Can barriers prevent suicide or do they just shift the problem?

Suicide barriers can save lives and are worth the investment. Ground Zero

There has been widespread media coverage over over the past ten days about the tragic deaths of a man and his son at the Story Bridge in Brisbane. The Brisbane Council was quick to announce it would fund suicide-prevention signs and telephones at the site, but the Council has refused to install safety barriers that could prevent further deaths from the bridge.

Brisbane’s Deputy Mayor, Adrian Schrinner, questioned the value of physical barriers at what have become known as suicide “hotspots”, saying they would simply “shift the problem” to other sites.

The view that “if people really want to kill themselves there is nothing we can do to stop them” has pervaded for decades. But many, if not most, suicides are preventable – we just need to know how best to prevent them. And reducing access to a means of suicide has been shown to be one of the most effective approaches.

Restricting access to paracetamol, restricting the availability of pesticides, reducing access to domestic gas, implementing gun controls and reducing carbon monoxide emissions, have all lead to a reduction in suicide deaths.

So what exactly is a suicide hotspot and what does the evidence tell us about barriers on bridges?

A suicide hotspot is a specific, usually public, site that provides the means for suicide and is frequently used as a location for people to end their life. Often, a location will become a hotspot through media reporting of suicide, or simply by word of mouth.

Despite this method being a relatively rare means of suicide (accounting for fewer than 10% of suicides in Australia), it is highly distressing for bystanders and friends and family of the deceased. It can also receive high profile media coverage, which in turn leads to the potential for additional suicides at the same site.

As a result, iconic high bridges have become hotspots all over the world, including the Westgate Bridge in Melbourne, the Golden Gate Bridge in San Francisco and the Clifton Suspension Bridge in England.

Preventing suicide on bridges

Barriers are one of the most common ways of reducing suicide risk at popular jumping sites. They have been installed at a number of suicide hotspots across Australia, including The Gateway Bridge in Brisbane, the Mooney Mooney Bridge and Long Gully Bridge in New South Wales and the West Gate Bridge in Melbourne.

Despite speculation to the contrary, there is strong evidence from a wide range of studies that show erecting barriers and installing nets at bridges known to be hotspots, (including the Sydney Harbour Bridge, the Clifton Suspension Bridge in England, and the Memorial Bridge in the US), are effective in reducing suicide rates, in some cases by as much 50%.

Take, for example, the Clifton Suspension Bridge in England. Between 1994 and 1998 there were around eight suicides per year at this site – 90% of these were men. In 1998, the main section of the bridge was fenced, after which suicides at this site halved (four suicides were reported per year between 1999 and 2003). And although some suicides did shift to the unfenced edges of the bridge, there was no overall increase in male suicide by jumping from other sites in the area.

We also know that the removal of safety barriers from the Grafton Bridge in Auckland led to a substantial increase in suicide deaths by jumping from the bridge. Moreover, it influenced the pattern of suicides across the city, with fewer suicides by jumping recorded at surrounding sites, and more at the Grafton Bridge. In response, the barriers were replaced and no further suicides by jumping from the bridge have been reported.

Temporary fencing was erected on Melbourne’s West Gate Bridge in 2010 and has since been replaced with permanent barriers. AAP

Barriers at jumping sites are thought to work in two ways. Firstly, they restrict access for the person attempting to commit suicide and secondly, they allow more time for the public or staff to intervene, or for someone to simply change their mind. For many people, suicidal thoughts or feelings can be fleeting and a simple barrier or interruption can be enough to save a life.

So, does restricting access to one site simply mean suicides will increase elsewhere?

Installing barriers or safety nets along certain bridges may result in some people seeking out an alternative location to attempt suicide. Following the installation of safety barriers on the Bloor Street Viaduct in Toronto, Canada, overall rates of suicide by jumping in Toronto did not decrease, but annual rates of suicide by jumping from other bridges and tall buildings in the surrounding area increased.

However, several other studies report that suicide by jumping did not increase in surrounding locations following access restrictions at well-known jump sites.

In fact, a study by Cantor and Hill monitored the suicidal behaviour at the Story and Gateway bridges in Brisbane found that people prevented from jumping from one bridge did not automatically jump from another. The authors attributed this finding to the fact that people who frequent one bridge may be different from those who frequent another, so restricting access at a bridge of choice did not appear to lead those people to simply try somewhere else.

So reducing access to a hotspot location does not always result in people seeking out an alternative jumping site. And if some lives can be saved by erecting safety barriers, then surely it is a worthwhile investment.

Indeed, the installation of barriers at hotspots was a recommendation of the 2010 Senate Inquiry into suicide in Australia and is a current priority of the Commonwealth Government, which is in the process of developing guidelines for the management of suicide hotspots.

Tragically, despite our best efforts in suicide prevention, some people will continue to take their own lives. But we mustn’t become infected with the pessimism that has previously pervaded this field. We must continue to draw on the best available evidence to improve our chances of saving as many lives as we can.

If you or someone you know needs help contact Lifeline’s 24-hour helpline on 13 11 14, SANE Australia on 1800 18 7263 or the Beyondblue Info Line 1300 22 4636.