Hi All - As promised, here is Thomas Joiner's "take" on suicide barriers in his
latest book (Harvard University Press, 2010), "Myths about Suicide." Joiner is
well known suicidologist and one of the most prominent (if not the most
prominent) in academic psychology, so I assumed (perhaps incorrectly?) that his
stance on this issue represents the best current consensus in the suicide
field. Joiner reviews the evidence re: suicide barriers and related attempts
to decrease suicide risk on pp. 147-168 of his book, for those TIPSters who
might have it. Incidentally, his book is informative and interesting, and is
certainly worth a read.
As I mentioned in an earlier e-mail, Joiner is quite unambiguous about the
helpful preventative effects of suicide barriers. A few quotations..."The
answer to this [the question about whether suicide barriers work] is that this
is a moral outrage and that I and many others believe would never happen for
any other public health problem - only suicide could be stigmatized and thus
misunderstood to the extent that thirty people's deaths [those who jump from
the Golden Gate Bridge] are ignored year in and year out. The data on this
are in, they have been in for around thirty years or more, and they could not
be clearer - the vast majority of those who intend to jump from the Golden Gate
Bridge but are restrained from doing so go on to live productive lives" (p.
150). And more..."evidently, physical barriers that prevent people from jumping
from bridges have saved many lives" (p. 155). And still more: "Given this
abundance of evidence, one would think it self-evident that there would have
been a barrier on the Golden Gate Bridge all along, given that someone dies
there every ten days or so. That there was not is a travesty" (p. 156). And on
and on. Hence, the basis for my earlier e-mail that the recent Bloor Street
data conclusions run counter to conventional wisdom in the field.
How persuasive are the data reviewed by Joiner? Not having read the
original studies, I'm frankly not sure. Joiner reviews pre-post data from
several bridges (ironically including earlier data on the Bloor Street Bridge)
as well as the Eiffel Tower, and concludes that barriers "work" in that they
(a) decrease suicides at that spot without (b) increasing suicides at other
high-risk spots, like other bridges. For example, he reviews evidence on the
construction of barriers on the Arroyo Seco Bridge in Pasadena and the Duke
Ellington Bridge in Washington D.C. "Regarding the latter," Joiner says, "an
average of four people per year died by jumping from the bridge before a
barrier was erected; during the construction of the barrier, there was one
suicide, and over a five year span after completion of the barrier, there were
no suicides. Crucially, the construction of the barrier did not cause a
corresponding increase in the suicide rate at a nearby bridge (the Taft
Bridge)" (p. 154). Mike Palij stated that the article discussed on TIPS
claimed that no previous study had shown a statistically significant drop in
suicides following the construction of a bridge barrier. I don't know what to
make of that statement; it does indeed seem to be at odds with the data
reviewed by Joiner, but perhaps it's correct. Perhaps Joiner is relying on
consistency of nonsignificant trends across studies or perhaps he is relying on
meta-analytic data of which I'm not aware. Or perhaps he is overstating the
strength of the evidence. Or maybe the assertion in the article is
incorrect...I'm frankly pretty confused.
What about Chris Green's point that the barriers may indeed decrease
suicides at the bridges themselves and perhaps even nearby bridges, but that
people who were going to jump probably end up killing themselves through other
means, like shooting themselves, hanging themselves, poisoning themselves,
etc.? So far as I can tell, the only evidence bearing on this question
reviewed by Joiner is Richard Seiden's 1978 study of people restrained by
police from jumping from the Golden Gate Bridge (Joiner relies heavily on this
study in his discussion). According to Joiner, "Seiden located and obtained
data on 515 people who were restrained from jumping from the bridge. He
compared them to a group of 184 people who had attempted suicide by other means
and who had been taken to a San Francisco Emergency Room. If the view that
'they'll just go elsewhere to die by suicide' has any merit whatsoever, one
would expect at least half of those restrained to do so. But the actual figure
is nowhere close to that. Approximately 95 percent of those who were
restrained either were still alive at the time of the study or had died of
natural causes" (p. 151). So Joiner clearly thinks that the erection of bridge
barriers doesn't result in "displacement effects" - merely leading potential
suicides to just kill themselves in other places or through other means. I'm
not entirely sure how well these data address Chris' concern, though, as
Seiden's study doesn't bear explicitly on suicide barriers - although Joiner
makes a direct connection. Moreover, one might wonder whether people who are
restrained by police are more ambivalent in some way than most other potential
jumpers - perhaps they were restrained because they were standing on the bridge
for a long time, willing to talk to police, willing to be talked out of
jumping, and so on. Nor do I know how many people who were restrained by
police were referred to treatment that might have diminished their suicide
risk. In any case, I'm not sure that these data conclusively address Chris'
question, nor am I sure that data to do so exist.
So, the only conclusion I can come to at this point, especially after
reading the recent report of the Bloor Street Bridge study, is that this
literature is a lot more confusing than one would like. Perhaps later this
summer, I'll try to dig into the original reports themselves to try to make
sense of them.
Scott O. Lilienfeld, Ph.D.
Professor
Editor, Scientific Review of Mental Health Practice
Department of Psychology, Room 473 Psychology and Interdisciplinary Sciences
(PAIS)
Emory University
36 Eagle Row
Atlanta, Georgia 30322
[email protected]
(404) 727-1125
Psychology Today Blog:
http://www.psychologytoday.com/blog/the-skeptical-psychologist
50 Great Myths of Popular Psychology:
http://www.wiley.com/WileyCDA/WileyTitle/productCd-140513111X.html
Scientific American Mind: Facts and Fictions in Mental Health Column:
http://www.scientificamerican.com/sciammind/
The Master in the Art of Living makes little distinction between his work and
his play,
his labor and his leisure, his mind and his body, his education and his
recreation,
his love and his intellectual passions. He hardly knows which is which.
He simply pursues his vision of excellence in whatever he does,
leaving others to decide whether he is working or playing.
To him - he is always doing both.
- Zen Buddhist text
(slightly modified)
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