Hanging is the main method of suicide for mental health service users, whether they are in in-patient units or in the community. Hanging may involve suspending the body from a high ligature point although many deaths also occur through asphyxiation or strangulation, without suspension of the body, using a ligature point below head height.

A significant proportion of suicides are believed to occur through impulsive acts, using what may be seen as reasonably obvious ligature points. Because of this data, the National Suicide Prevention Strategy for England (DoH 2002) states that likely ligature points in mental health service environments should be removed or covered. Due to human ingenuity and/or lack of a technical solution, it is not possible for all potential ligature points to be addressed, and a judgment therefore has to be made about the likelihood of something being used as a ligature point. Equally, there may be some potential ligature points that need to remain, since to remove them would create a greater risk to the patient i.e. grab rails in elderly units/disabled access facilities.

Ligature Risks Audit Tool

JustSafety Ligature Audit Tool – To ensure a systematic approach when undertaking audits, JustSafety have developed a simple Ligature Audit Tool which ensures the following is applied:

• Establish, through the person in charge, all areas to which patients have access.
• Check all rooms in a similar and structured manner, working each time from an identified point in the room, and moving left-right and up-down from that point.
• Adopt a systematic approach to the identification of observation points into, and within a room, checking and noting all ligature points which are seen.
• When a ligature point has been identified, the details should be noted on the Ligature Audit Form.
• All sections of the Form should be completed, especially the section headed “Recommended / Remedial Action” and the “Responsible Person for Action”.

For more information about JustSafety’s Ligature Audit Service call 01420 489267

or email info@justsafety.co.uk