Cell phones on psych wards – yea or nay?

smartphone

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I saw a post about this issue on Twitter recently, and it stirred up a pretty 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 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 were not willing to 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.

I believe that one of the arguments that gets made against cell phones is in regards to the camera function.  I’m not convinced, though, that this is sufficient grounds for a flat-out 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, but I don’t think that should mean that everyone else has to miss out on access to their support network.

For so 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 a smartphone.

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 developed my own mental illness.  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 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.

We may be patients, and we may have mental illnesses, but we are still human.  We deserve to be treated on 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 just for the sake of keeping staff and patients apart.  Treatment should be about healing, not about punishment.

So that’s my rant.  What are your thoughts on this issue?

 

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38 thoughts on “Cell phones on psych wards – yea or nay?

  1. Sean says:

    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. BeckiesMentalMess.wordpress.com says:

    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. brittanythebookguru says:

    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. tal.seaa says:

    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).

    • ashleyleia says:

      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.

  5. DopamineQueen says:

    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. Johnzelle says:

    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. Invisibly Me says:

    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. Melanie B Cee says:

    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.

    • ashleyleia says:

      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.

      • Melanie B Cee says:

        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. Meg says:

    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!!

  10. marandarussell says:

    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.

  11. Concious Delirium says:

    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. Heather Tasker says:

    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. Nickelinho says:

    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. Dee Kelly says:

    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.

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