Month: February 2024

Suicide Prevention Today

Since recorded history anti ligature lock set, suicide and mental illness have lurked in the shadows in many cultures. But the shadow continues to exist, and every year valuable lives, many of which could be prevented, are lost. The suicide rate among those aged 10-64 was expected to be high in 2020. In the age groups of 10-14 years and 25-34, suicide was the number two cause for death. The statistics are discouraging and add further confusion to the topic of ligature-resistant hardware.

Fortunately, today there are a number of educational, prevention, rehabilitation, and support organisations that help to bring this side to light. The American Hospital Association follows the Joint Commission and ASHE guidelines. These guidelines include making patient rooms, bathrooms, corridors, and common patient care areas “ligature-resistant.”

These guidelines only apply to a psychiatric department of a hospital and not to the entire facility. It makes sense to follow this protocol, except when there are no behavioral beds available. In this case, patients are placed in “general populations rooms,” which do not have ligature resistance and can be dangerous for a patient to self harm.

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1. Saving Lives: The hospitals are a valuable asset to any community. They save many lives every day. In hospitals, suicides occur on average every year. 75 percent of these suicides happen at the patient’s bedroom door. Mentally distressed patients scan the room and check for ligature resistance. They are usually discouraged to self-harm if they notice a space with products that resist ligatures.

2. Safety: We refer to measures taken in the hospital’s environment to avoid harm. Webster’s definition of safety begins with “the condition or state of being safe, freedom from risk, injury, and danger.” For example, when a hospital patient checks out the room, they notice the doors that are resistant to ligatures. It was worth the effort to install ligature-resistant equipment.

3. Less Lawsuits: It is hard to determine the exact number, but there are many lawsuits filed against medical centres where people feel that a suicidal act could have been avoided. Recenty, a woman of 22 years old was confined to a behavioral unit. She could move freely on her floor after leaving her room. She entered the laundry room and tied a bedsheet around a latch on the door. She draped the sheet on top of the lock and suffocated. In the laundry, it was discovered that there were no ligature-resistant locks on the doors. They had to pay $2,2 million as a consequence.

4. The best practices: Medical facilities that install hardware resistant to ligatures in all areas of their facility will be safe. Other facilities may also adopt similar measures, if they have had good results with ligature-resistant equipment in rooms for general populations. On the whole, this good practice might also encourage more comprehensive architectural requirements in new medical centers.

Why aren’t all hospitals equipped with ligature resistant door locks?

AHA’s “Ligature Requirements” article, “Separating Fact from Fiction in Suicide Prevention”, begins by saying: “Few health-care events are as tragic — and as preventable — than a suicide. However, data shows that the problem of suicide is a real one. Hospitals must be better at identifying patients that are at high risk for suicide and eliminating the suicide-inducing environment.

It is difficult to find information that explains the lack of ligature-resistant door installation in all medical facilities. We can take into consideration a number of factors.

1. Cost and Efficiency. Even though the ligature-resistant lock is less expensive, it still costs a lot to replace all the existing door locks.

2. Regulations: Ligature resistant environments are currently only required in behavioral health beds. This regulation is from the Joint Commission, in conjunction with SAMHSA CMS, and ASHE. They are each responsible for a different aspect of the ligature resistance environment today in inpatient psychiatric treatment.

3. Sociologists define Social Change as: “Changes to human relationships and interactions that transform social and cultural institutions.” Media coverage of suicide prevention is higher than it has ever been in history. Perhaps the “let’s ignore it and pretend that it doesn’t even exist” attitude is changing due to today’s sheer rise in suicides. Recent research found that every suicide affects up to 135.

Conclusion: There’s no reason to believe that medical facilities haven’t installed ligature-resistant hardware on all doors in medical rooms. As a community, we cannot come up with a solution that will end suicide. However, we can help by contributing our voice, eyes and compassion. We can all save lives if we continue to talk about the topic, with each other and our local hospital leaders.