Introducing mobile phones for consumer use in an acute mental health inpatient unit

Southern NSW Local Health District

Promoting access to mobile phones in mental health inpatient units enabling consumers to remain connected to their lives.

At the time of this project, no acute mental health units in NSW allowed consumers to have free access to e-devices while being an inpatient. No policies or protocols from the NSW Ministry of Health are in existence.

Service targeted

Acute Mental Health Inpatient Units, Rural Health Service, SNSWLHD

How was the project embedded within practice?

Consumer participation was key to address risks in the use of mobile phones within a shared space.

Inpatient consumers participated in co-design consultations to determine how mobile devices should be accessed and used in shared spaces. These co-designed consultations led to the establishment and agreement of guidelines addressing privacy, confidentiality, consumer responsibility and phone etiquette to avoid intrusion and distress to other consumers.

All consumers will have access to their phones unless a risk or inappropriate use has been identified (reviewed every two days).

Only medical staff can deny a consumer access to their mobile phone for therapeutic reasons if a risk is identified.

Consumers identified inappropriate use as:

using the camera or video in the unit
recording conversations in the unit
attempts to damage their phone or throwing the phone.

Guidelines for respectful use of mobile phones in the units included the following.

Phones must be kept on vibrate.
Phones must be turned off or switched to silent for group sessions, medical reviews etc.
People should go to their rooms or a quieter area to take or make calls.
People must take responsibility for their own phone and each must have a name tag.
Headphones may be used for self-soothing e.g. for sleep disturbance or anxiety, etc.
People do not have to keep their mobile if they don’t wish too (can be placed in a locker).
Access to e-devices could not be used as punishment.

Executive team supported the use of mobile phones. Information sessions occurred with all staff and provided the opportunity to identify issues as well as to address their concerns. The clinical director openly highlighted their support by communicating with medical staff directly.

Charging stations located in day rooms except for the high dependency area where they are located in the nurse’s station.

What worked well?

By using the co-design method, staff gained a meaningful understanding of the impact that being disconnected can have for consumers and carers. Consumers and carers were empowered to raise risks and concerns, make decisions, and to collaborate in the establishment of considerate and respectful guidelines (rather than having guidelines imposed upon them). Collaborating and working in partnership has enabled the successful implementation of a process for the safe and appropriate use of devices within the shared environment.

Consumers could maintain relationships with family and friends without asking permission, or waiting to access a common phone.
Consumers were able to continue management of their private affairs such as pay bills, find accommodation and work etc.
Individual assessment by the treating team.
Staff had more time to spend with consumers.

This project was evaluated by:

surveys conducted with consumers and staff (available for completion any time)
consumers raising issues at various forums (e.g. consumer rounding sessions, morning unit meetings) and individually with staff
focussed interviews with consumer and their carers
Your experience of service (YES) surveys results.

All feedback is reviewed by the mental health unit management team, and issues requiring action are immediately addressed.

Consumer feedback

“It has helped me stay independent with appointment management, bills etc., while being able to use the internet to self-soothe and stay connected with friends and family.”

“Last time I was here, phones weren’t allowed and I would end up self-harming as I had no tools to self-soothe with.”

“Less distraction for me not having my phone and I LIKE having the choice.”

“Best thing since sliced bread to be able to have your telephone for contact with your family and loved ones, and in case of emergencies as well.”

“My phone helps me - knowing I can reach out to family and friends and have the support from people I know and trust, due to having trust issues talking to new people about what’s going on is difficult for me.”

Staff feedback

“Empowers consumers.”

“Has reduced aggression and violence – can speak to family and close friends and helps people’s anxiety coming from uncertainly.”

“Less telephone traffic for staff, allowing for other duties.”

Resources

Mental health inpatient unit mobile phone/personal communication device agreement example