Welcome to our information hub on anti-ligature. Safehinge Primera works closely with professionals at Mental Health Facilities throughout the UK, the United States, and Australia. We deliver anti-ligature products as part of our mission to design for good and to help people in vulnerable times - including lowering ligature and suicide risk. 

      Those working in Mental Healthcare facilities, including Nurses, Ward Managers, Clinicians, Doctors, and Psychiatrists, are all too aware of ligature and barricade risk. For Mental Health care professionals worldwide, anti-ligature products are part of everyday management of minimising risk and ensuring patient safety. They can also positively impact psychological safety and well-being by creating a familiar and comfortable inpatient environment. We have found that anti-ligature products significantly affect patient recovery in Mental Health care environments. 

      Questions and considerations we will cover on this page:

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      What does Anti-Ligature mean?

      Let's start with the definition of Ligature and Anti-ligature.

       

      Ligature on a Door

      Definition of Ligature

      A ligature is a binding or tying material used to tightly connect objects or secure something in place, often referring to a tie around the neck causing compression of airways, resulting in suffocation and death. 

      Within Mental Health facilities, 'ligature' means self-harm. 'Ligature points' continue to be one of the main safety concerns in Mental Health inpatient facilities globally.

      Definition of Anti-ligature

      Anti-ligature refers to devices or products designed to prevent individuals from self-harm or suicide by removing or reducing the possibility of using ligatures to inflict harm or suicide.

      It is a safety measure used in hospitals, prisons, and Mental Health facilities to protect vulnerable individuals from harming themselves. The practice aims to lower ligature risk, risk of patient harm and suicide.

      Anti-Ligature En-Suite Door

      Why are Anti-Ligature products considered essential in Mental Health facilities?


      Anti-ligature products and appliances are critical in promoting a safe, secure, therapeutic environment for Mental Health patients. At their core, these products are designed to prevent individuals from using ligatures to harm themselves, which is a common method of suicide. 

      Patients experiencing Mental Health challenges and life changes may feel trapped and unable to see a path to healing; they may resort to self-harm as a means of coping. Mental health patients are often in a vulnerable and distressed state and may not be able to recognise their path to recovery, which can lead to suicidal thoughts and self-harm attempts. 

      Using anti-ligature products to prevent such harmful acts and suicidal attempts, clinical teams can work more closely with patients to work on their path to recovery. To learn more, visit the key considerations when creating a healing recovery space for patients page.

      Inpatient Suicide Statistics

      Source: National Confidential Inquiry into Suicide and Safety in Mental Health Annual Report 2022

      What Anti-Ligature products exist?

      Various anti-ligature products have been innovated-upon and explicitly created with Mental Health wards in mind. These products usually focus on doors, door handles, window handles, anti-ligature lighting, coat hooks, and shower rails, to name a few. The most crucial developments in this are anti-ligature doors, door handles, window handles, and restrictors. Addressing the risk on those products is critical since they pose the highest risk for ligature suicide attempts. To learn about products designed to reduce ligature risk, visit the Anti-Ligature product page.

       

      Different approaches to Anti-ligature design

      Anti-Ligature design is intended to prevent the attachment of chords, ropes, fabric/material or other objects that patients could use for self-harm or suicide. Several approaches to design are within the category of 'ligature prevention'. These types of designs are used in both Mental Health and correctional/custodial facilities to ensure the safety of patients and inmates.

       

      Load Released Anti-Ligature
      Anti-Ligature Handle
      Anti-Ligature Alarm

      Load-released

      Load Released Anti-Ligature

      These products are typically made of stainless steel or other durable materials and feature a spring-loaded mechanism that releases when a certain amount of weight is applied.

      This allows for the products to be held in place securely but also allows them to be released if needed. Some of these products are also designed to be easy to install and uninstall, providing flexibility in their use, for example, anti-ligature coat hooks. This is a popular anti-ligature tactic due to its ease of implementation. Products like load-released en-suite doors or anti-ligature shower rails only take minutes to install with no specialist equipment.

      Load release detachment diagram

       

      Fixed

      Fixed Anti-Ligature

      Anti-ligature fixed products are designed to prevent people from being able to tie ligatures around fixtures and fittings, such as door locks, door handles and water taps, in order to reduce the risk of self-harm or suicide.

      These products are designed to be robust and secure and can include tamper-proof screws, anti-ligature plates and guards, and other components to reduce the risk of these fixtures being abused.

      handle-with-invisible-backplate-Handle_Exploded-View

       

      Alarm

      Ligature Alarm

      Ligature alarm products are designed to protect people who may be at risk of harming themselves by attaching a ligature.

      These alarms are typically placed on or within the door and can be triggered if the weight is applied to a door or if the door is otherwise tampered with.  When the alarm is triggered, it will alert clinical staff of the potential danger. These alarms provide an additional means of patient observation, which is especially important for busy clinical environments such as Mental Health wards. Knowing the difference between door full-door ligature alarm, door edge alarms, and door top alarms is important. The first two kinds only cover the door's edges and leave the risk undetected on the door's surface (door handle, vision panel, etc.). 

      door-top-alarm-comparison

       

      Anti-Ligature regulations


      While no global or universal anti-ligature policy applies to all Mental Health settings, each NHS Trust within a Local Authority or Private Healthcare Unit will have its own anti-ligature policy. Each approach is based on the interpretation and implementation of recommendations from the government.

      Find out more by visiting the dedicated Mental Health Design Regulations Page.

       

       

      According to the 2022 National Confidential Inquiry into Suicide and Safety in Mental Health, prepared by the Healthcare Quality Improvement Partnership, the most common ligature points are doors -

      49%

       

      Why are Anti-ligature Door Handles and Doorsets especially important?

      A door is an essential consideration for a Mental Health patient as it represents privacy, dignity, and empowerment. Creating an environment as normal as possible is crucial in enabling the patient to succeed in their recovery journey. As clinical teams cannot be everywhere at all times, providing additional observation options through effective door design can significantly aid clinicians in caring for their patients more effectively. Watch our webinar "Considering Mental Health Design From A Patient Perspective" to hear what Katharine Lazenby, an expert by experience, says about taking on a recovery journey within an inpatient Mental Health facility.

      ANTI-BARRICADE DOORSETS

      Patient safety is a priority when choosing a door set for Mental Health bedrooms, requiring both anti-ligature and anti-barricade environmental design.

      Door barricades are common in Mental Health environments, so it's important that clinical staff access patient bedrooms quickly and safely to provide essential help in those barricade situations. 

      Modern anti-barricade door sets have a door release mechanism and anti-barricade locksets to break simple (leaning on the door) and more determined barricades (a compromised lockset). This combination creates a reliable door set for quick access, supporting caregivers and increasing patient safety.

      Where can I purchase Anti-ligature products?

      When it comes to Mental Health environments, safety is always a top priority. 

      That's why choosing the right products is essential to ensure the well-being of patients and staff. At Safehinge Primera, we take pride in offering a wide range of innovative and high-quality anti-ligature products designed to meet the diverse needs of Mental Health facilities. Providing peace of mind for patients and caregivers, our door systems (including ligature door alarms, anti-barricade doorsets, load-release fixings, door locksets & handles, and other anti-ligature products) have been tested by independent testing organisations, proven effective, and compliant with the latest technical standards.

       

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