Suicide statistics in mental health settings demonstrate that three-quarters of patients who kill themselves on a psychiatric ward do so by hanging or strangulation, prompting regulators to focus heavily on ligature risks.

Architects, specifiers and ward managers should closely observe any ligature risk- no matter how big or small-when redesigning or upgrading their facility.

Key examples:

Even the smallest risk must be identified, and measures put in place to minimise. Some examples of risks are as follows:

• Power cords on medical equipment
• Call bell cords
• Handrails
• Doors
• Doorknobs
• Door hinges and hardware
• Showerheads and curtains
• Exposed plumbing or piping
• Paper towel and soap dispensers on walls
• Electrical switches
• Lighting fixtures
• Projections from ceilings

Managing identified risks

It’s extremely difficult, and in some cases impossible, to completely remove ligature risks. Doing so may serve as a hindrance for employees carrying out necessary tasks, and for service users by taking away their rights of independence.

In managing risks, it is recommended that you take a ‘remove, replace, protect, or manage’ approach, as highlighted by The Nottinghamshire Healthcare NHS Ligature Risk Reduction Policy (2019).

Remove, replace, protect, manage


*anti-ligature piece of equipment.
**hide the potential ligature.
Source

Examples of ligatures and ligature point risks

Before we head into the examples, it’s important to understand the distinction between ligatures and ligature points.

Ligature: Anything that binds or ties. Examples include: chains, linen, clothing, cords, tubing, etc

Ligature point: Anything that could be used to attach or secure a ligature. Examples include: shower rails, coat hooks, water pipes, door frames, etc.


***appropriate covers
Source

When assessing ligature risks, consider the use of the outdoor environment too. Anchor points in the garden may include windows, drainpipes, fencing, and trees.

Conclusion

We hope that this blog will enable you to identify and list all potential ligature points within your working environment that are accessible to Service Users.

Contour’s range of anti-ligature products are designed to help minimise the risk of self-harm and suicide in mental health settings, providing Service Users with a safe and secure environment.

If you’d like to learn more about how we work with mental health settings to reduce ligature risks, fill out the form below.