Can Physical Barriers Prevent Suicides from U.S. Bridges?
The cell phone texts to people living in the small city of Coronado, Calif., come with a distressing regularity: The bridge is closed again.
The San Diego-Coronado Bridge connects the stunning peninsula of Coronado with San Diego, flying 200 feet above San Diego Bay on concrete girders for more than two miles. Sometimes the span is closed because of a traffic accident. But too often the bridge is closed while police respond to a suspected suicide attempt.
“Our bridge has been a significant source of suicides,” Coronado Police Chief Jon Froomin said.
The Coronado Bridge is one of the most frequent spots for suicide attempts in the nation, along with the Golden Gate Bridge in San Francisco and the Aurora Bridge in Seattle — or dozens of other bridges spread around the country and world. More than 400 people are believed to have jumped to their death from the Coronado Bridge since it opened in 1969.
Countless others have considered jumping from the bridge and did not go through with it.
As a result, the public safety alerts sent to Coronado residents about the bridge carry with them a sense of dread. One of the people receiving these alerts is Jennifer Lewis, a clinical assistant professor at the University of Southern California’s Suzanne Dworak-Peck School of Social Work. She’s lived in Coronado for seven years. And she has worked on the problem of suicide in the lesbian, gay, bisexual and transgender community. She knows how to intervene when someone is suicidal.
A couple years ago, Lewis began to delve into addressing the problem of suicide on the massive bridge she crossed nearly every day. In that process, Lewis recognized the value of her social work background and the importance of looking to other specialties for help in tackling complex, entrenched problems such as suicide.
Lewis began focusing on the bridge after reading a social media post complaining that an emergency callbox at the base of the span did not work. The callbox was supposed to direct-dial a suicide prevention hotline. Signs directing people to the callbox dotted the massive span. It was intended to be a solid suicide prevention measure.
She discovered that yes, the callbox did not work — and even more surprising: No one knew how long that had been the case because no one had ever tried using it.
“They’d never received a call from that phone,” Lewis said. “That’s initially what got me interested.”
She contacted Golden Gate Bridge authorities to learn about their experience with callboxes. They said their callboxes were rarely used. So Lewis started looking at other ways to prevent suicide.
And that’s when she learned about suicide means restriction. The idea is simple: Reducing access to lethal ends should result in lower suicide rates. One example is removing firearms from the home of a suicidal person or making it harder for people to access certain poisons. Another example: Placing barriers or nets along bridges where suicide is abnormally prevalent.
“I, like pretty much everyone else, thought they will just find another place,” Lewis said. “So I was surprised by that.”
Earlier this year, construction began on “suicide deterrent” nets along the Golden Gate Bridge, long considered the No. 1 bridge for suicide attempts in the United States. The $200 million project is expected to be completed in 2021. Although the idea of adding some kind of suicide deterrent to the iconic San Francisco span has been floated for decades, it was only in more recent years that a plan began to take shape. It was widely debated. Some considered it an exorbitant project or an unsightly addition to an architectural masterpiece.
But there is little doubt that barriers and nets work, said Dr. Jill Harkavy-Friedman, vice president of research at the American Foundation for Suicide Prevention.
“There are quite a few studies that show building barriers can save considerable numbers of lives, and people don’t just go to another location,” Harkavy-Friedman said.
Suicide rate declines of 30 to 50 percent have been reported when the availability to highly lethal and commonly used suicide methods is restricted. Meanwhile, research has not shown that posting suicide-prevention signs along a bridge has any effect on suicide rates, according to AFSP.
And those people deterred by a bridge barrier generally do not just drive to another bridge.
“If you limit access, then the crisis will pass,” Harkavy-Friedman said.
Many people who are suicidal are suffering an acute emotional or mental crisis. Their decision-making is impaired. They may be intoxicated. Some don’t even necessarily want to die — they just want the pain of the moment to end. Restricting access to lethal means allows time for that person to move out of the crisis and for other people to intervene.
One of the most stunning examples of suicide means restriction was discovered by accident in the United Kingdom in the 1960s and 1970s. Before the 1950s, almost all of the domestic gas energy used in the U.K. came from coal and contained up to 20 percent carbon monoxide. The leading means of suicide at the time was gas poisoning. But natural gas — which is almost free of carbon monoxide — was introduced to the U.K. in 1958. By 1971, nearly 70 percent of the gas used was natural gas. And as natural gas use grew, the number of suicides by carbon monoxide poisoning plummeted. One study found that while the suicides by other methods grew by a small amount, there was a net drop in overall suicides, especially among women.
Harkavy-Friedman is such a strong supporter of bridge barriers that she maintains a Pinterest page of photos of interesting and attractive barriers. One example is the elegant aluminum safety screens installed in a library atrium at New York University.
Lewis hopes to bring a bridge barrier or netting to the Coronado Bridge. She has worked with local advocacy group the Coronado Bay Bridge Suicide Prevention Collaboration to push for changes. She and others considered additional options to address the suicide problem. Maybe they could put more callboxes on the bridge. Or station someone on the bridge 24 hours a day to stand as a sentry. Or launch a series of suicide awareness and counseling programs.
But the problem is intensely targeted along a single bridge span.
“It became really clear in the empirical research that means restriction is more effective than counseling for a case like this,” Lewis said.
Lewis and other residents began pushing local and state officials to address the suicide problem on the Coronado Bridge. Now, the California Department of Transportation is conducting a feasibility study of adding barriers or netting to the span. It is expected to be completed in 2018.
And Lewis hopes to create a program for other communities struggling to deal with “suicide hot spots.” It would be a manual explaining how to bring about change.
Lewis said the experience of confronting the suicide problem on the Coronado Bridge revealed how the devastating effects of someone taking their own life can ripple through a community —even when it involves a total stranger. Lewis said she’s seen Coronado residents face stress from witnessing suicide attempts on the bridge or just from the “Bridge is closed” texts that allude to the events. Some residents have become hypervigilant about suicide attempts on the span or experience anxiety just driving over it.
So the benefits of barriers or netting extend far beyond the vast bridge.