On mental health care and staying connected

A still image from the BBC documentary Don't Call Me Crazy, showing a girl sitting on the floor with her legs raised and her arm wrapped round her face.A few years ago I wrote a post on here (The Importance of Staying Connected) about how the Internet had changed from being a niche service which few people outside academia had access to, and which was a very definite luxury, to a mass medium which was a lifeline for very many people including disabled people. A friend who was a mental health inpatient had been transferred to a clinic in a remote part of Germany and had her phone and computer confiscated as the institution catered to people with dual diagnoses, including addictions, who could have used them to order drugs; after a few days, she jumped from a balcony. In that and other countries in Europe, including the UK, people receiving standard mental health inpatient care are allowed mobile phones and Internet access (though not provided with it) but not those in ‘secure’ units which house people who have been sent there on court orders as well as those detained under the Mental Health Act (which only needs two doctors) or in most adolescent units. In the USA, though, it appears to be different; people on mental health wards routinely have their phones taken away and a friend of mine who was recently admitted said she would not be able to keep in touch with us (or do the work she relies on the Internet to do) while in hospital.

Another friend of mine was recently discharged from an acute mental health unit in England. She had her phone with her all the time and kept in contact with me and other friends throughout this and a previous admission earlier this year. Wards can be stressful places with patients coming and going making it difficult to form friendships and some of them are difficult to get on with — this was a mixed ward and one of the male patients made threatening sexual advances and she needed advice as to what to do (in the end, the police were called and the man was transferred to the adjacent locked unit). She was able to arrange visits and meet-ups with friends locally during leave. Being able to keep in touch with friends staves off boredom and gives people distraction from their own thoughts which is important if those thoughts are distressing and often, because of lack of funds, mental health units are unable to provide any other adequate distraction. (This unit had a garden, for example, but patients were rarely allowed access to it.) However, a few years ago an acquaintance who had been in many different hospitals said that a previous ward she had been admitted to for more than a year had a strict no-phones and no-Internet policy and that confidentiality was given as the reason (nowadays, the policy is that patients are not allowed to photograph staff or other patients, but are allowed to keep their phones).

A while ago I read a question and answer on a medical website; the questioner was a doctor who was also a mother of a teenaged son with both Tourettes and co-morbid depression who had to be admitted to hospital from time to time to deal with the latter. One of his Tourette’s tics was to push at his teeth, which had over the years led to losing most of them; his usual way of keeping himself busy and his hands occupied was to play his electric guitar and to talk to his friends online, but the hospital had a policy of not allowing internet access because of concerns about privacy, and presumably the electric guitar would have caused disturbance to others. To avoid causing further damage to his teeth while being prevented from doing anything to distract him, he asked for restraints to be applied and he and his mother had had to persuade staff to apply them as the unit had an anti-restraint policy — as a lot of wards do, because they’re demeaning, often applied as punishments and almost never without alternatives. Worse, they set a time limit which was before the anxiety that led him to ask for the restraints had worn off. The person answering (another mental health professional) agreed with the decision to request restraints, but sensibly suggested that the hospital should reconsider its policy on electronics as this was clearly counter-therapeutic: someone who needed to be active was instead forced to lie idle in bed for hours or days.

That’s not to say that removing someone’s Internet access for a few days (or longer) isn’t sometimes beneficial; in some cases someone’s mental illness may be contributed to by online bullying, for example, and there are such things as “pro-ana” sites which encourage people with anorexia to continue slimming and resist treatment. Sometimes a person’s treatment requires them having a break from the stress of daily life and taking them away from the Internet is the only way of achieving this. But these issues do not apply to everyone who needs mental health inpatient treatment; many need to be able to talk to their friends, to get advice from someone who isn’t a mental health professional (or in some cases, other professionals who aren’t of the same mindset as those in charge of their ward) or to get help when there is danger on the ward and they may need to talk to outsiders without anyone on the ward hearing. It’s about time the people who still insist on cutting people off from the world for days or weeks a time when they need mental health treatment, regardless of individual circumstance, learned that it’s not necessary and can in fact be harmful.

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