Ligature and/or Suicide Risk Reduction - Inpatient Psychiatric Units - Tamper Resistant Receptacles

Are Tamper Resistant Receptacles (TRRs) required in a Behavior Health In-Patient Setting?

Any examples are for illustrative purposes only.

Yes, although there is some disagreement about the effectiveness of tamper resistant with arc fault and ground interruption, The Joint Commission requires these devices to be installed throughout the psychiatric unit, patient bedrooms and restrooms, corridors and common spaces. TRRs provide a simple, affordable, reliable, and permanent solution to help prevent injuries.

Technical Information:
Automatic Protection
TRRs look just like ordinary outlets but are designed with spring-loaded receptacle cover plates that close off the receptacle openings, or slots.
When equal pressure is simultaneously applied to both sides, the receptacle cover plates open to allow the standard plug to make contact with the receptacle contact points. Without this simultaneous pressure, the cover plates remain closed, preventing insertion of foreign objects and protecting patients from painful, traumatic electrical injuries.  In fact, TRRs have proven to be so effective that the National Electrical Code (NEC) now requires them to be installed in all new home construction.  

Accidental or Deliberate Self-Harm
Provide tamper resistant receptacles with arc fault and ground fault interruption in all patient accessible areas of all psychiatric hospitals and wards.

Tamper Resistant Receptacles
Tamper resistant receptacles do not provide an adequate level of protection against self-harm alone. Tamper resistant electrical receptacles are designed to prevent accidental electrical self-harm to toddlers and small children. They are not designed to protect against intentional self-harm due to deliberate attack by adults. The protective measures of a tamper resistant receptacle can be easily defeated by older children and adults. Once defeated, electrical self-harm can be induced by either arc or ground fault. Arc fault self-harm can be induced by holding two insulated conductors (e.g. paper clips while holding them in flexible plastic or rubber as an insulator) and bending them close enough together to get an electrical current to arc between them, perhaps in an effort to create a cigarette lighter or start a fire. Ground fault self-harm can be induced by grounding oneself (e.g. to the floor) while holding one conductor (i.e., paper clips) in the hot side of the receptacle, causing the electrical current to flow through oneself to the ground.

NY Office of Mental Health Design Guide Division 26 Electrical
AFCI (Arc Fault Circuit Interrupter) & GFCI (Ground Fault Circuit Interrupter) Protection
“Caution: Provide tamper resistant receptacles with arc fault and ground fault interruption in all patient accessible areas of all psychiatric hospitals”.

Additional Resource:
Suicide Prevention Portal

Last updated on February 22, 2021
Manual: Behavioral Health
Chapter: National Patient Safety Goals NPSG

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