Anti-ligature design is a specialized form of architecture and product engineering intended to create a safer environment for individuals at risk of self-harm. This preventative safety measure systematically removes or modifies structural elements and fixtures that could be misused as anchor points for a cord, rope, or other material. The goal is to eliminate the possibility of a person creating a ligature, thereby reducing the risk of suicide or serious injury by hanging or strangulation.
Defining Anti-Ligature Design
The fundamental principle of anti-ligature design is the elimination of “ligature points,” which are any fixed structures or objects capable of supporting a person’s weight if a loop or cord were attached. This includes any gap, protrusion, or anchor point that could be used to secure a material like a bedsheet or clothing to create a noose. Standard architectural features such as door handles, coat hooks, or exposed plumbing pipes all pose potential risks in high-risk settings. Designers achieve ligature resistance by making surfaces smooth, rounded, or sloped, preventing anything from being tied around them securely. Instead of a projecting coat hook, for example, a fixture may be recessed into the wall or designed to break away under minimal load.
Key Environments Requiring Ligature Resistance
The application of anti-ligature design is primarily found in facilities housing populations at a heightened risk of self-harm or suicide. These specialized environments include psychiatric hospitals, inpatient behavioral health units, and correctional facilities, such as prisons and jails.
Secure residential treatment centers and certain areas within general hospital emergency departments that manage behavioral health patients are increasingly required to adopt these measures. High-risk areas like patient bedrooms, bathrooms, and corridors must meet rigorous safety requirements because they are often the least supervised spaces.
Regulatory and accreditation standards drive the implementation of these safety features in healthcare settings. The Joint Commission (TJC) emphasizes assessing and mitigating environmental risks, particularly in inpatient psychiatric areas. Furthermore, the Facility Guidelines Institute (FGI) provides specific design criteria that define what constitutes a ligature-resistant environment for new construction and renovation projects.
Common Anti-Ligature Features and Fixtures
Anti-ligature features are implemented across a facility, transforming everyday items into safer, specialized fixtures. Door hardware, for instance, often utilizes recessed handles or handles with sloped tops that prevent a cord from being looped over them. Continuous hinges are frequently used instead of standard hinges to eliminate the small gap between the door and the frame, which could otherwise serve as an anchor point.
In bathrooms, the design modifications are extensive to address the numerous plumbing and accessory risks. Sink basins are often sloped and flush with the wall, and pipes are completely covered by shrouds to prevent access. Specialized showerheads are flush-mounted or designed with minimal projection, and towel rails are engineered to break away when even a small amount of weight is applied. Touchless faucets further minimize protrusions that could be misused in these sensitive areas.
Furniture in these environments is typically heavy and fixed to the floor or wall to prevent it from being moved or used to gain access to ceiling fixtures. All edges of desks, chairs, and beds are rounded or sloped, and the construction is often monolithic or one-piece to eliminate small gaps or exposed anchors. This design approach prevents the furniture itself from becoming a weapon or a tool for creating a ligature point.
Ventilation grilles and other wall-mounted accessories are also specifically designed for ligature resistance. Instead of open slats, these grilles feature a pattern of small, perforated holes that allow for necessary airflow while being too small to pass a thread or cord through. They are often constructed from durable materials like Zintec or Magnelis steel and secured with specialized security fixings to prevent tampering or removal by residents.