What does ‘anti-ligature’ mean?
The term ‘anti-ligature’ describes any object that is designed to prevent the ability of securing a ligature to it.
As such, anti-ligature design plays a crucial role in protecting those who are most vulnerable in mental health and challenging environments by reducing the risk of self-harm or suicide by use of a ligature.
Best practices within design for mental health facilities have greatly improved in recent years through collaborative efforts to create safer environments. Anti-ligature design is one of the factors that has played a key role in this.

What is a 'ligature'?
A ‘ligature’ is any item that can be used to tie or bind something tightly, such as a rope, cord, or items of clothing or bedding. Such items pose a significant risk in mental health settings and challenging environments for their potential to be used in self-harm or suicide attempts. This risk is increased by the presence of ‘ligature points’ – a point on furniture, architecture, or any other physical object that allows a ligature to be affixed.
Anti-ligature design reduces the presence of these ligature points and therefore plays an essential role in mitigating the risk of a ligature being used to self-harm.

Why is 'anti-ligature' design important?
Drawing guidance from research across the globe, a study carried out in 2012 into cases of suicide within psychiatric wards in England and Wales found that of the 448 suicides that occurred between 1999-2007, 77% were by hanging. The study highlighted the most common ligature points as doors, hooks, handles, and windows. The most common ligatures used were belts, sheets, and towels.
The National Confidential Inquiry into Suicide and Safety in Mental Health Annual Report 2022 investigated data on UK suicides between 2009-2019. The report found that 49% of deaths by hanging or strangulation on wards used a door as a ligature point.

What anti-ligature solutions are available?
Kingsway offer an extensive range of anti-ligature internal door sets to ensure the ligature risk can be reduced in any given area of a mental health facility, including; service user bedrooms, staff areas, communal spaces, washroom facilities and more.
Our anti-ligature Complete Door Systems are designed in collaboration with healthcare professionals and Experts by Experience to help prevent service user self-harm or suicide within challenging environments. Through our expertise gained in delivering anti-ligature solutions for over 10,000 projects globally, we ensure the best-suited materials are selected to deliver the robustness and reliability demanded by mental health environments.
Aesthetically pleasing without sacrificing safety or security, our products improve patient and staff safety within challenging environments while contributing to creating therapeutic, de-institutionalised spaces. And as your partner in patient safety, all our Complete Door Systems come with a 5-Year Manufacturer’s Defect Guarantee at no extra cost.
In addition to anti-ligature door systems, we offer a number of anti-ligature solutions to reduce risk within challenging mental health settings, including washroom dispensers, shatter-resistant mirrors, coat & towel hooks, handrails and more.

What are 'ligature monitors'?
A ligature monitor is a device that can detect ligature attempts and will alert staff to allow swift clinical intervention. Their use can dramatically improve staff responsiveness to life-threatening incidents. Our SENTRY Complete Door System features anti-ligature design along with ligature monitoring technology that spans the full length of all exposed edges on the doorset. The ligature monitors will alert staff if a service user attempts to anchor or wedge a ligature.
To maximise the benefits of ligature monitors and to support staff further, we have developed our KOSMOS Smart Monitoring System – the next-generation ligature monitoring software. KOSMOS provides live ligature monitoring across wards with early warning indicators to enable proactive clinical intervention. KOSMOS also aids management teams by providing invaluable data for future review. By recording a complete audit trail of patient activity, staff observations and alarm activations, KOSMOS can help management teams review patient care quality and highlight key trends on wards.
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Joondalup Health Campus, Perth, Western Australia
Mental HealthThe Joondalup Health Campus is the largest health care facility in the northern suburbs of Perth with a total capacity of over 700 beds; 102 of which being specifically for mental health care services.
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Dorset HealthCare University NHS Foundation Trust – Kimmeridge Court
Eating Disorder UnitKingsway Group provided a bespoke anti-ligature and anti-barricade doorset package to minimise risk in the new UK-based Eating Disorder Unit.
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South West London & St George’s Mental Health NHS Trust – Trinity Building
CAMHS UnitKingsway Group were approached by the Trust’s design team and architects to work collaboratively on selecting and fine tuning our door packages to suit the specific requirements for this project.
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