No More Asylum

A psychiatrist wrote about his experience of working at a mental hospital where cell phones, laptops, and other such devices were permitted to patients. As experiments went, this one had its problems. He raised an interesting point as well — mental hospitals formerly provided respite from the world to give the patient time to recover. From In a Mental Institute, the Call of the Outside:

We said O.K. to the cellphones and the other wireless devices on the research unit. Dr. C. even got some power strips to allow more chargers to be plugged in. We were proud. Here, as in so many other areas, our institute was on the leading edge — with Internet access in occupational therapy, and with all these devices on the floor. And the devices multiplied. Besides cellphones and laptops, we now had an influx of Palm Pilots and BlackBerries and pagers as well.

And soon, perhaps predictably, problems arose. Some were practical. What if a device disappeared, or if one patient broke another’s device? Nurses complained that they spent an inordinate amount of time untangling cords and baby-sitting delicate gizmos.

Other issues were clinical. What if patients spent all their time on the phone and refused to go to therapy? What if substance abusers used their phones to “order in” their drugs of abuse (not a far-fetched idea in Manhattan)? Clearly, limits had to be set. On the other hand, we wanted some patients to talk on the phone: the ability to reach out to others might speed a patient’s recovery from depression, or hasten the emergence from psychosis.

We marveled at another change, in stigma. Traditionally, the last thing patients want is for their friends and neighbors to know they had checked into the “nuthouse.” Now, when the phone rang, and a friend asked, “Where are you?” the answer could be, “In the psych hospital.” From that perspective, bringing your cellphone seemed like a brash vote of confidence for the New Psychiatry.

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