Contraband

What do you consider "out of the box"? There's a lot more to it on any psych unit I've ever experienced than just "weapons." Toiletries containing EtOH or otherwise toxic, anything in glass containers, cords/shoelaces/drawstrings/belts, any electronic devices, knitting needles. Obviously, any kind of smoking/vaping materials. Any kind of medication. I've worked on adolescent units in which paperclips and pencils with the rubber erasers on the end were considered contraband and were carefully controlled.

Having said all that, it's impossible to create an environment safe enough that you don't need to be constantly monitoring client's emotional states and behaviors. I've worked places in which some staff erroneously believed that, if we just controlled enough stuff and made the unit safe enough, we could sit on our butts at the nurses' station all day and not have to keep track of people or be concerned about safety. Never gonna happen ... :)

My most memorable was a sex toy. She wasn't intentionally trying to sneak it on the unit--her admission was rather precipitous and she had thrown a whole bunch of stuff in her suitcase in her haste to get here. I had fun calling the supervisor and asking if we should put it in the safe :)

She also had "included" a whole batch of used syringes and some heroin. Not the most fun belongings search.

As far as measures to prevent stuff from entering the unit...all patients are scanned with a metal detector, then have to undergo a body search down to the skin (no cavities). Usually if people are trying to smuggle in stuff, they do it in their clothing or suitcases, or have a visitor try to bring it in.

You will never make a 100% safe environment. I had a teen patient who cut herself with pieces of plastic from the shampoo bottle cap. If it wasn't that, I'm sure she'd have found some other benign object around the unit to use.

When I was IP last year, I wasn't even allowed my iPod because of the wires. I can't imagine how I could've caused myself any harm with those, but who knows...one of the other patients on the unit cut his wrists with a plastic toothbrush he'd snapped in half. Where there's a will, there's a way I suppose.

On our unit, iPods and such aren't allowed either. The ability to take pictures can be invasion of the other patients' privacy.

I've never heard of a psych unit that would allow any kind of electronic device, including cell phones, because:

A) Nearly all of the cell phones, tablets, laptops, etc. have cameras built in, which aren't allowed for confidentiality reasons.

B) Chargers, headphones, earbuds, etc., involve cords which could be dangerous. The concern is not necessarily the person who owns the device, but anyone on the unit could possibly get hold of a charger, headphones, etc., and use it to harm her/himself. People who want to do so are often extremely creative and resourceful about finding things they can use.

C) Units don't want to have anything of any value floating around on the unit (including things that might not be specifically dangerous, like jewelry) because they don't want to have there be any question of responsibility/liability if something valuable gets damaged or stolen.

At the current hospital I work at, we have "open" units where patients can have such things as iPods, personal electronics, jewelry and other extras, though cell phones and cameras are not OK because of the privacy rules. They were also more lenient with what was allowed in terms of attire--drawstrings, sashes and underwires were usually OK. These units are only for patients with a very low risk of suicide (e.g., detox or who came in voluntary without SI).