Patient Clothing for Mental Health Units: Design Questions for Your Safety Team

Patient clothing for mental health units should be chosen by the unit's clinical and safety team first, with the textile supplier working to their brief rather than the other way round. In practice, that usually means reviewing every tie, cord, drawstring, fastening and seam against the unit's ligature and self-harm risk assessment, and balancing that with dignity, comfort and a sense of normality. A supplier can make what the team specifies; it cannot decide what is safe for your patients.

This post explains the questions a procurement or linen manager should take to the clinical team, the design choices that typically come up, and how to run a safe sampling and approval process.

Why mental health units are different

On most wards, patient gowns are chosen for access, comfort and laundry life. In mental health settings the priorities change. Patients may be at risk of self-harm, may be distressed or disoriented, and often stay for weeks rather than days. They are usually mobile, spend time in communal areas and take part in activities.

That creates two pressures that pull in different directions:

• Safety: any part of a garment that could be used as a ligature, or removed and misused, needs scrutiny.
• Dignity and recovery: many clinicians prefer patients to wear their own clothes or clothing that looks like everyday wear, because a hospital gown can feel stigmatising and institutional.

Only the clinical team can weigh these for their patient group. Your role is to bring them clear options and a supplier who will build to their decisions.

Start with the clinical and safety team

Before you request any quotation, agree a short written brief with the people responsible for patient safety on the unit. That normally includes the nurse in charge or ward manager, the consultant psychiatrist or clinical lead, and whoever owns the unit's environmental or ligature risk assessment. Infection control may also need to be involved for laundering.

Questions to settle with them:

1. Which patients will wear unit-issued clothing, and in what circumstances? (For example, on admission only, when own clothing is unavailable, or under specific observation levels.)
2. Are ties, cords and drawstrings permitted at all? If not, what fastenings are acceptable?
3. Are pockets permitted?
4. What tear behaviour does the team want from the fabric and seams, if any? Specialist anti-ligature garments exist and are a different product category; the team should decide whether they are needed.
5. Should garments look like hospital wear or like everyday clothing?
6. How should garments be marked so they return from the laundry without creating a hazard (for example, labels that cannot be removed and misused)?

Record the answers. They become the specification, and they protect everyone if the design is later questioned.

Design features to review with the team

The table below lists features that commonly come up. It is a prompt for discussion, not a recommendation. The clinical team decides what applies.

Feature	Why it is reviewed	Options to discuss
Ties and tapes	Can be removed or used as a ligature	Omit, replace with press studs, or use a pull-on design
Drawstrings in waistbands	Same concern as ties	Enclosed elastic waist with no cord
Long sleeves	Usually fine, but cuffs and tabs are reviewed	Plain hems, no tabs or loops
Pockets	Concealment of items	Omit or keep shallow, as the team prefers
Belt loops, hanging loops, tabs	Possible anchor points	Omit
Labels	Could be removed; sharp edges	Printed or woven-in marking agreed with the team
Fastenings	Small parts, metal	Press studs or pull-on designs, as the team prefers
Fabric and seam strength	Affects how a garment tears	Team decides; specialist garments if required

Pull-on designs

Many units move away from open-back gowns entirely and use simple pull-on tops and trousers with no ties or drawstrings. These look more like everyday clothing and remove several features from the risk list at once. Our post on patient tops and trousers covers this garment type in general terms.

Fastenings

Where a fastening is needed, the choice between ties and press studs matters more here than anywhere else in the hospital. Our general comparison of ties vs press studs on patient gowns covers laundering and ease of use; in a mental health setting, the clinical team's view on each option overrides those practical points.

Dignity, comfort and normality

Safety review can strip a garment back so far that it looks institutional. That is worth resisting where the team agrees it is safe to do so.

• Colour: soft, calm colours are usually preferred over stark white or bright theatre shades. Some units use different colours for different areas so staff can spot clothing from another ward.
• Cut: a relaxed fit that looks like loungewear tends to be better received than a classic hospital gown.
• Fabric: soft cotton or cotton-rich fabric feels more like home clothing. Poly-cotton is more hard-wearing and keeps its shape and colour better through repeated laundering. Ask the team and the laundry together.
• Sizes: patients come in every shape. A narrow size range means some patients wear ill-fitting clothes, which affects dignity. Plan a broad range, including larger sizes.
• Modesty: full-length trousers and longer tops help patients who prefer more coverage.

Laundering and loss

Mental health units often have long stays and patients who keep garments in their rooms, so loss and mixing with personal laundry are common. Clear marking helps, but it has to be agreed with the safety team: sewn-in labels that can be pulled off may be unwelcome, while marking printed or woven into the fabric may be preferred. Our post on marking patient gowns for laundry explains the general options.

Agree with the laundry how unit garments are bagged, washed and returned, and whether they go back to a central store or straight to the unit.

Sampling and sign-off

Because the stakes are higher, sampling should be more structured than for a general ward.

1. Send the written brief to the supplier and ask for a sample made exactly to it.
2. Have the clinical and safety team inspect the sample against the brief, feature by feature.
3. Launder the sample through your actual process several times and inspect again for loose threads, failing seams or changes to fastenings.
4. Record approval in writing, with photographs of the approved sample.
5. Make sure the approved specification is kept on record so reorders match exactly. Any change (fabric, fastening, label) should go back to the team before it is accepted.

A short checklist

• Written brief agreed with the clinical and safety team
• Decision recorded on ties, drawstrings, pockets, loops and labels
• Fastening type approved by the team
• Colour, cut and size range chosen with dignity in mind
• Marking method approved by the team
• Sample inspected, laundered and re-inspected
• Approval recorded, and specification locked for reorders

Working with a supplier

A good supplier will ask for your clinical team's brief rather than offering a "safe" design of its own. MISHAREN makes reusable patient gowns, tops and trousers to order at its own production unit in Konni, Kerala, shipping to the UAE and delivering across all seven emirates. Fastenings (ties, press studs or a mix), sleeve length, fabric, colour by ward, sizes and marking are all set by your specification, and a sample is approved before bulk. MISHAREN does not certify garments as anti-ligature or safe for any particular patient group; that judgement stays with your clinical team.

To discuss a specification your safety team has drawn up, see our patient gowns page or contact us for a quotation.