A toilet or shower room is widely believed to be the most dangerous room in a psychiatric unit. It is the one place where a patient can spend a considerable amount of time completely unsupervised. It is also the hardest space to make safe. The toilet or shower room combines the most opportunities to miss a ligature point with the most time for the patient to identify and act on that opportunity. Yikes!
With that said, this isn’t a post about beautiful finishes or homey environment, except to say that there are many safe, secure and visually acceptable products that, when well organized, can make for a pleasant environment for a toilet room. Please use them. Email me if you need help!
This post is really about the unresolved debate about floor and wall finishes. I say “unresolved” because I hear a variety of opinions from clinical and facilities staff in different hospitals. Some say that tile is a hazard. Too easy to weaponize; too easy to break; too easy to latch on to. This same group often feel it is hard to clean and are looking for a more durable, easier to clean solution. Others say they have never had an issue with tile. It is tried and true, durable, cleanable and repairable. They like and want to keep it. To those that like tile in these rooms, I say, that’s fine. Let’s use an appropriate, cleanable, strong tile with a secure anti-fungal grout and implement regular maintenance and proper cleaning protocols.
To those who oppose the use of tile, I say, here are some options:
- Fluid applied flooring. An epoxy floor with a non-slip aggregate makes an excellent choice for a durable, cleanable floor that is safe and relatively attractive (if you make good color choices). It has the added bonus of being cheaper than tile in most cases. If you go this route, please consider that many of these floors come in bright colors which may not be the best choice for your psychiatric unit. Also, carefully consider the impact of an integral base. Many patients are dealing with some level of cognitive impairment and they may have a hard time seeing where the floor ends and the wall begins if the same color extends up the wall 4 inches.
- Fluid applied flooring – on the wall. If you have bought into the idea of an epoxy floor, it is a short leap to epoxy on the wall as well, for all the same reasons (but please leave out the non-slip aggregate). My concern about bright colors should be doubled in this application. This isn’t my favorite solution because if I was worried about the visual impact of extending the floor materials 4 inches up the wall, I am downright concerned about the idea of extending the same finish all the way up the wall.
- Solid surface wall panels. Solid surface isn’t just for countertops. Used in a thinner application, this material makes a very durable, easily cleanable wall surface. The only joints are the seams between panels which can be covered with a batten of the same material or simply caulked with security sealant (often called pick-proof caulk). Depending on brand, type and color, this will likely cost more than tile, but it does have many long-term advantages.
- FRP panels. Popular in one- to three-star hotels, these panels are inexpensive, durable and are made to look like tile (if you want that). These typically are only available in white, but with the right pattern, it can work well. Hotels are experts at creating a homelike environment, so if they use them, we can too.
My current favorite combination is an epoxy floor with solid surface wall panels. The panels can extend all the way to the floor eliminating the need for an integral base and making for a clear line of demarcation where floor and wall meet.
Whatever your preference, good luck and choose beautifully!