Journal scan

Locked doors do not help patient wellbeing in mental health units

Prevention of suicides or reducing absconding is not improved by restricting freedom.
Open door health

Patients in psychiatric wards may have better health outcomes if an ‘open door’ policy is operated.

A report in The Lancet Psychiatry suggests that traditional locked-door wards are not effective in reducing patient suicide attempts, or eliminating unauthorised absence.

On the contrary, a 15-year study in Germany of 145,000 patient cases concludes that fewer restrictions create a more therapeutic atmosphere and promote better health outcomes.

While the authors caution that the findings may not apply to all countries, they say the study challenges general preconceptions.

By analysing data from 21 German hospitals from 1998-2012, the report – compiled by researchers at the Universitäre Psychiatrische Kliniken Basel in Switzerland – concludes that rates of suicide attempt and completed suicide did not differ significantly between hospitals with an open-door policy compared to those without.

Similarly, absconding rates (with or without return) were not increased in


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