AI-based Nursing Observations in Acute Psychiatric Settings: Looking into the Psychiatric Panopticon

Dr Piers Gooding1, Mr  Timothy  Kariotis1, Dr David Clifford1

1University Of Melbourne, Australia

This presentation will share results of a literature review and workshop on the law and ethics of ‘digitally assisted nursing observation’ in psychiatric settings.

In acute psychiatric units, patients are routinely monitored in their bedrooms by nurses. ‘Digitally assisted nursing observation’ has emerged as a novel attempt to semi-automate this process. Patients’ bedrooms are fitted with sensors that monitor the person’s body using computer vision, signal processing and AI techniques to remotely and continuously track micromovements and colour changes.  The person’s pulse and breathing rate can be detected by the sensors and efforts are reportedly underway to detect behaviours associated with self-harm, assault and suicide. Aims include improving patients’ safety, minimising nighttime sleep disruption and reducing nursing labour. Several Australian hospitals appear set to trial this technology in acute psychiatric units. Yet, there remains a research gap concerning the ethical, legal and social implications. These implications are serious given around half of inpatients in acute psychiatric settings are detained and treated involuntarily.

This presentation will share findings of an inter-disciplinary research project consisting of a literature review and workshop exploring ethical, legal and social issues with digitally-assisted nursing observation in psychiatric settings. The workshop involved 20-30 affected and influential parties, including mental health consumer-advocates, nurses, hospital managers, technologists, ethicists and legal academics. The presentation will present findings from the review and workshop, and make recommendations regarding this proposed technologically-enabled practice.


Dr Piers Gooding is an Australian Research Council DECRA Fellow at the University of Melbourne Law School. His work focuses on socio-legal concerns with disability and mental health. He is the author of A New Era for Mental Health Law and Policy (2017) with Cambridge University Press.

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