Image courtesy of Safehinge Primera

Health care is facing a unique challenge. 

Ninety percent of suicides in mental health care facilities occur on a door or door hardware.  In fact, patients in behavioral health environments can create a ligature point on a door in just a few seconds. This can have a devastating impact and cause harm to the patient and, in some instances, a loss of life. 

Sadly, many patients attempt to take their own life in a private area, such as their bedroom or bathroom. Although privacy creates risk in behavioral health environments it is also pivotal in helping to aid positive patient outcomes, particularly for those who experience sleep disruption or have past experiences related to sexual or physical abuse, in which case shared rooms may bring on feelings of discomfort.  

Time is critical

Even though staff are required to provide regular patient observations, they cannot be everywhere at once. With increasing demands placed on a health care worker’s time, the risk of patients attempting to take their own life increases as well. Patients knowing that there is a window of time before their next observation creates an opportunity for them to barricade themselves in their room and create a ligature on their bedroom door.  

Doors are the most commonly used barrier when a patient attempts to take their own life. Patients can block their door or tamper with the lock to prevent staff from entering the room. They may use items such as a belt or bedsheet to wedge the door shut, or place chewing gum or pins inside the lock to prevent clinicians from unlocking the door from the outside.  

In one case, a behavioral health patient trapped an environmental services worker inside a room by pressing their hand hard against the door, which also pressed against the worker's neck.

Fortunately, on-site construction workers intervened and opened the door using a mallet to break open the lock and save the patient and worker in time and support the patient in distress. However, this could have been a different story if the construction workers could not access the room in time. Safehinge Primera’s Anti-barricade Door Set with Full-Door Ligature Alarm is designed to prevent these types of incidents. 

What is the solution? 

Nearly 54% of ligatures occur at a lower level on the door, making door technology crucial in preventing patient suicides in behavioral health environments. 

These specialized settings are designed to provide care and support for individuals with mental health challenges, including those at risk of self-harm. 

Implementing advanced door systems can significantly enhance patient safety and minimize the potential for suicide attempts. The technology itself can never replace staff and the human connection that is vital to promoting positive patient outcomes, but it can be used to support staff by alerting them of an emergency when every minute counts.  

First for Safety … by Design

Safehinge Primera has worked together with clinicians, architects and others to design the fastest Anti-barricade Door Set featuring one of the only Full-Door Ligature Alarms on the market. In an emergency, this world-leading door set provides staff access to a patient's room in seconds. Here are some of the door set’s innovative features:

Reliably release the anti-barricade stop. Swiftstop, a collapsible anti-barricade doorstop, is released by the turn of a single key to provide emergency staff access quickly, even if internal pressure is applied by the patient on the bedroom side. The bedroom door can be pulled outward when the anti-barricade stop is released, overcoming the most determined barricade scenarios. Swiftstop has a discreet design that complements the door and provides a more residential feel, helping to create a therapeutic environment. The Safehinge Primera team also created the same key for their vision panel and doorstop to allow staff to observe and access a room, integral for saving lives.

Operate from a position of safety. Standing safely to one side to avoid the outward swing of the door path, staff can keep out of harm's way and position themselves with a clear line of sight into the patient's bedroom.

Early detection with Full-Door Ligature Alarm. The Full-Door Ligature Alarm further enhances safety by providing early detection of ligature attempts with live status monitoring by turning the entire door into a weighing scale that detects vertical loads over 5 kilograms. This feature helps staff intervene promptly to prevent patients from causing themselves harm. The alarm system is integrated into the door, enabling full coverage and immediate notification in case of any ligature activity. Alerting the staff allows them to react swiftly and save lives.

Real-time monitoring and valuable data. The Full-Door Ligature Alarm provides an added layer of safety by detecting ligature attempts in real time. Additionally, the system provides detailed reports of door usage, giving health care facilities valuable data on patterns in patient behavior for further analysis and improvement of safety protocols.

Minimizing staff stress and increasing efficiency. In an emergency, every second counts. Safehinge Primera’s technology helps to reduce staff stress by allowing fast and reliable access to a patient’s bedroom. 

Focusing on outcomes 

This door set supports the prevention of barricade incidents, and early detection provided by the ligature alarm helps staff to respond quickly, potentially preventing life-threatening situations. With this technology, health care staff can focus more on providing timely and effective support by reducing the time spent accessing a patient's room. Additionally, patients can feel more secure knowing that staff can promptly respond to their needs. This improved sense of safety can positively impact patient outcomes. 

Overall, the issue of suicides occurring on doors or door hardware in behavioral health environments is a growing concern that requires effective solutions. Patients in these settings can create a ligature on a door in seconds, posing a severe risk to their lives. Despite regular observations, staff can't be present everywhere at all times. Additionally, staff shortages and increasing demands further exacerbate the risk. 

By combining technological innovations with a focus on staff and patient safety, such as Safehinge Primera’s Anti-barricade Door Set with Full-Door Ligature Alarm, behavioral health facilities can enhance overall patient care, reduce staff and patient risks, and promote a supportive and healing environment.


Blaire Breslin is the senior marketing executive at Safehinge Primera.