Last week’s New York TimesMagazinehad an interesting article on suicide by Scott Anderson. At the outset, it should be noted that his article is basically about people that jump off bridges or buildings to commit suicide, “jumpers”. (John Grohol writes “Suicide Barriers Are Effective”here.) It’s always an important topic: Roughly 32,000 people commit suicide yearly in the United States. That makes it the 11th most common cause of death among adults.
This has to be less than 8 percent of all suicides. The rough breakdown of method according to U.S. statistics of suicide (2005) is: Firearms - 52 percent; hanging, strangling, suffocation - 22 percent; poison - 18 percent; all other methods - 8 percent. In fact here’s what they say at suicide.org:
Back to Anderson. He wonders why if 90 percent of all suicides are by people with “some form of a diagnosable mental disorder” then why haven’t “advances in the treatment of mental illness had so little effect?” Actually, here’s what the NIMH lists as one risk factor:
- depression and other mental disorders, or a substance-abuse disorder (often in combination with other mental disorders). More than 90 percent of people who die by suicide have these risk factors
So Anderson doesn’t mention the risk of alcohol or substance abuse, or that these are often co-occurring with mental disorders. Other possible answers to Anderson’s question: Not all those with mental illness seek treatment. Or, even those in treatment suffer from impulsiveness and difficulties with planning. Some risk factors, such as having a family member that committed suicide, cannot be “treated” in the usual sense.
Anderson answer is to address that outcome of suicide has less to do with the “why” of suicide (such as mental illness), but the “how” of suicide. Is the act premeditated or impulsive? Many impulsive suicides, Anderson suggests, are preventable. Anderson argues that jumping off a bridge is seldom premeditated, often impulsive. (He cites interviews survivors of attempted suicide by jumping.) And he offers an interesting case study:
In Northwest Washington stands a pretty neoclassical-style bridge named for one of the city’s most famous native sons,Duke Ellington. Running perpendicular to the Ellington, a stone’s throw away, is another bridge, the Taft. Both span Rock Creek, and even though they have virtually identical drops into the gorge below — about 125 feet — it is the Ellington that has always been notorious as Washington’s “suicide bridge.” By the 1980s, the four people who, on average, leapt from its stone balustrades each year accounted for half of all jumping suicides in the nation’s capital. The adjacent Taft, by contrast, averaged less than two.
Opponents to setting up a fence on the Ellington bridge argued that the suicidal would simply travel the hundred odd yards to the Taft bridge.
Except the opponents were wrong. A study conducted five years after the Ellington barrier went up showed that while suicides at the Ellington were eliminated completely, the rate at the Taft barely changed, inching up from 1.7 to 2 deaths per year. What’s more, over the same five-year span, the total number of jumping suicides in Washington had decreased by 50 percent, or the precise percentage the Ellington once accounted for.
The difference in the two bridges?
So why the Ellington more than the Taft? In its own way, that little riddle rather buttresses the environmental-cue theory, for the one glaring difference between the two bridges — a difference readily apparent to most anyone who walked over them in their original state — was the height of their balustrades. The concrete railing on the Taft stands chest-high on an average man, while the pre-barrier Ellington came to just above the belt line. A jump from either was lethal, but one required a bit more effort and a bit more time, and both factors stand in the way of impulsive action.
Essentially the article argues that many suicides are preventable. Anderson goes on to examine some interesting history of the Golden Gate Bridge. Since 1937 an estimated 2000 people ended their lives jumping off it. The details are quiteinteresting.