Saving lives at 18 of the world's suicide 'hot spots'

By Carina Storrs | 9/24/2015, 2:10 p.m.

Since the Golden Gate Bridge was built in San Francisco in 1937, more than 1,600 people have jumped off it and died. The bridge is one of many sites around the world that are considered suicide hot spots because people use them frequently to take their own lives.

A new analysis suggests that several different types of interventions could help reduce the risk of suicide at these hot spots, typically bridges, cliffs or other high places.

Jane Pirkis, a professor at Australia's University of Melbourne in the Melbourne School of Population and Global Health, and colleagues in Australia and Hong Kong looked at studies on the number of suicides before and after interventions were in place in 18 different hot spots in the United States, Canada, Australia, New Zealand, China and Europe.

The researchers found that installing barriers at bridges and railway platforms was associated with a reduction in suicide risk of 93%, and providing signs with help line numbers at these sites could reduce the risk by 61%.

"These numbers are phenomenal," said Dr. Eric D. Caine, director of the Injury Control Research Center for Suicide Prevention at the University of Rochester Medical Center. Caine was not involved in the new study, but wrote a commentary about it. Both were published on Wednesday in the journal Lancet.

However, interventions at suicide hot spots will not have a big impact on the overall suicide rate because they are only involved in a small percentage of suicides overall, Caine said. Of the approximately 40,000 people who take their own lives every year in the United States, most use guns (52%), hanging (25%) or poisoning (16%), and only a small number jump from a tall height (2%) or in front of a moving object (1%).

Although it is important to put interventions in place at common suicide locations, "we have got to have a strategy where fewer people come to suicide attempts, (because) once someone is determined to die, it is much harder to intervene," Cain said. This strategy should be multifaceted and include improving mental health services and helping people who are abused, he added.

The authors of the Lancet article urged interventions at suicide hot spots, "not only to prevent so-called copycat events, but also because of the effect that suicides at these sites have on people who work at them, live near them, or frequent them for other reasons."

The current analysis suggests that three types of strategies can have big effects: reducing access to the sites, providing information about getting help and making it easier for another person to intervene.

Reducing access

One of the most studied interventions for reducing deaths at suicide hot spots involves reducing access. It was associated with between 62% and 99% fewer suicide deaths in 10 different studies.

One of the studies found that Beachy Head, one of the highest sea cliffs in the United Kingdom, had about 16 suicides a year in the 1980s and 1990s. But in the months after road access was blocked in 2001 -- because of concern over an outbreak of foot-and-mouth disease in animals -- the number dropped to zero. At the Jacques Cartier Bridge in Montreal, annual suicides decreased from 10 to 2.6 after the construction of a tall fence.