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open door

Locking mental health patients into wards 'does not reduce suicide risk'

German research carried out over a 14-year period has cast doubts over the practice.

AN EXTENSIVE NEW study has shown that there could be a significant misunderstanding in the treatment of mental health patients.

The 14-year project, which looked at the prevalence of suicide among residents of mental health facilities in Germany, found a lower rate among those on wards with open-door policies, than those on wards with locked-door policies.

Allowing residents to come and go was more likely to create a better therapeutic atmosphere and facilitate better outcomes, the study said.

Irish mental health facilities

While the results only apply to Germany, they have a bearing on how things are done in the Irish system.

Mental health inpatient facilities in this country have become increasingly open over the past decades, but locked wards are still used in some cases for patients that are categorised as ‘difficult to manage’.

In the study, the authors warn that further research with different groups of patients is required to understand how universally applicable the results are – but that it is possible that the study “could challenge medical practice in many countries”.

What exactly did it find? 

The research looked at 145,000 patients between 1998 and 2012.

Three measures were looked at as part of the study: suicides, suicide attempts and patients absconding.

The different mental health conditions of those included in the study were taken into account as a variable.

It was found that patients being treated on open wards were less likely to attempt suicide than those being treated on a locked ward, although there was no difference in the rate of patients completing suicide.

Patients were also no more likely to abscond from open wards than from locked ones.

Speaking about the findings, one of the authors Dr Christian Huber said:

“These findings suggest that locked-door policies may not help to improve the safety of patients in psychiatric hospitals, and are not generally successful in preventing people from absconding.

In fact, a locked-door policy probably imposes a more oppressive atmosphere, which could reduce the effectiveness of treatments, resulting in longer stays in hospital. The practice may even lend motivation for patients to abscond.
Anyone impacted by the issue of suicide can contact the following numbers:
  • Samaritans 116 123 or email
  • Aware 1800 80 48 48 (depression, anxiety)
  • Pieta House 01 601 0000 or email – (suicide, self-harm)
  • Teen-Line Ireland 1800 833 634 (for ages 13 to 19)
  • Childline 1800 66 66 66 (for under 18s)

Read: Girls make up vast majority of young people seeking psychiatric help for eating disorders

Also: Tallaght’s psychiatric nurses ‘exhausted and frustrated’ by staff shortages

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