Safety and security in a therapeutic setting

Design engineers, Safehinge Primera, are passionate about working alongside mental healthcare providers to develop products that create safe spaces for recovery. A facility that encapsulates this is The Junipers Psychiatric Intensive Care Unit in Wonford, Exeter – purpose-designed to allow patients to recover in a safe, therapeutic environment. Having worked closely with Devon Partnership NHS Trust (DPT) to achieve this, Safehinge Primera’s Business Development manager, Sebastian Mann, discusses the importance of working with mental healthcare providers to overcome challenges through good design, and ‘why safety doesn’t have to be institutional’.

When I first began discussions surrounding The Junipers with DPT, it was clear that we had a shared passion. We want to help people at vulnerable times – that’s ultimately why we do what we do. I knew it was set to be a particularly special facility, as it is the first of its kind in the south-west of England; offering inpatient support that’s closer to home for people with complex mental health needs. Before it was built, patients and their families were forced to travel long distances to receive the support they needed – causing unnecessary additional strain for all of those involved. It was clear that this new facility was going to transform people’s lives for the better, and I felt – and still feel – very privileged to be a part of it.

The impact of good design At our core, we’re product designers – which means our role is to listen to the challenges faced by those on the frontline

of mental health environments, and demonstrate the impact that good design can have. We truly believe that a combination of well-designed products with good clinical practice can deliver a step-change to inpatient safety within the bedroom – the place where 67% of inpatient suicides sadly occur.1

Safety within the bedroom was therefore our main priority for The Junipers. DPT advised me that it had looked into installing a full door with a door-top ligature alarm for the en-suite within each bedroom. From experience, I knew that this presented a major risk for a number of reasons. Firstly, this creates a blind spot for clinical staff while carrying out observations, and, secondly, there are known ways in which to create a ligature on this kind of door.

It was at this point that we introduced

our en-suite door. Developed and tested over a period of 18 months, our load

release door has no known ligature points, and still allows staff to carry out partial observations – ultimately moving the risk away from this area of the bedroom, while still maintaining patients’ privacy and dignity.

DPT was also very keen, like us, to ensure that The Junipers was a welcoming and therapeutic space for patients, and chose a mixture of beach and mint green prints for the en-suite doors to help create this.

Moving the risk to the bedroom door

We know that there is a harsh reality when it comes to mental health inpatient facilities – and that is that often patients attempt to take their own lives. Generally, we find that these attempts are not in isolation, and that patients will continue to search for new ways to be successful. By removing the opportunity for ligature learning on the en-suite door, this immediately moved the risk to the bedroom door within The Junipers – given that 46% of ligatures are attempted on the door or door hardware.1 DPT had considered using a door-top alarm on the bedroom doors, as this was a solution that the Trust was familiar with. We’d previously shared with the Trust concerns over the effectiveness and risks associated, with news of a number of successful suicides in inpatient environments that had door-top alarms fitted. This is what led us on to speaking at length about how we came to develop our full-door ligature alarm.

Turning the door into a weighing scale

‘A great example of how safety in mental health environments doesn’t have to be institutional’. 24

Door-top alarms have been around for a long time – originating in the US over 10 years ago. A chunky metal strip across the top of the door, these alarms are institutional by design, but, most importantly, they don’t address all risk points on the door, and that can be the difference between life and death.


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