February 27, 2005

Suicide Barrier for the Golden Gate Bridge?

The Golden Gate suicide prevention debate has sprung up again, this time because filmmaker Eric Steel admitted to bridge officials that he'd been filming the bridge to capture suicides rather than rolling fog. Upset families recently testified before bridge officials, prompting approval of plans to at least look into erecting a suicide barrier to stop people from jumping the over 200-feet to what must be a momentarily yet excruciatingly painful demise. I can see how Steel's actions would upset people and I support a practical, tasteful barrier for the world's #1 suicide spot, I'd like to take this opportunity to point out some things this documentary might have noted as well. (I won't even get into the obvious free speech issues here...) While preventing suicides is a good thing, there are a lot of pressing problems here in San Francisco, the nation and the world that are reflected in suicide statistics that require government attention. From economic crises to cultural romanticism of suicide, from America's obsession with guns to our underfunding of preventive health care, there are factors out there that both impact suicide rates and overall death rates. Perhaps instead of erecting a barrier to prevent people from jumping, we should try to help them before things have gone that far.


The Golden Gate Bridge isn't the only "suicide hotspot" in the world.
According to the World Health Organization, Eastern Bloc countries have the highest suicide rates in the world. An estimated 800,000 world-wide take their lives every year, with the US comprising about 31,000 of those deaths (1.3% of all US deaths). Although that's a staggering amount of people, it was about 21 for every 100,000 Americans in 2000, whereas it was about 93 and 80 for every 100,000 Lituanians and Russians, respectively, in 2002.

In Japan, where seppuku has been romanticized for centuries, the rate was about 48 for every 100,000 in 2000. The Golden Gate has had about 1,300 since it first opened, with an estimated 20-25 per year. About 100 people per year in Japan step in front of trains, which has become so common that the trains are rarely delayed and the railway often has families compensate them for delays or derailment. Apparently, Japan's Golden Gate is the Aokigahara Forest at the foot of Mt. Fuji. A dense, scary-looking forest, it sees about 75 suicides a year, most of which are found during an "annual sweep."

Aokigahara Forest doesn't look like a fun place

1) $paginate_current_page = 1; $paginate_sections = array( 0 , 1); $paginate_top_section = $paginate_sections[$paginate_current_page-1]+1; $paginate_bottom_section = $paginate_sections[$paginate_current_page]; } else { $paginate_top_section = 1; $paginate_bottom_section = 1; } $paginate_self = '&' . $_SERVER['QUERY_STRING'] . '&'; $paginate_self = preg_replace("/&page=[^&]*&/", "&", $paginate_self); $paginate_self = substr($paginate_self, 1, strlen($paginate_self) - 1); if($paginate_self == '&') $paginate_self = ''; else $paginate_self = htmlentities($paginate_self); $paginate_self = basename($_SERVER['PHP_SELF']) . "?${paginate_self}page"; ?> Posted by Kristina at February 27, 2005 11:03 AM

You have to admire these people for taking on what's clearly going to turn into an enormous task. If the goal is to prevent suicide by removing the means instead of the cause, they're going to have to barricade every bridge and tall building in the world, outlaw firearms entirely, enact quantity-buying controls on household cleaners and medications, win the war on drugs, clean up the black market on basically everything, shut down the Ginsu, Henckels and Chefmate knife companies (as well as the Swiss Army company, its many knockoffs, and anyone who makes razor blades), outlaw the possession of plastic bags and duct tape, and, as evidenced by the recent frat-hazing death case, restrict access to drinking water. I'm sure they've thought this through and seen how reasonable, effective and helpful it's going to be.

Also, what happened to cause of death #13 on that list?

Posted by: Dianna at February 27, 2005 02:38 PM

Shoot, I forgot about rope. Get that stuff off the market too, and quickly!

Posted by: Dianna at February 27, 2005 02:40 PM

i whole-heartedly agree with you, dianna. that was the post i would have posted had i gotten here earlier. i join your opinion without reservation.

Posted by: holohan at February 27, 2005 04:28 PM

Safety measures are nearly impossible to fight against and stop. No matter how small the minority might be, there's never going to be an anti-barrier group as organized and passionate as the pro-barrier group. It's always a bad sign when the passing of some legal measure is accompanied by "emotional" testimony on one side.

Once installed, a stop sign never goes away. That goes double for a suicide barrier.

Posted by: sean at February 27, 2005 10:38 PM

#13: Essential hypertension and renal disease, rate: 7.0, total 20,261.

I think (if I had more free time) I'd like to start an anti-barrier group. I'd advocate using the $4 million for public (mental) health care and outreach programs in San Francisco. People who live in Marin County can pay for their own mental health care.

Posted by: Kristina at February 27, 2005 11:25 PM

To the people who wrote the last couple of anti barrier comments, how sad it is that you lie in your ignorance of this particular issue. The fact is that the golden gate bridge is the number one landmark in the world for suicides.
and if a barrier is to be erected it would save approximately 23-24 lives a year. suicide off this bridge tends to be impulsive, a perminent solution to a temporary problem. People who are suicidal will not just go somewhere else or find some other means. a barrier gives them another opportunity ot ask for help.
my name is kevin and i jumped off the golden gate in 2000. i survived and i know if there had been a barrier, i would not have a metal plate in my back.
by the way the money being raised to build this barrier has nothing to do with the government it is all private as far as i know.
so maybe you can re think your comments and your ideation.

Posted by: John Kevin hines at March 4, 2005 10:30 AM

Considering the size of its population, America has a relatively low suicide rate. Rates higher in Eastern European countries than anywhere else in the world and India actually sees the greatest overall number every year. As I noted in my blog above, over 100 people per year throw themselves in front of trains in Japan and about 75 people per year commit suicide in Japan's Aokigahara Forest. So, the Golden Gate Bridge is not actually the #1 suidice spot in the world. Although I will grant that it is the most famous and widely publicized, it's not really the same thing.

I never said I think that the barrier won't save lives. I realize that the decision to jump is almost always impulsive and that such a barrier is the only sure-fire way of preventing such deaths. However, what I was really trying to get at in my article was that more unnecessary deaths could be prevented if the US had better mental health care and outreach programs, as well as better overall health care, welfare and unemployment support, gun control, etc. Unlike Eastern European countries and South Asian countries, we're actually a relatively rich nation that could afford such programs and help for our citizens if only we had to political will to do so. Our not providing such support for our citizens displays our nation's bad habit of merely putting band aids on problems that have wide, systemic and long-term causes.

I think the amount of publicity this issue is getting - although wholly deserving of serious consideration - is only the tip of the iceberg that is preventable death in the US and the world. While we can't afford to ignore this particular problem, what about all the other similar problems that we seem to think we can afford to ignore that take and forever alter more lives every day of every year? I do feel for you, Kevin, and am glad that you got a second chance, but I think that you should also think about the hundreds of thousands of people who will die this year all over the world from preventable diseases, terminal illnesses, murder and violence, drug use, car crashes, infant mortality and starvation.

Lastly, I'd like to note that Dianna was merely pointing out that even if you take away this method, there are still many other ways that people can take their own lives and it's not very likely that the barrier will affect suicide rates. Falls only account for 2.3% of all suicides in the US and suicides only account for 1.3% of all US deaths, so that's just 740 deaths out of 2,443,387 US per year, whereas 17,108 die from self-inflicted gunshot wounds and 65,681 die from the flu/pnemonia! While no one is discounting your plight, we all have a duty to think of the bigger picture, so you shouln't rag on us for doing that.

Posted by: Kristina at March 4, 2005 12:35 PM

I think Kevin is basically right here and the rest of us haven't really considered this issue carefully enough. The FAA estimates the value of an American's life to be ~2.5 million. If we could save 20 lives a year (or even 5) by spending 4 million on a barrier then it's really a no brainer.

Posted by: dr v at March 4, 2005 01:40 PM

an interview with Kevin that I've found interesting.

Posted by: gene at March 4, 2005 02:14 PM

I've only ever known one person who was suicidal and the similarities of what I've heard Kevin talking about (the language used and ideas) and what I'd been told from the person I knew are striking.

Posted by: gene at March 4, 2005 02:19 PM

Ah, but Dr. V., if those 5-20 people jump and survive, the cost of their medical care will be so staggering that they'll put that $2.5m back into the economy by spending it on bills, debt management services, and outrageous interest. Just think of all the revenue for ruthless financial institutions! We'll all be better off for their success.

Jeez, man, take a look at how much research Kristina did before she wrote this entry. Of all the things to suggest about her, I'm not sure how anyone could pick ignorance.

Posted by: Dianna at March 4, 2005 02:31 PM

If you go down the road of attaching monetary value to human life (which I admit is necessary sometimes), you could also argue that if the $4M was put into mental health programs or other more fundamental suicide prevention efforts, a lot more than 5-20 lives would be saved. Addressing the "Golden Gate Bride Causes Suicide" problem is a dramatic and tangible (and therefore politically savvy) means of addressing the problem of suicide, but that there are more effective and less sexy ways to address the issue that are likely to be overshadowed by a barrier campaign.

Posted by: holohan at March 4, 2005 02:41 PM

"Ah, but Dr. V., if those 5-20 people jump and survive, the cost of their medical care will be so staggering that they'll put that $2.5m back into the economy by spending it on bills, debt management services, and outrageous interest. Just think of all the revenue for ruthless financial institutions! We'll all be better off for their success."

uhmm no...that's called cost not value.

Posted by: dr v at March 4, 2005 07:35 PM

and that's 5-20 people per year, not just once off, at no additional cost

Posted by: dr v at March 4, 2005 07:38 PM

Nope. Try reading again. It's value to the people collecting the interest.

Posted by: Dianna at March 4, 2005 08:04 PM

I like that Dr. V. has chosen to disagree with me here, rather than in real life. I completes the idea that Dr. V. is purely a web persona and not the man I actually know. Anyway, if the value of a human life is really $2.4 million think about how great it would be to be able to save 100 or 1000 or 10,000 lives through not only suicide prevention programs, but also general improved health care and social support programs. Holohan really summed up what I've been trying to say all along. While I believe this issue is an important one and I'm all for preventing suicides, this bridge-only way of looking at the problem of Bay Area suicides is hiding a much bigger, much deeper problem. Instead of looking to save the lives of the 20-25 bridge jumpers per year, shouldn't we be looking to save MORE lives by addressing the larger problems these people face?

I watched the interview with Kevin, and I really don't think jumping from the bridge is a truly impulsive act. It's not like these people just happen to be walking over the Golden Gate one day and realize that it would be super easy to go over the side. They already have all the symptoms and have been considering the ultimate act for some time. Kevin himself said that he was on 14 different meds for his condition and took the bus there while debating with himself (or at least the voices in his head) whether to do it or not. While the ultimate decision may be impulsive after a lengthy struggle with one's self, people go there knowing there's a good chance that's exactly what they're going to do once they get there. That being said, if there was a suicide barrier on the Golden Gate, people with those kinds of issues will simply choose another method; one that can't be addressed as easily as putting up a fence or a net. The barrier won't do a damned thing to bring down overall suicide rates, just the number of suicides at that particular location.

Like I've been saying and as you can see from the SF suicide bar graph above, poisoning, suffocation and self-inflicted gunshots are all much more prevalent means of suicide than falls, even in San Francisco. It's just that when someone intentionally OD's or puts a bag over their head in the privacy of their own home, you don't see them or their families going on TV asking for sleeping pills or plastic bags to be made unavailable, and surely no one seriously expects guns to be outlawed in the US.

Moreover, the incredible suicide rates in the rest of the world suggests that our focusing on our own relatively low suicide rates is blinding us from the larger issues of world poverty, global economic crises and starvation. People in the rest of the world also suffer from mental illness, but they have the added problems of actually being a burden on their families in the sense that they're another mouth to feed where there is no food, that they have illnesses that will cost 5-10 years' salary to treat, that they can't find a job to feed their families because every factory within 100 miles has been closed or all of the fish in their area are gone. I already believe Americaa is self-absorbed and short-sighted and, for me, this issue is just an example of that.

By focusing on preventing only these kinds of deaths, rather than using your experience and your second chance at life to prevent as much death and suffering as possible, is narrow-minded and an inefficient use of time, influence and the media's interest in you. Today, I was thinking about other people who have used their tragic experiences to campaign for larger change. All the time you hear about individuals and groups that use their fame to try to effect large-scale change and public awareness of issues; to try to have as great an effect as possible. Women who've lost family and friends to drunk drivers don't only try to get sobriety check points on their block, but lobby for state and national laws and get airtime for anti-drunk driving commercials. People who've survived diseases or who've lost loved ones to diseases don't just try to get their local hospitals to improve their treatments, but lobby for better health care for us all, start research foundations and clinics and even go to foreign countries to see what they can do there. Look at the bigger picture, people - it's there if you open your eyes beyond your own little world. You can do so much for so many if you just open your mind and your heart.

As for funding the project, this is from the Golden Gate Bridge, Highway & Transportation District website:

With the mandate from the California State Legislature to enter the public transit business, the District planned, developed, and implemented what is today a nationally renowned bus and ferry system. The District is also unique among Bay Area transit operations because it provides transit services without support from local sales tax measures or dedicated general funds. As the District does not have the authority to levy taxes, the use of surplus Bridge toll revenue is the only available local means the District has to support the District's transbay transit services. Presently, Golden Gate Transit bus and ferry operations are funded approximately 50 percent by surplus Golden Gate Bridge tolls and 30 percent by transit fares. The remainder is met by federal, state and local subsidies along with advertising and property equipment rental revenues.

Lastly, as Dianna noted, I went out of my way to research this topic before I formed my opinion about it - and I'll say it again: Sure, go ahead and put up the barrier (I don't really care about how the bridge looks anyway; I've lived in the Bay Area my whole life and I've never walked across it), but don't forget that there's a lot more out there than this issue.

Posted by: Kristina at March 4, 2005 09:29 PM

I'd also like to clarify that my "anti-barrier" group wouldn't be so much about preventing the Bridge District from putting up the barrier as talking about wider issues of preventable deaths and suicide prevention. I could call it a "barrier-plus" group, but that's not nearly as (to respectfully use Holohan's words) "dramatic and tangible (and therefore politically savvy)."

Posted by: Kristina at March 5, 2005 09:54 AM

By injuring yourself and requiring medical attention you are draining society's resources not creating new ones.

Posted by: dr v at March 5, 2005 01:11 PM

It is correct that there is some benefit to the economy from money being spent on healthcare from a jumper incurring medical costs. I think the main problem is that people that are severely injured or killed are probably not going to be working and earning a salary anytime soon. That, and most of the jumpers I doubt will be able to pay for their own medical care. Insurance companies do not cover costs for suicide attempts so it will be left to us to pay the bill -- either through higher hospital fees or taxes. All of the above negatives would likely outweigh any positives gained from the stimulative effect of money being spent on healthcare in the short term.

Posted by: dr v at March 6, 2005 08:50 AM

While I agree with some of what you say, I have read that many of the suicides (estimated at closer to 2,000, not 1,300 as you mention) are committed impulsively. I have a dear friend who's son jumped, and miraculously survived. He regrets to this day that he jumped. He is trying to help others who suffer from depression.

Because of the impulsive nature of bridge jump suicides, I do believe a barrier would help spare lives. Most of the people who survive never actually try to commit suicide a second time. That to me says a barrier will help.

Posted by: Lisa at March 7, 2005 09:32 AM

I have a new theory that no one really reads what I write.

Posted by: Kristina at March 7, 2005 08:54 PM

I saw a suicide in progress on the Golden Gate once. As I drove across the bridge to Sonoma County, there was a man hanging off the outside of the bridge with his back to the Pacific. I've heard most people jump facing the city. As I drove back several hours later, the man was still there, this time surrounded on three sides by public safety workers.

Posted by: Cody at March 7, 2005 09:44 PM

We have to balance the asthetics of a barrier-free bridge with protecting people from themselves. I would argue that the latter is not the job of an object, but rather mental health professionals. A barrier is just a reflection of our view of the world, and a real "cure" has to involve people who care enough to work at solving the suicide problem.

And this whole debate only becomes relevant if you short change the value of an elegant Golden Gate Bridge where every structural component serves to keep the bridge aloft.

Posted by: Cody at March 7, 2005 09:47 PM

I agree, Cody. The solution we chose to concentrate on says something about us as a society and also says something about its proponents. As for how the bridge looks, I don't think that really matters all that much. No barrier, ugly barrier, unnoticeable barrier... no matter what, tourists will still want to walk across it, people will still try to jump off it and those who can afford the $5 toll will continue to drive across it. Personally, I've never walked across the Golden Gate, so I'm not sure how it'd affect the experience, but I've also never been to Alcatraz, Mt. Tam, the SF Zoo, the Conservatory of Flowers, the Legion of Honor or inside City Hall... so perhaps that just means I'm a bad San Franciscan.

Posted by: Kristina at March 8, 2005 12:31 PM