Psychiatr Serv 59:1100-1102, October 2008
doi: 10.1176/appi.ps.59.10.1100
© 2008 American Psychiatric Association
Best Practices: To Lock or Not to Lock Patients'Rooms: The Key to Autonomy?
Netta Shoenfeld,
Anne-Marie Ulman, M.D.,
Mordechai Weiss, M.D. and
Rael D. Strous, M.D.
The authors are affiliated with the Beer Yaakov Mental Health Center, Yaakov, Israel. Dr. Ulman, Dr. Weiss, and Dr. Strous are also with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Send correspondence to Dr. Strous at Beer Yaakov Mental Health Center, P.O. Box 1, Beer Yaakov 70350, Israel (e-mail: raels{at}post.tau.ac.il). William M. Glazer, M.D., is editor of this column.
Many patients with schizophrenia experience prominent negative symptoms. Functional impairment often results in patients who remain in their rooms for most of the day. It has thus become common practice in many psychiatric wards to lock patients' rooms during much of the morning and afternoon hours to encourage participation in ward activities and treatment modalities. Within the context of a quality control evaluation, two self-report surveys were conducted among patients (N=20) and staff members (N=9) in Beer Yaakov, Israel: the first survey was given when the rooms were locked at certain times, and the second survey was given after the rooms had been unlocked for one week. Patients and staff members expressed differing views both before and after the week-long open-door policy (patients enjoyed the policy, whereas many staff did not). Behavior during the period of the open-door policy varied among patients. The authors discuss the ethical grounds of locking doors and whether it is a best practice in keeping with rehabilitation interests.
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