Am inclined to mostly agree with Dooey. Though not everyone admitted to an acute facility is there under involuntary order, those who are suffer deprivation similar to high security prisoners. Most will be well established smokers and many will have alcohol or other substance 'issues' as well.

Once in the Unit, the only likely 'comfort' is going to be the old cancer sticks. Any other 'crutch' the patient has been using will be withdrawn - completely and abruptly. A non-smoker who'd rather everyone else was too, I still support the availability of a smoking area for these people even if nicotine replacement/Quit therapy is at hand. BTW - is it usually available and offered?

Provided there is a secure outdoor area designated for smokers I can't see a great problem for staff either. Sure it's a bit of a pain policing the "No Smoking except for designated area" rule and patients cadging or squabbling over cigarettes can create some hassles but the suggestion that Duty of Care requires staff to be at the patients side while he/she has a smoke is false. They just need to be able to observe from a reasonable distance.

Smoking is highly undesirable, but here I feel it is a lack of compassion that may be the greater of two evils.

I am very sorry to hear for the pain of your loss *Carol83*

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There were some who feared that they would lose me some 15 years or so ago.

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Had I known then what I know now about the condition, I could have initiated a powerful mechanism for likely recovery in no more than 3 months, but as it was, it took me the best part of 10 years to bring it all together and to come back from once being a *Clozapine* patient to where I am now here to converse with you.

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I recommend the following for everyone's interest and note that there is no risk of *Akathisia* associated, not to mention the cost savings to the PBS and likely increased longevity to those inflicted, who otherwise depend on neuroleptics which have been evidenced by the morgue to take 10 - 15 years of the lives of sufferers:

http://en.wikipedia.org/wiki/Cannabidiol

This was a good article and a subject that has caused me a great deal of harm as a mental health nurse. This ban on smoking "on all hospital grounds" has been in place in WA for some 3 years. It has been disastrous.
The distress caused to involuntary patients admitted to locked wards and denied the ability to smoke is terrible to see. The policy is nothing short of cruel. People in the throws of a psychotic episode are seldom able to be reasoned with and tend to [perceive the ban as a malicious act of the nursing staff. This causes a massive amount of conflict in an area that is already fraught with conflict. Far from reducing the dangers to nursing staff (from outdoor environmental tobacco smoke, a very minor danger) it has increased the danger of assault and massively increased the amount of abuse thrown at us by distressed patients.
There is a very close association between tobacco use and schizophrenia. People who go on to develop schizophrenia smoke at much higher rates even before the onset of their illness. Furthermore the medications they need to take increase their desire to smoke. This has been shown in double blind trial.
Its all very well offering nicotine patches or gum, but these simply don't cut it. They want a smoke, not a patch.
No other group in our society is being singled out to be forced to give up smoking. Even prisoners are still allowed to smoke.
It is not surprising as the mentally ill are probably the most voiceless group in society and so vulnerable to those who wish to force their ideology onto them.

In addition the bans have not achieved what they set out to achieve.
As there are no longer discrete smoking areas in the hospital, voluntary patients or those with leave from the wards (as well as staff) smoke on the pavement outside the hospital, which not only looks bad, but forces anyone who wishes to enter the hospital to walk through a haze of smoke and wade through cigarette butts. Now patients smuggle lighters in and smoke in their rooms where there is a genuine fire risk, rather than in outdoor smoking areas where a safe lighter was provided.
This policy is simply using the mental health act as a tool to force people to give up smoking. The mental health act was never meant to be used for this purpose. In fact the Western Australian Mental Health Act states in section 5 that its objective is to ensure that the mentally ill receive treatment with "the least restriction on their rights, dignity and freedoms". Forcing someone to give up smoking at the worst possible time in their lives is hardly the least restriction on their rights or freedoms.

Yes but *Rhys* whilst there is merit in what you say, overcoming the "addictive mind set" for want of a better term, and side effects of substances such as niccotine, is also one of the goals on the road to ever greater recovery.

Additionally, there are alternatives to generating a bi-release of dopamine to rebalance the system post antagonist over dose, such as the partial dopamine agonist properties of the drug Abilify to be consumed first, prior to pushing the antagonists higher up and closer to the trouble, which is a possible better targeting strategy.

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I enclose a glad bag of good things for cognition and mental health, compiled from a variety of sources such as "New Scientist" for everyones interest:

a. Clean water, a healthy diet (heavy on the veg) + omega 3 + active daily exercise.

b. Flavenoids (Blueberries, Red Wine(hmmm), Dark Chocolate (Hmmm), Magnesium-L-Threonate)

c. Bright (blue) light (protect the eyes though)

d. Meditation pre-activity

e. Music training

DreamOn, Whilst giving up nicotine addiction may be one of your goals, it is not necessarily the goal of all people suffering a serious mental illness. And while it may be the goal of many, few would feel that the middle of a psychotic relapse, accompanied by forced hospitalisation, and the accompanying psychological distress, is the appropriate occasion to bring this goal to fruition.
I am fully aware of the terrible effects of tobacco on the physical health on the mentally ill, just as I am aware of the terrible effects of tobacco on the health of the non-mentally ill. I simply feel we should treat the mentally ill with the same respect we afford all other Australians. Not singling them out for this peculiar punishment.