By Healthcare Facilities Today

Psychiatric hospitals have their own design needs and do not necessarily benefit from the evidence-based design practices suitable for a general hospital, according to an article in Behavioral Healthcare. Failing to consider design-based solutions possible in behavioral health facilities can expose patients to increased risk, pose challenges to the staff entrusted with their care and add unnecessary long-term costs as these risks are mitigated with operational strategies, such as increased staffing.

A primary concern in psychiatric hospitals is the increased risk for suicide. There are several assumptions in the design community that presume certain mitigation strategies are effective and certain design risks are unavoidable, which should be questioned, according to the article.

The American Psychiatric Association and the Veterans Hospital Administration have deemed unreliable the tools used by healthcare professionals to evaluate suicide risk in patients. Therefore, facility considerations should assume all patients will be at risk and all design should be as suicide-resistant as possible.

A proposed cost-saving measure might be to provide the unit with a few more specialized rooms within view of the nurse station for patients considered at risk for suicide attempt. However, at the very least this puts unnecessary strain on staff to constantly evaluate which patients are in most need.

Behavioral Healthcare reports there are tools available to minimize the ligature risk of tight fitting doors, which are required by code and are often considered an unavoidable risk factor. These include pressure sensors, which would alarm to a central station. Anti-ligature door hardware is also available.

There is no safe zone when it comes to ligature attachment, neither in terms of height nor in terms of space use, such as patient rooms versus spaces like offices or storerooms. Often these spaces where patients are never expected are left unlocked.

Even doors on patient wardrobes and cabinets case pose a risk, both as a point of ligature attachment and as potential weapons. Curtains and drapes, even when used with breakaway hangers, should be avoided.

Read the article.