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Ligature Resistant Construction Tips for Healthcare Providers

Planning a Safe Patient Experience with Suicide Resistant Fixtures


Healthcare providers are consistently faced with a large undertaking – constructing, building, operating, and maintaining a place that houses many different individuals under their direct care.

In healthcare, there are also risks involved with watching after patients with mental illness or risk of suicide, particularly in behavioral healthcare or mental health facilities. According to The Joint Commission, 70% of suicides occur using ligature points in a patient’s bathroom, bedroom, or closet area. These same risks are also present in other facilities, such as general hospitals, rehabilitation centers, surgical units, or long-term care facilities.

There are many challenges or factors to consider when constructing these facilities with suicide resistant or ligature resistant products. Here are some ligature resistant construction tips for healthcare facilities and providers:

1. Safety Awareness

How do you know where the hazards are in a patient’s living or recovery area? The first step of this process is to accurately identify where patients could be at risk when unsupervised, such as an opportunity to create a sharp object, a ligature point for hanging, or any other means of self-harm.

While there are many potential dangers in any situation, here are a few things in a patient’s living area that could be used to harm oneself or others:

  • Shower heads, knobs, valves, panels, drains, or other fixtures
  • Sinks, faucets, knobs, drains, or sink pipes
  • Mirrors, signs, frames, or art pieces (glass or shattering matter)
  • Grab bars or ADA assistance fixtures
  • Towel hooks, key hooks, or coat racks
  • Toilet bowl, seat, flush handle, water tank, or pipes
  • Liquid or paper dispensers (soap, paper towels, toilet paper, hand sanitizer, and others)
  • Furniture (beds, chairs, storage, bookcases, dressers, desks, nightstands, and many others)
  • Exhaust or supply grilles, ventilation grates, and others
  • Air conditioning and PTAC units or other fixtures
  • Thermostat, electrical outlets, light switches, or cable outlets
  • Doors, door handles or knobs, deadbolts, and hinges
  • Televisions, tablets or computers, and their cables or cords
  • Windows, blinds, curtains, curtain rods, or shades

While some of these fixtures may seem basic in a living area, each of those appliances or furniture has the potential to be turned into a hazard if tampered with or used for ligature. Ligature resistant fixtures are designed to deter hanging points, tampering, shattering, or other actions for harm. It is essential to be aware of the danger and replace standard fixtures with fixtures that are ligature resistant, tamper-resistant, and abuse-resistant.

2. Meeting Standards & Regulatory Code

In any healthcare setting, many codes and standards must be adhered to. These codes and regulations include fire, electricity, sanitation, ADA, OSHA, and many more. Choosing products or fixtures that are compliant and considered safe by the governing body that oversees a facility is essential. This should be discussed at length during a facility’s planning and pre-design phase. It would be helpful to select and plan for ligature resistant products that meet those standards ahead of any construction decisions.

3. Installation Time & Costs

Whether it be new construction or an alteration or renovation of an existing facility, installation costs are a significant factor to consider. Installation time and cost directly impact a facility’s financial health, quality, and timing of care for patients, so choosing the best ligature resistant products that alleviate these concerns is highly beneficial. Opening a facility on time can reduce overall costs and give you more time to treat patients.

4. Reliability & Sustainability

As with many products in a household or facility, furniture or appliances can break. In a healthcare facility with mental illness as a concern for patients, this can be dangerous. A broken sink, toilet, or mirror (made of sharp porcelain or glass) could create a weapon, sharp edge, or ligature point. Choosing durable and reliable products that stand the test of time in your facility will not only reduce costs in the long run, but have a much higher chance of keeping your patients safe from harm. Durable materials, such as polycarbonate or aircraft-grade aluminum make those products solid and reliable.

5. Maintenance Procedures & Costs

As with any facility, appliances can break or need replacement parts. When a repair is in motion, such as a broken sink or shower, the patient cannot use that room until the fixes are complete. This can introduce a room shortage, higher costs, unsatisfied patients, or frustration. Ligature resistant products should be designed to be low-maintenance and cost less to maintain to save time and money. While maintenance is expected in any healthcare facility, choosing fixtures with easily lockable access panels and safety enclosures can allow maintenance staff to quickly and efficiently complete repairs.

6. Design Aesthetics

Aesthetically pleasing environments are very beneficial for healthcare patients. Negative features such as hard metallic features or poor lighting can make a space feel threatening or unwelcoming. Settings such as this can make patients feel intimidated or cause anxiety. Creating a place of care that helps its inhabitants feel at home with a comforting design can be excellent for residents and the healthcare staff who spend their time working there. Ligature resistant products should be safe for patients and support a patient’s mental and environmental well-being.

With over 45 years of experience in the behavioral healthcare industry, Behavioral Safety Product’s passion is to save patient lives while improving the quality of their environment. We work with facilities, architects, and engineers to be front-runners in problem-solving as new safety issues arise. Behavioral Safety also provides rapid access to critical products, as facilities face steady increases in patient acuity and greater difficulty in patient monitoring. We equip customers with an integration of engineering input, product support, and knowledge from extensive field experience that will assist any facility.

Behavioral Safety specializes in designing products for patient environments that promote suicide prevention. Our extensive line of ligature resistant products can completely outfit a new facility or retrofit an existing one. Are you interested in our products and our cause? Feel free to contact us or learn about our mission for more.



The Joint Commission

Information and Technical Assistance on the Americans with Disabilities Act

U.S. Department of Labor – Occupational Safety and Health Administration