The Final Leap (27 page)

In 2006, England's National Institute of Mental Health studied a variety of “suicide hotspots,” including bridges. The report concluded by saying, “The most effective form of prevention at jumping sites is a physical barrier, which literally restricts access to the drop.”The Lifeline paper ends much the same way: “Decades of research clearly demonstrate that barriers are the most effective means of preventing [bridge] suicides.”

In 2005, the Journal of the American Medical Association published the most complete review to date of suicide prevention strategies. Twenty-three physicians and scientists from the United States, Europe, and Asia authored the review after studying forty years of published scientific research. They concluded that the two most effective ways to prevent suicide are to restrict access to lethal means and to train health care professionals to recognize suicide warning signs and intervene when the risk is present. Treatment such as counseling and prescription medication provides long-term benefits, but in the moment, when a person feels that life is unbearable and suicide is the only way out, barring access to means—a gun, drugs, tall building, or bridge—makes all the difference.

The
JAMA
report noted that according to seventeen published studies, the rate of suicide deaths in gun-owning households is three to five times higher than in households without guns. At the same time, where guns are present, safety procedures such as using gunlocks and properly securing ammunition reduce the risk of suicide by two-thirds. The article also noted that in Australia, suicide from sedative overdose increased when medications were relatively easy to procure and decreased when access was restricted. A similar result occurred in England when legislation was passed in 1998 that limited the pack size of analgesics and prohibited pharmacies from selling more than thirty-two tablets per customer (non-pharmacies were restricted from selling more than sixteen tablets per customer). In 2004 the
British Medical Journal
reported that after the legislation was implemented there was a 22 percent reduction in suicides related to acetaminophen overdoses and a 30 percent reduction in liver transplants and hospital admissions to liver units (overdosing on acetaminophen severely damages the liver).

California's 2008 “Strategic Plan on Suicide Prevention,” issued by the state Department of Mental Health, supports the
JAMA
findings. It notes, “Restricting access to lethal means can put time between the impulse to complete suicide and the act itself, allowing opportunities for the impulse to subside or warning signs to be recognized.”

Despite this evidence, people hold onto the mistaken belief that someone who is suicidal will resort to any means available. Paul Muller of the Bridge Rail Foundation offers this response:

Much of what science tells us about the world we live in is counterintuitive. Think about the relationship between the sun and earth. When I get up in the morning I see the sun rise in the east, then creep across the southern sky and set in the west. Everything about my experience says the sun revolves around the earth. And historically people believed this so fervently that it became a matter of religious faith. Yet now we know the earth revolves around the sun. So, too, with suicide. Common sense tells us that if a suicidal person cannot get a gun, he or she can just get a knife. If there are no knives, then pills will do. Yet the research tells us something very different. Restricting easy access to a single means of suicides reduces suicides. In every case studied where it was harder to get access to guns or poisons or carbon monoxide, the number of suicides went down. The same is true with bridges.

Scott Anderson, in his
New York Times Magazine
article, wrote, “If a man shoots his wife amid a heated argument, we recognize the crucial role played by the gun's availability. We don't automatically think, Well, if the gun hadn't been there, he surely would have strangled her. When it comes to suicide, however, most of us make no such allowance.”

Thomas Joiner is a psychology professor at Florida State University and one of the preeminent suicide researchers in the country. In a recent book,
Myths about Suicide
, he dispels a number of false beliefs. One of them is the myth of means substitution; that is, if one method of suicide is unavailable, people will choose a replacement method. Imagine, he writes, if someone you know, a loved one, had a heart attack or stroke and was refused medical treatment because the prevailing public policy was that it didn't make sense to intervene, the person would just have another heart attack or stroke anyway. “It would be an outrage even if it were true,” Joiner writes; that's no reason to deny care. Besides, it's not necessarily true that someone who has suffered from a heart attack or stroke will have another one. The odds may be greater; however, there's no certainty that it'll happen to any one individual. The same is true with suicide. Some people are at greater risk, especially if they've made an attempt before, but that doesn't mean they're sure to kill themselves. Far from it. No other public health problem is so stigmatized or misunderstood.

“It is unconscionable that a suicide barrier has not been erected on the Golden Gate Bridge,” Joiner concludes. “The problem is not money and aesthetics, though if it were that would be appalling enough. The problem, rather, is ignorance and prejudice.”

A different approach to countering the argument that people who are thwarted from one means of suicide will resort to another means is to apply that same thinking to a related project. Consider, for example, the planned multi-million-dollar meridian on the Golden Gate Bridge separating oncoming vehicle traffic. According to Paul Muller,

If you think in terms of traffic safety, we build median barriers to prevent head-on collisions. Drunk or drowsy drivers cause many of these collisions, but who objects to building these barriers? Has anyone ever suggested that “the drunks will just go down the road, so don't bother with a barrier”? Likewise, no one believes that median barriers will solve drunk driving, but we recognize they are one necessary element in reducing the most extreme tragedies. Bridge barriers and nets do the same for suicides. They are not the solution, but one necessary means to reduce the most extreme tragedies.

Another argument against a barrier is that the number of people who jump off the Golden Gate Bridge is a small fraction of the total number of people who die by suicide in this country. Why focus only on them? Are their lives worth more? It's true that the number of suicides from the Golden Gate Bridge is negligible compared with more than 3,000 suicides per year in California, representing only 1 percent of the total. This doesn't mean that they're irrelevant, however. “Every suicide and accidental death is tragic,” as John Brooks says.

But if we have such an obvious, blatant, and shameful magnet for death in our community, how on earth can we be so blasé about it? If a few people a month jumped from a downtown high-rise—even if that accounted for a small percentage of the total—don't you think that access to that roof would be immediately barred? How about a particularly dangerous stretch of road notorious for deadly crashes? We don't ignore them because the fatalities are small relative to total fatalities. One life is not worth any more than another, but when this is so in-our-face, how can we ignore it?

It's interesting to note that if we were talking about reducing the homicide rate, even minimally, everyone would be in favor of it. Yet nearly twice as many people kill themselves every year in the United States as are murdered—35,000 suicides versus 18,000 homicides—and yet there are people who oppose taking action that would save lives.

In
November of the Soul: The Enigma of Suicide
, George Howe Colt wrote, “Clearly, we cannot and should not make the world ‘suicide proof' nor our lives a twenty-four-hour suicide watch. Even if we could, suicides would of course still occur. But even if bridge barriers and gun control legislation were to have no effect on the suicide rate, there may be compelling reasons why such measures should nevertheless be taken. To put up or not put up a barrier says something about the way we feel about suicide and suicidal people.” Colt recounts his conversation with a friend who believes that it's unfair to ruin the view for the sake of a few, and who asks, “If they want to die so much, why not let them?” Colt responded, “It troubles me that so many otherwise kindhearted people should object to preventative measures. For how far is it from this passive condoning to the voices one sometimes hears when a crowd has gathered at the base of a tall building to watch the weeping man on the ledge high above, shouting, ‘Jump, jump, jump?' ”

It turns out that it's not far at all. As Tad Friend reported in the
New Yorker
, an engineer named Roger Grimes walked back and forth on the Golden Gate Bridge for several years wearing a sandwich board with a heartfelt message: “Please Care. Support a Suicide Barrier.”

“He gave up,” Friend wrote, “stunned that in an area as famously liberal as San Francisco, where you can always find a constituency for the view that pets should be citizens or that poison oak has a right to exist, there was so little empathy for the depressed.”

“People were very hostile,” Grimes told Friend. “They would throw soda cans at me, or yell, ‘Jump!' ”

Heidi Benson was one of the
San Francisco Chronicle
reporters who contributed to the newspaper's 2005 seven-part series on Golden Gate Bridge suicides. She wrote, “The assumption that suicide is not preventable is an enabling one. It enables the public to remain passive.”

It is this passivity more than anything else that fuels the suicide barrier debate. People who believe that a barrier won't make a difference see no reason to have one. Why spend money to ruin the view when the impact is negligible?

Mary Zablotney doesn't buy it. As the mother of an eighteen-year-old son who jumped from the bridge, she's incensed that people are so unconcerned. “What kind of monster would stand there before me and tell me that aesthetics are more important than my son's life?” she wrote in a blog. Several people responded that it wasn't the bridge's fault. Individuals who use the bridge as a place to kill themselves, they said, are to blame. Their comments had the same tone as gun owners who maintain that firearms aren't responsible for the country's high homicide and suicide rates—that the people who use them inappropriately are.

What has been ignored is the fact that at least three children under age five have died because the Golden Gate Bridge didn't have a suicide barrier. Their fathers were able to throw them over the railing because it was so low. These children weren't trying to kill themselves; they were murdered. The Golden Gate Bridge was the weapon.

Also ignored is the fact that bridges are supposed to be safe. A net was installed during construction to protect the workers. A barrier was built to protect bicyclists. A meridian will be erected to protect motorists. If the bridge is going to be accessible to pedestrians, then people who walk on the bridge need to be protected, too, sometimes from themselves. A taller railing would do that. So would a net. To let the deaths continue and take no immediate action to stop them runs counter to the policy governing every other roadway in this country, as well as every other one-time suicide magnet in the world.

In 1979, a thirty-three-year-old woman in Berkeley, being treated for depression, used what little money she had to take a bus to San Francisco, then a cab to the Golden Gate Bridge. She scribbled a note of apology to her seven-year-old son, then walked out on the span. In her words, “I had been suffering from severe, immobilizing, tortuous depression for several months, and was simply obsessed with killing myself to end the agony that no medication seemed to touch.” She took off her glasses (“I figured if I couldn't see the water too clearly, it would be easier to jump”), and climbed over the railing onto the thirty-two-inch-wide beam on the other side. She couldn't bring herself to jump, though, and climbed back onto the pedestrian path. Then she climbed over the railing again, trying to summon the will to fall. Once again her survival instinct was too strong, and police were able to intervene. A few weeks after that she was put on new medication and her depression lifted. “I was suddenly back to normal, no longer in torment,” she said. Twenty-five years later, she has had no further thoughts of killing herself.

In one of his many letters to the editor following the death of his daughter, John Brooks wrote, “Before this tragedy, I had never had a close encounter with suicide, never gave a suicide barrier a second thought, and pretty much felt that a suicidal person could not be stopped. The Golden Gate Bridge was nothing more than the highlight of my daily commute from Marin [County] to San Francisco. Imagine how it feels now?”

Ever since her son jumped, Mary Zablotny has referred to the Golden Gate Bride as “that damn orange thing.” It's impossible for her to see any beauty in it, she says.

Renee Milligan, the mother of fourteen-year-old bridge jumper Marissa Imrie, doesn't see any beauty in the bridge, either. “I just feel haunted by it,” she said. “And living in the Bay Area, you can't get away from it.”

Milligan's comments were made to a reporter shortly before she testified in 2005 to a Bridge District committee that, once again, was considering a suicide barrier. “I'm here for all the moms, all the dads, all the aunts and uncles and sisters and brothers who have lost someone on the Golden Gate Bridge,” she told committee members. “Yes, my daughter must have been suffering from some type of mental illness and you might say, ‘How did you miss it, Renee?' I was there, I would pick her up from school, I don't know how I missed it, but I did.”

“We are given a rare opportunity to make a difference, to save lives, to decrease suffering,” says psychiatrist Mel Blaustein. “As people of conscience, how can we allow these suicides that we can prevent to continue?”