A psychiatric ward is a specialized medical environment designed to provide short-term stabilization and treatment for individuals experiencing an acute mental health crisis. Policies governing patient attire are primarily established to ensure safety and maintain a secure therapeutic milieu. Clothing guidelines are a direct component of the facility’s approach to reducing the risk of self-harm, particularly suicide by ligature. These restrictions balance the patient’s right to dignity and comfort with the medical mandate to provide a safe, ligature-resistant environment.
Personal Attire Versus Hospital-Issued Clothing
Most psychiatric units encourage patients to wear their own personal clothing to promote a sense of normalization and comfort during their stay. Patients are advised to bring casual, comfortable clothes, such as sweatpants, t-shirts, and sneakers, which can aid in the recovery process by supporting a sense of self and routine. Upon admission, all personal items are searched and inventoried by staff, and any items posing a safety risk are removed and securely stored until the patient is discharged. This initial screening process ensures that the clothing brought onto the unit complies with the facility’s safety standards before it is permitted for daily use.
In specific circumstances, personal clothing is restricted and hospital-issued attire is provided. Patients who arrive without appropriate clothing, or those admitted during an acute behavioral crisis, are often given hospital scrubs or gowns temporarily. These institutional garments are designed to be safe, lacking potential ligature points or hidden compartments. Patients deemed at high risk of elopement or those requiring constant monitoring may be required to wear facility-provided scrubs for the duration of their stay.
Mandatory Safety Restrictions on Specific Items
The primary goal of clothing restrictions is to eliminate potential ligature points, which are objects that could be used for hanging or strangulation. Items that can be stretched, torn, or tied into a cord are universally prohibited. This includes belts, neckties, scarves, and shoelaces, which are removed immediately upon admission. Drawstrings found in the waistbands of sweatpants, shorts, or hoodies are also routinely pulled out by staff.
Footwear is restricted to items without laces, such as slip-on sneakers, sandals, or hospital-provided non-skid socks. Heavy boots or high-heeled shoes are not allowed because they can be used to inflict injury or do not support the casual environment of the ward. Jewelry, especially large or heavy pieces, is prohibited because it can be used for self-harm, weaponized, or become a choking hazard. Patients are encouraged to remove all personal jewelry, including body piercings, prior to admission to prevent loss or mandatory removal.
Underwire bras are restricted because the metal wire can be extracted and used as a sharp object for self-harm. Patients are encouraged to wear sports bras or other wire-free alternatives. Clothing with excessive metal components, such as large buckles, studs, or grommets, is not allowed due to the risk of the metal being detached and used inappropriately. In high-risk settings, tear-proof or anti-ligature clothing made of durable, non-fray material may be substituted for personal clothes to prevent makeshift ligatures.
Managing Clothing Needs During a Stay
The day-to-day management of clothing is handled through established logistical protocols. For patients with longer stays, laundry services are performed regularly, often on-site, to ensure clean clothes are available. Some facilities allow patients to use laundry facilities under staff supervision as part of a therapeutic routine. Patients are not required to bring an extensive wardrobe, typically only three to seven days’ worth of clothing, due to these regular laundry cycles.
If a patient’s stay is longer than anticipated or they were admitted without adequate clothing, the unit coordinates with family members to arrange a drop-off of clean, appropriate items. Any new clothes brought in are subject to the same rigorous safety inspection as the admission inventory. Many facilities maintain a clothing bank of donated items for patients who cannot have personal clothing brought in or if existing items become damaged or lost. Patients do not need to bring heavy outerwear, as the interior temperature is maintained at a comfortable level, and outdoor access is limited or supervised.