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mental health & dementia
News archive - September 2015
Lack of guidance stifles anti-ligature innovation
Mental health design is a very-specialist area, and nowhere is this more apparent than in the manufacturing of products.
Due to the very-sensitive nature of mental health conditions, the environment in which people are treated must be safe, secure and, above all, therapeutic.
Over the past 10 years this has led to a large number of product manufacturers launching anti-ligature ranges, helping providers to keep patients safe and cutting down on the number of hangings within psychiatric units.
Pretty much every trust, particularly NHS organisations, will now routinely specify anti-ligature fixtures, fittings and furniture in their units.
But this increasing trend has come about despite the fact there is no official guidance covering how manufacturers should test these products.
Instead, each company draws up its own regime and then, the majority of the time, the mental health trust itself will carry out further testing before choosing which products to buy.
Speaking to hdm, Philip Ross, director of Safehinge, explains: “The main issue we have is that the tests which do exist are extremely unscientific and not repeatable.
“What we do is basically whack products with a mallet, but me doing that and someone else doing that will bring very different results. It makes it almost physically impossible to compare one product to another.
“The other challenge is that mental health organisations are, on the whole, very untrusting and will still want to do the tests themselves and that’s time consuming for all of us.
“It’s an inefficient way to do things and in my opinion it stifles innovation and trusts do not get best-value procurement.”
This is a view shared by David Vesty, managing director of Tough Furniture. He said: “When you get into these very-detailed areas like mental health, it’s very hard.
“Most of the current guidance covers normal use and not extreme situations, such as mental health environments, so manufacturers have to come up with their own tests.”
Testing the load
The closest thing currently to official standards for this area is The Door & Hardware Federation’s Technical Specification TS001:2013.
Aimed at addressing the safety of people who may be at risk of self-harm while in special care environments; it is primarily aimed at door hardware, but can also include non-door-mounted hardware such as coat hooks and curtain rails.
It introduces three tests. The first is ‘Multi-Directional’ testing. This is a test for fixed hardware devices and fixed mounting devices tested in multiple directions; up, down, left, right and away from the face of the mounting surface. The test load is 0.475kg and classifications are A1 to A4 depending on the test wire diameter.
The second test is ‘Vertically Downwards’. This is a test for fixed hardware devices tested in a downward direction only. The test load is 0.475kg and classifications are B1 to B4 depending on the test wire diameter.
Lastly is the ‘Load Release’ test. This is for load release hardware devices. The test wire has a diameter of 4mm and classifications are C1 and C4 depending on the test weight used.
Manufacturers are already using this standard to gauge the effectiveness of products. One of these is Primera Life, which has recently published a flyer covering the Door & Hardware Federation standard.
A spokesman said: “The specification has been adopted by the Guild of Architectural Ironmongers and we use it to test and classify all of our anti-ligature hardware.
“We’ve proven that our fixed door hardware won’t support a 0.475kg load on a 0.5mm ligature, either vertically downwards or in multi-directional tests. We’ve also shown that our CLIK load release system separates under a 10kg load. Put simply, we’ve demonstrated that our products can improve the chances of survival for those who may attempt to take their own lives.”
A design challenge
But for manufacturers whose products fall outside the remit of this guidance, there is some hope.
Safehinge is taking the lead and working on its own guidance which will be transferable to other manufacturers.
The Design in Mental Health Network and the Building Research Establishment (BRE) are also currently looking to introduce joint standards.
In the meantime, manufacturers need to work closely with mental health providers, says Vesty.
He added: “With anti-ligature devices you can’t test for every possible event. Instead, you have to be customer led, and at the moment every customer wants something different. They will have entirely different risk assessments and you’ll always get one customer who will regale you with stories of what people do and what they perceive to be a ligature risk.
“Yes we do need standards, but I think they are a way off, so it’s about working with customers to find out what they want and then, as designers, coming up with the most-innovative solution.”