In order to establish a reasonable and effective strategy of closed psychiatric ward management, we evaluated and compared the attitudes of the patients and their reponsible family members regarding telephone use by the patients. The patient
group
included those who had met the following inclusion criteria: (1) admission period longer than two weeks, (2) unlimited telephone access during the first two weeks and (3) patients filled out a questionnaire on the day of admission and on the 14th
day of
hospitalization. The family members also filled out the questionnaires during these two occasions. The control group consisted of ward patients who did not use the telephone during the first two weeks of hospitalization. We studied the frequency
of
phone calls made by the patients, telephone misuse by the patients and the attitude change of the guardians regarding patient access to telephones. In addition, we compared the mode of discharge and frequency of outpatient clinic visits per month
between the patient and control groups.
Of total 43cases the number of patients who wanted unlimited phone access was 39cases (90.7%) upon admission and 40cases (93.0%) on the 14th day of hospitalization. The number of guardians who permitted unlimited phone access was 36 (83.7%) on
both
occasions. Of the four patients who did not want to use the telephone upon admission, two patients requested telephone privileges by the 14th day. However, of the 39 patients who wanted to use the telephone on the day of admission, only one
patient
did
not want phone access by the 14th day. Of the 36 guardians who allowed unlimited phone access upon patient admission, only three changed their attitude regarding that access.
Patients made an average of 1.4 calls per day. The number of patients who used the phone less than three times a day was 39(90.7%). The number of patients who were discharged against medical advice was 9(20.9%) and in the control group, 16
(37.2%).
We conclude that unlimited, free telephone access for patients admitted to a closed psychiatric ward was favorable in almost all instances, with the only exception being that such unlimited use had a minor negative impact on ward management.
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