Doors between patient rooms and corridors as well as patient bathrooms are frequently used by patients in committing suicide. Studies by The Joint Commission (Suicide Prevention: Toolkit for Implementing National Safety Goal 15A: (2007) Joint Commission Resources) and the VA Hospital System (Mills P. (2008) Inpatient Suicide and Suicide Attempts in Veterans Affairs Hospitals) have shown that these doors present a significant suicide risk to patients.
Tight fitting doors are typically required by applicable building codes for corridor doors to limit the spread of fire and smoke. There are other options available for patient bathroom doors that open directly into the patient rooms, but these options are frequently not applicable for facilities that feel the need to be able to occasionally lock patients out of their bathrooms.
Door hinges and the handles may provide ligature attachment possibilities and there are a variety of products available to reduce these potential hazards.
The joint between the top of the door and the head of the door frame is more difficult to address. There are several products available that will detect downward pressure being exerted on the top of a door by an object that is placed over the top of the door, such as a sheet with a knot tied in it or an article of clothing such as a sweatshirt or pair of jeans. These sensors will activate an alarm to alert staff of the situation and the location from which the alarm originated. Some of these devices can integrate with a facility’s present alarm systems and/or pager or cell phone reporting system. These alarm systems have been available for a few years and the various manufacturers will be able to provide references for their products and reasons why their product is the best choice for your particular facility.
Which product is chosen by a particular hospital is not as important to me as getting more facilities to utilize this technology to help reduce the number of inpatient suicides which are continuing to raise (according to the latest data from The Joint Commission) regardless of concentrated efforts to reduce their number for several years.
More information on specific products and sources for over the door alarm systems (as well as hinges and handles) is available in the “Design Guide for the Built Environment of Behavioral Health Facilities” that is published by the National Association of Psychiatric Health Systems and is available free of charge from their website www.naphs.org .