Inpatient psychiatric facilities maintain a standardized set of safety protocols intended to protect patients, staff, and the therapeutic environment. Policies regarding personal belongings, including piercings and jewelry, are a standard component of these protocols across most institutions. While the specifics can vary between hospitals, the general expectation is that items that could pose a risk of harm will be restricted or removed upon admission.
The Primary Safety Rationale for Removal
The main reason for requesting the removal of all jewelry and body piercings is to mitigate the risk of self-harm and harm to others within a high-acuity environment. Metal jewelry, including rings, necklaces, and piercing hardware, can be broken or modified to create a sharp edge. These small, hard objects introduce a risk of cutting or scratching the skin, which is a significant concern for patients admitted with self-injurious behaviors.
A secondary concern is the potential for jewelry to be used as a weapon against other patients or staff members, particularly during a behavioral crisis. Small, removable items also present a choking or aspiration hazard if they are swallowed, either intentionally or accidentally. Furthermore, long necklaces or earrings with loops pose a ligature risk, meaning they could be used to tie or hang oneself, though this is a less common concern for small piercings.
Intake Procedure and Documentation
The process of managing piercings begins immediately upon a patient’s admission to a psychiatric unit. During the intake assessment, staff conducts a thorough search for restricted items, often involving a metal detector wand. Patients are typically asked to remove all jewelry, including body piercings, and change into hospital-provided clothing.
All items removed from the patient are meticulously inventoried, documented, and placed into secure storage, often a sealed envelope or container. This safekeeping procedure is mandated to ensure accountability and the return of belongings upon discharge. While staff take reasonable measures to secure valuables, facilities generally advise against bringing items of high monetary or sentimental value, as the hospital is usually not liable for loss unless negligence is proven.
Facility Context and Policy Strictness
The degree of strictness regarding piercings often depends on the type of psychiatric facility and the patient’s individual risk assessment. Acute Care Units, which are short-term and high-observation settings, maintain the most stringent rules, typically requiring the mandatory removal of nearly all metal or hard jewelry. These units are designed for patients in a state of crisis, where the risk of impulsive behavior is highest.
In contrast, Long-Term Residential or Voluntary Treatment Centers may have slightly more relaxed policies, especially for smaller, fixed jewelry, such as simple ear studs. However, the final decision is always individualized. A patient with a history of severe self-harm or poor impulse control will likely be required to remove all piercings, regardless of the unit type, a decision often signed off by the attending psychiatrist.
Handling Non-Removable Jewelry
A common challenge arises with newer or complex piercings that cannot be easily removed by the patient or staff without specialized tools. These piercings, such as fresh ones or those with complex ball-closure rings, still fall under the general safety restrictions. In these situations, the patient may be asked to have the jewelry removed by a medical professional, such as a doctor or a trained nurse, before or shortly after admission.
An alternative solution that may be approved by the attending physician is the temporary use of non-metallic retainers. These are typically made of flexible plastic, acrylic, or glass, which eliminates the risk of a sharp metal weapon. In some low-risk settings, staff may permit a small, non-removable piercing to remain if it is securely covered with medical tape; however, this is rare and always subject to the unit manager’s final safety determination.