From prohibition to proportionality: a case study of supervised mobile-phone access in a rural psychiatric inpatient unit

Purpose This case study describes the design, implementation, and qualitative outcomes of a supervised mobile phone access policy in a rural psychiatric inpatient unit in Chile. This study aims to provide a practical blueprint for similar resource-constrained services seeking to enhance patient connection and align care with human rights standards. Design/methodology/approach This study outlines a participatory, iterative quality improvement project. Following multidisciplinary discussions, a pilot policy was introduced in November 2024. After a three-month review period involving the entire team, a formal protocol was established in February 2025. The case is presented through a descriptive narrative of the process, challenges, adaptations and observed effects. Findings The implementation of structured, supervised access proved feasible and safe. Staff observed improved patient tolerance of hospitalisation, enhanced asynchronous contact with distant families, engagement with external recovery resources and proactive health information-seeking. Early challenges, such as unauthorised photography and conflict during a video call, led to specific protocol refinements, including prohibiting voice/video calls. The policy operated at zero financial cost, governed by simple, teachable rules. Originality/value This case study contributes a real-world, transferable model for advancing digital inclusion and least-restrictive practice in rural inpatient psychiatry. It explicitly operationalises principles from the UN Convention on the Rights of Persons with Disabilities and WHO QualityRights into a simple, actionable protocol. The account offers direct, practical insights for clinicians and managers aiming to replicate similar rights-based innovations.