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Fixed attachment points in psychiatric care patient rooms

Hanging and strangulation using fixed attachment points are the most common methods of suicide during inpatient stays in psychiatric care. Suicide is often an impulsive act, and readily accessible attachment points pose a risk. 

Attachment Points 

In this report, we use the term "attachment points" for interior details that patients can use to commit suicide by strangulation (hanging or suffocation). In the international literature, these attachment points are referred to as "ligature points." The higher up on the wall the point is, the greater the risk of suicide. However, attachment points down to floor level have also been reported. More discussion and a Danish report can be found in an appendix on attachment points. 

Over the past year, Ukom has received several reports of deaths where patients have used attachment points. We have investigated which risky attachment points exist in patient rooms in psychiatric care. Incident analyses and inspection reports following suicides in institutions most often focus primarily on suicide risk assessments and specific safety measures around the individual patient. In this report, we address prevention measures that institutions can implement independently of risk assessments related to the individual patient. The report can support construction projects and control activities. Staff involved in operations and maintenance, rehabilitation, and new construction will find practical guidance in the report. 

Ukom recommends that institutions replace dangerous attachment points with safer and dignified solutions. We advise regulatory authorities to follow up on institutions' prevention work. Hospital Construction HF is an advisory body for safer patient rooms. Data from the National Suicide Mapping System is a valuable source for assessing new measures. 

This report is aimed at healthcare professionals, leaders, and others responsible for improving safety and dignity in psychiatric care institutions. 

The translation from Norwegian to English is based in AI. Ukom has reviewed, edited and quality assured the translation.