About year ago we took a family vacation in San Francisco and I walked across the Golden Gate Bridge with my granddaughter who was just becoming an avid reader. At various intervals on the walk we encountered a suicide hotline telephone and a sign which said There is Hope. Make the Call. The Consequences of Jumping From This Bridge are Fatal and Tragic. This put me in the difficult position of trying to explain to a seven year girl why people might want to kill themselves and why do they choose this bridge to do it.
I first encountered this special characteristic of this beautiful bridge during my rotating internship at San Francisco General Hospital when I had the opportunity to examine would-be jumpers who were brought to the ER or to the Psychiatric Service. An update on knowledge known about this subject, some of which I will discuss in this blog, just came out in the October 2009 issue of the American Journal of Psychiatry in an article titled Suicide From the Golden Gate Bridge by Drs. Mel Blaustein and Anne Fleming.
It Wasn’t Suppose to be A Place For Suicide
In 1936, Chief Engineer Joseph Strauss wrote, The Golden Gate Bridge is practically suicide proof. Suicide from the bridge is neither possible nor probable. It turned out however that the Golden Gate Bridge is the most popular suicide site in the world. By 2008 it was calculated the number of suicidal deaths form this bridge was close to 2000.
The bridge is really quite an accessible site to someone determined to use it for suicide. It has a pedestrian walk, a four-foot railing, a bus stop and a parking lot.
What is the Attraction of This Bridge For Suicide?
It certainly is a beautiful bridge offering breathtaking views of San Francisco, Oakland, Berkeley, Alcatraz and the San Francisco-Oakland Bay Bridge as well as the Pacific Ocean. There is often a morning and evening mist. It may be the most photographed man-made structure in the world.
Between 2005 and 2008 Dr. Blaustein interviewed 63 people who had threatened to go to the bridge to commit suicide. 49 of them were male with a mean age of 38. The reasons that they gave for selecting the bridge included accessible/easy (N=36), romantic (N=15), painless (N=6), other reason (N=16). It is quite doubtful that it is painless. Jumpers fall over 200 feet and hit the water in 4 seconds at 75 mph. They die from massive injuries to the chest, heart, central nervous system (spine and brain) or by drowning. The fatality rate is 99%. One report of an interview of 6 of the survivors revealed that all of them said that their suicide plans involved only the Golden Gate Bridge.
People who commit suicide from the Golden Gate Bridge do not have a greater degree of mental illness than suicides in general. 40 % were under psychiatric care at the time of their deaths. 22% had made prior attempts and 25% had left suicide notes. The majority of them were believed to have been employed. Suicide jumpers at the Golden Gate Bridge according to the Blaustein & Flemming article come from all walks of life including a county medical society president, a pastor of a Lutheran church, a president of the Oakland Real Estate Board, the founder of Victoria’s Secret and the son of President Kennedy’s press secretary.
I use to think that San Francisco was a magnet for people from all over with problems and those who wanted a try a new lease on life. I had thought that perhaps suicide from the bridge might be more likely to occur in those who came there and still couldn’t deal with their problems. However it turns out that mostly local residents commit bridge suicides. Only 5% of jumpers between 1995-2005 were non-Californians. Apparently there are similar statistics at Niagara Falls where during one time period the 141 people who committed suicide lived within a 10-mile radius of the Falls.
Will a Special Barrier at the Bridge Prevent Suicides?
Many people have wanted a barrier to be built at the Golden Gate Bridge to prevent people from jumping off the bridge. Barriers have been shown to reduce suicides at a given location. Barriers at the Eiffel tower, Empire State Building and the Harbor Bridge in Sydney, Australia have virtually eliminated suicides at these locations. However, clinicians have known that if people are determined to kill themselves, there is no foolproof method of stopping them from eventually carrying out this desire.
That being said, many studies have shown that reducing a lethal means can reduce suicide statistics. When non-lethal gas was substituted for coal gas, which was previously known to be the cause of 1/3 of suicides in England, the suicide rate fell 25%. Building a suicidal barrier at the Duke Ellington Bridge in Washington D.C. reduced the number of suicides in a seven year period from twenty-three to one. The suicide rate from the nearby Taft bridge that doesn’t have a suicide barrier did not increase Similar examples are sited from Augusta, Maine, Bern, Switzerland and Bristol, England.
One study examined 515 people who were restrained by police or bridge workers from jumping off the Golden Gate Bridge between 1937-1971. As of 1978 94% either were still alive or had died of natural causes. Only 6 % were believed to have subsequently committed suicide.
Blaustein and Flemming in their excellent article offer some suggestions as to how a barrier at the Golden Gate Bridge might work to prevent suicide beside the obvious one of blocking access to a lethal method of killing oneself. They note that even if people were diverted to another method to attempt suicide, it is likely that such a method would be less lethal. They also discuss the theory that suicidal individuals may interpret a barrier as a “sign of care” and possibly reduce their despair. Finally they speculate that certain sites such as the Golden Gate Bridge may become suicide magnets and may even catalyze or amplify suicidal feeling in vulnerable individuals therefore a barrier at such a site could be effective in reducing suicides.
In October 2008 an effort by many organizations led by the Psychiatric Foundation of Northern California was successful in getting the Golden Gate Bridge Board to approve the construction of a suicide barrier. Environmental studies and a funding plan need to now be developed before it can be built.
Understanding Suicidal Behavior and Preventing It
Psychiatrists and other mental health professionals have been studying suicide for many years with the hope that the more we understand it, the better that we will be in treating suicidal people and preventing suicide. We believe that the treatment of depression with medication, psychotherapy and often in combination is probably one of the more effective deterrents to suicide.
Research has shown that there are biochemical differences in various parts of the brain in people who become suicidal. There also has been evidence that higher levels of impulsive aggression in individual as well as a family history of suicidal behavior appear to be predictors of suicidal behavior in individuals. These characteristics are not simply explained by the presence of depression. It also has been shown that a history of childhood sexual abuse can be associated with subsequent suicidal behavior as an adult.
Do Ask and Do Tell !
Mental Health professionals know that one of the best methods of determining if someone might be suicidal is to ask them. It is a misconception that when a caring person inquires about suicidal thoughts, this will somehow give a person this idea or intensify any such tendency. Much more likely, the presence of someone who cares enough to ask them will make it possible to get that person to accept help.
We know that people who are depressed do come out of this bleak mood. Not only does the support of others make a difference but also treatment for depression does work. This is why the irreversible act of suicide is all the more tragic. Perhaps this is best illustrated by the words of one of the few people who survived a jump off the Golden Gate Bridge as reported by Blaustein and Flemming in the American Journal of Psychiatry.
I just looked out over the water to the city and it was beautiful. I felt that this was the right time and place to kill myself. The last thing I saw leave the bridge was my hands. It was at that time that I realized what a stupid thing I was doing and there was nothing I could do but fall. The next things I knew I was in the water hoping that someone would save me saying, “Please God, save me, somebody save me.” It was incredible how quickly I had decided that I wanted to live once I realized everything that I was going to lose, my wife, my daughter, the rest of my family.
This man is currently in his 30th year of marriage. He is a high school teacher and part time coach. His daughter is an elementary school teacher.
Your comments are welcome.