One reason suicide is so difficult to prevent is that it is difficult to predict. Those who have suicidal thoughts, engage in non-suicidal self injury, or even make non-lethal attempts are not necessarily the same people who who actually die by suicide. Many who kill themselves never show up for treatment. Alcohol is obviously a big factor. I agree that reducing easily available means is probably our best bet at least for now.
Speaking of the impulsivity involved in suicide, here are excerpts from a New Yorker article from 2003 about a documentary on Golden Gate Bridge jumpers. The anecdotes from two men who survived their jumps always stuck with me and I relate it to my patients often:
"Survivors often regret their decision in midair, if not before. Ken Baldwin and Kevin Hines both say they hurdled over the railing, afraid that if they stood on the chord they might lose their courage. Baldwin was twenty-eight and severely depressed on the August day in 1985 when he told his wife not to expect him home till late. “I wanted to disappear,” he said. “So the Golden Gate was the spot. I’d heard that the water just sweeps you under.” On the bridge, Baldwin counted to ten and stayed frozen. He counted to ten again, then vaulted over. “I still see my hands coming off the railing,” he said. As he crossed the chord in flight, Baldwin recalls, “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped.”
Kevin Hines was eighteen when he took a municipal bus to the bridge one day in September, 2000. After treating himself to a last meal of Starbursts and Skittles, he paced back and forth and sobbed on the bridge walkway for half an hour. No one asked him what was wrong. A beautiful German tourist approached, handed him her camera, and asked him to take her picture, which he did. “I was like, ‘Fuck this, nobody cares,’ ” he told me. “So I jumped.” But after he crossed the chord, he recalls, “My first thought was What the hell did I just do? I don’t want to die.”
Yeah the prediction problem is particularly annoying. Tyler Black had a good substack recently about the insanely high false positive rates in predicting suicide. Those jumping stories are fascinating, I had heard similar things, but never read the firsthand accounts. I see they've added nets to the golden gate bridge to discourage or save jumpers. Thanks for sharing!
You have definitely listed some straightforward, rational, and even achievable ideas for reducing impulsive suicides. And I would love to see them implemented for just this reason. However, at the end of the day, these changes will not stop someone who is determined to follow through with the act. And may in fact make those people harder to find.
Yeah I don’t doubt that if someone is seriously determined for a very long period they will find away. What policies like these try and mitigate are the impulsive suicides which make up more like 30-50% from what I understand. But if we could at least get rid of those that would be a huge improvement.
One reason suicide is so difficult to prevent is that it is difficult to predict. Those who have suicidal thoughts, engage in non-suicidal self injury, or even make non-lethal attempts are not necessarily the same people who who actually die by suicide. Many who kill themselves never show up for treatment. Alcohol is obviously a big factor. I agree that reducing easily available means is probably our best bet at least for now.
Speaking of the impulsivity involved in suicide, here are excerpts from a New Yorker article from 2003 about a documentary on Golden Gate Bridge jumpers. The anecdotes from two men who survived their jumps always stuck with me and I relate it to my patients often:
"Survivors often regret their decision in midair, if not before. Ken Baldwin and Kevin Hines both say they hurdled over the railing, afraid that if they stood on the chord they might lose their courage. Baldwin was twenty-eight and severely depressed on the August day in 1985 when he told his wife not to expect him home till late. “I wanted to disappear,” he said. “So the Golden Gate was the spot. I’d heard that the water just sweeps you under.” On the bridge, Baldwin counted to ten and stayed frozen. He counted to ten again, then vaulted over. “I still see my hands coming off the railing,” he said. As he crossed the chord in flight, Baldwin recalls, “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable—except for having just jumped.”
Kevin Hines was eighteen when he took a municipal bus to the bridge one day in September, 2000. After treating himself to a last meal of Starbursts and Skittles, he paced back and forth and sobbed on the bridge walkway for half an hour. No one asked him what was wrong. A beautiful German tourist approached, handed him her camera, and asked him to take her picture, which he did. “I was like, ‘Fuck this, nobody cares,’ ” he told me. “So I jumped.” But after he crossed the chord, he recalls, “My first thought was What the hell did I just do? I don’t want to die.”
https://www.newyorker.com/magazine/2003/10/13/jumpers
Yeah the prediction problem is particularly annoying. Tyler Black had a good substack recently about the insanely high false positive rates in predicting suicide. Those jumping stories are fascinating, I had heard similar things, but never read the firsthand accounts. I see they've added nets to the golden gate bridge to discourage or save jumpers. Thanks for sharing!
You have definitely listed some straightforward, rational, and even achievable ideas for reducing impulsive suicides. And I would love to see them implemented for just this reason. However, at the end of the day, these changes will not stop someone who is determined to follow through with the act. And may in fact make those people harder to find.
Yeah I don’t doubt that if someone is seriously determined for a very long period they will find away. What policies like these try and mitigate are the impulsive suicides which make up more like 30-50% from what I understand. But if we could at least get rid of those that would be a huge improvement.
I have just released a podcast with Kevin McCaffree who wrote the paper I discuss in this article https://www.mentaldisorder.ca/p/kevin-mccaffree-suicide-research#details