As reported recently in the Vermont Digger, there is a bill (H. 593) in the Vermont Legislature that would require some sort of suicide prevention action to be taken at the Quechee George Bridge, where there have been 8 suicides since 2008 (more than all other Vermont bridges combined).
While there are few people opposed to preventing suicide, there remain some legitimate questions about the bill and the effectiveness of similar efforts at other suicide “hotspots” such as the Golden Gate Bridge in San Francisco or several bridges around Cornell University in Ithaca, New York. People wonder about how effective such measures really are since people who are suicidal could simply go somewhere else. There are also concerns over spoiling the access or view of many people who gain benefit from being in these often beautiful places.
What is actually known about the value of trying to deter suicides at these particular places? A recent article in Lancet Psychiatry used meta-analytic techniques to provide a more definitive answer. The authors searched for scientific studies that assessed the effectiveness of hotspot suicide prevention. They point out that, while most people think of prevention efforts mainly in terms of restricting access through fences or nets, other types of interventions also can be implemented. Among these are efforts to encourage help-seeking (e.g. placing help lines phones at the site) and increasing the possibility of intervention by a third party (e.g. having more personnel near the site). In examining whether or not suicide prevention works, the authors divided the studies they found based on the type of intervention that was used (although some places had more than one). The primary outcome variable was a pooled incidence rate ratio (IRR) that reflected the change in number of suicides after the intervention was introduced. The length of time suicides were assessed prior and after the intervention ranged widely from 5 months to 22 years.
A total of 18 studies were identified, most of them related to efforts designed to prevent suicides at bridges and cliffs. By far the most common type of intervention were those that did restrict access. Overall, suicide rates dropped from 5.8 suicides per year to 2.4. In terms of intervention type, restricting access and increasing the possibility of third party involvement were significantly related to suicide reduction. For measures that encouraged help-seeking, there was also support for this intervention but this positive result required the removal of one outlier study.
The authors concluded that interventions at suicide hotspots are effective. Furthermore, they state that their finding of effectiveness for interventions other than restricting access supports the notion that these improvements are not simply the result of individuals substituting one place for another.
Reference
Pirkis J, et al. Interventions to reduce suicides at suicide hotspots: a systematic review and meta-analysis. Lancet Psychiatry 2015 Nov;2(11):994-1001