evaluation.

    In crisis, a good doctor would realize I benefit from contact but need limits so I can sleep!

  13. People should be allowed their phones in hospital, unless they are clearly doing something damaging like calling the police repeatedly and wasting their time. In the case there is a legitimate concern about the person’s phone use an individual plan can be made. A blanket ban seems like institutional abuse to me.

  14. Interesting debate. I agree with you…. although I do see that allowing access to take pictures/record video could also be a HIPPA issue. I would bet there’s a solution if someone took the time to actually try to solve to problem instead of just saying they’re taking access away from everyone.

  15. It’s not only the cellphone policy that needs to be rethought, it’s the entire inpatient psychiatric system itself.

    I’m an intelligent guy. I was hospitalized 4 times in 12 months for cannabis-induced psychosis. By the end of the last stay, I vowed I will never fucking return to an inpatient psychiatric hospital, ever. So that right there is a problem. If the people who may need help hate the experience so much that they’d rather not seek treatment, then there’s a problem with your treatment.

    All 4 times I could not fucking wait to get out. They were all 5-8 day stays. I’m sure this is all about getting as much money from the insurance as they can. I will admit that for the first 48 hours I was ok with being there. It helped me feel safe again, it got me time to meet with doctors and start meds, and for the effects of the drug to come down. I realize some people may need more than 48 hours, but it seemed like a pretty common theme from watching other patients enter that most people seem to feeling much better after a couple days.

    This of course does not include the more seriously inflicted patients, which brings me to the second issue. A huge problem with these places is how everyone is lumped together. The suicidal, the mentally ill who just need some meds, the more serious mentally ill cases where meds alone doesn’t seem to be enough, the drug cases, and the dangerous people are all lumped together in the same place. I understand that on some level we could all relate, but as a pretty much straight edge guy who occasionally smoked weed and got horrible reactions I didn’t feel I could relate much to hardcore drug addicts, people who had served in prison, and people who just seemed to be living in another dimension. Sure it was entertaining at times, but I felt I was pretty much forced to connect with people I didn’t care to know anything about, especially since they usually made you have a roommate.

    The TV room sucked, and by the 4th time they had gotten ridiculously strict on the viewing times. The people there tend to watch the dumbest shit. I’m convinced the majority of viewership of Ridiculousness is done in mental hospitals and rehabs. There was always someone complaining about what was on. There were hardly any books, all the puzzles and games were missing pieces. Sometimes people wanted to play cards, but it’s not that fun with people you don’t know.

    The groups are mostly worthless in my opinion. At least at this place they kind of let you not go to them. I was at one other facility about ten years ago, and they would force you to go to groups. But I also felt the groups at that facility were much better run, and much more interesting.

    So most of the time i just laid in bed waiting for meals. I can sleep a lot, so I did. But when I wasn’t sleeping, yes I wanted that smart phone, and I should have been able to have it. Because if you’re going to force me to be in a facility that isn’t enjoyable at all, you might as well let me enjoy my time having lots of educational material, ways to make money, and entertainment at my fingertips, instead of making me sit there painfully reading a book that I’m not interested in. I don’t even like reading books.

    I see little reason to force people to stay in those facilities for much more than 72 hours tops. Everything beyond that can be handled through daily outpatient treatment. It’s not much better than prison. It’s like their idea of making you feel better is to make you absolutely hate being there. How anyone thinks that’s effective treatment is beyond me. A good treatment facility would have patients at least somewhat feeling like they want to stay at the end, not absolutely relieved to get the hell out. I think they were fooled into thinking their treatment worked, because yes, I felt amazing the day I left, but only because i finally got away from the shitty food, the asshole roommates, the restricted TV use, the cell phone ban, and the need to constantly bother techs for everything I needed. At the place ten years ago, the duration was even worse. I was kept there like 12 days. There were people there with Tricare, the military coverage, that had THIRTY day mandatory stays. Can you imagine 30 days without your phone? It’s a terrible system, and needs a major overhaul. I don’t know how supposedly smart, educated people in the medical field are so blind to this.

    Just a couple other notes. They wouldn’t let me use my CPAP machine there. Yeah, really fucking helpful. There was always a med or two that they were like “Sorry, we don’t have that one”, so I had to have someone bring my meds from home, and then there would be several days of waiting to get it approved. So thanks, I miss several days of a med because of your stupid fucking policies. And they’re terrible places for diabetics. Nowhere near as bad as incarceration, but still pretty bad.

    Honestly ranting about all this has just made me more pissed off. These places are terrible. I truly believe they do more harm than good, and I also really believe the staff deep down know this.

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