Plumbing Design of Psychiatric Facilities

When designing plumbing systems in psychiatric facilities certain considerations must be made that differ from typical plumbing design. For an inpatient facility, the first step is to refer to the most recent edition of the Facility Guidelines Institute (FGI) Guidelines for Design and Construction of Hospitals. Within these guidelines is a section dedicated to the specific requirements for psychiatric hospitals. This section requires design in areas of patient toilet rooms, both adult and adolescent, to conform to ligature resistant plumbing fixtures and where required, sprinkler heads.

What does ligature resistant mean? A point of ligature is a means to create a tie-off point on an object to induce bodily harm or suicide. A point of ligature can be as low as 30” off the ground so special design must be made to incorporate a ligature free environment. In psychiatric facilities FGI requires all plumbing fixtures of patient access to be ligature resistant. This includes, but is not limited to, items such as curtain rods, grab bars, faucets, handles, flush valves and even sprinklers. There are many companies that provide specialized plumbing fixtures that are approved for use in psychiatric facilities. Use care when selecting these fixtures for your specific project.

An example of a ligature resistant faucet would be one in which the neck of the faucet is angled in such a way that a tie-off point would slip off the fixture. Typically these style of faucets will also have push button metering water control valves or sensor activation to eliminate handles all together. When selecting water closets, it is good practice to review shop drawings. If there is a gap between the wall and the fixture, this can be considered a point of ligature. A style of water closet to prevent this would be a floor mounted, back outlet so that the fixture is flush against the wall. A concealed flush valve or flush valve cover would then be specified on the flush valve so that only a portion of the handle is accessible to flush the toilet. To prevent points of ligature on shower heads, valves and sprinkler heads select institutional style fixtures that are flush to the wall and ceiling.

It is an important practice to stay up to date on all plumbing fixture manufacturers as requirements change in future editions of the FGI. Verify all fixtures maintain institutional standards and meet your specific hospital criteria.

If you would like more information or assistance, please contact David Taylor, PE at or (717) 845-7654.