Four reasons medical centers require ligature resistant door hardware throughout their facility

Suicide Prevention Today

Since recorded history, mental illness and suicide have been a shadow in many cultures read more. This shadow still exists, and it is a sad fact that many lives are lost every year. Sadly, some of these deaths were preventable. In 2020, suicide was among the top nine causes of death for people aged 10 to 65. Suicide was the second leading cause of death for people between 10-14 and 25-34. It’s a sad statistic to add to an already challenging topic: ligature-resistant door hardware.

There are a number of educational, prevention, and rehabilitation groups as well as support organizations that can shed light on the dark side of modern life. The American Hospital Association (AHA) also follows guidelines from the American Society for Health Care Engineering, and Joint Commission. These guidelines include making patient rooms, bathrooms, corridors, and common patient care areas “ligature-resistant.”

The guidelines only apply to the psychiatric unit of the hospital and not the entire building. The protocol is reasonable except when all behavioral beds are full. The patient is then placed in “general population” rooms, which are susceptible to ligatures.

Four good reasons.

1. Hospitals are vital to the community. They save lives every day. In a typical year, hospitals are responsible for 1,500 suicides. In 75%, suicides happen outside the patient’s front door. Patients in mental distress will check to see if their room is ligature resistant. Many people are discouraged to harm themselves when they enter a space that contains ligature-resistant products.

2. The act of protecting a patient’s physical health is called safety. Webster defines “safety” as the state of not being in danger, or injured; absence of risk. When a patient scans the room and notices that the doors are ligature-resistant, it is a good sign. Installation of ligature-resistant hardware was successful.

3. Fewer lawsuits are filed. It is hard to know the exact number, but there are many lawsuits filed against medical facilities each year where someone believes a suicide could have been prevented. Recently, a 22-year-old woman spent some time in a mental unit. She was allowed to leave her bedroom and walk around the floor. She made a noose in the laundry by tying a bedsheet to the lock of a door. The woman then threw the bedsheet over top, suffocating herself. The hospital failed to install ligature-resistant door locks in the laundry room. As a result, the hospital had to pay $2.2million.

4. If medical centers choose to install ligature-resistant hardware throughout their facility, they will be in a safe environment. Other medical centers may follow suit if they see positive results with the installation of ligature-resistant hardware in public areas. This best practice could also lead to more architectural standards in medical facilities.

Why don’t hospitals have locks that resist ligatures on their doors?

AHA published a piece entitled “Ligature Risk Requirements: Separating Fact from Fiction in Suicide Prevention” which begins by saying: “Few incidents within healthcare facilities are as devastating – and preventable – as a suicide.” The data shows that suicides are common in hospitals. It is important to identify patients at risk and monitor them, as well as remove any tools that could lead a patient to suicide.

It is difficult to find direct information on why ligature-resistant doors are not installed in medical centers. Consider these factors.

1. The cost of ligature-resistant locks is lower and more efficient than any other lock available today, and they are also longer and wider.

2. Only behavioral health facilities require beds that are ligature-resistant. These regulations were developed by the Joint Commission in collaboration with SAMHSA CMS, ASHE and ASHE. All of these organizations are responsible for different aspects of the ligature-resistant environment in psychiatric patients today.

3. Sociologists define social change as “Changes in human interaction and relationships between people and institutions”. Media today are more focused than ever on suicide prevention. It may be that the sheer number of suicides around the world is changing attitudes. A recent study found that every suicide affects up to 135 people.

Medical centers have no excuse not to install ligature-resistant door hardware in their medical rooms. As a group, we cannot come up with a solution that will stop suicide. We can still make a difference if we use our voices and compassion. By continuing to talk about suicide with local leaders and hospital staff, we can save lives.

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