At the January 2008, National Suicide Prevention Lifeline Bi-Annual Steering Committee meeting, the Committee addressed the question:

What is the position of the Lifeline Steering Committee on the use of bridge phones as the primary intervention to prevent bridge suicides?

The Lifeline Steering Committee position is that the use of bridge barriers is the most effective means of bridge suicide prevention.   Subsequently, as bridge/transportation authorities or other stakeholders approach the Lifeline with requests for implementing bridge phones, the Lifeline should emphasize the need for barriers as the most effective solution.

In addition to “reducing access to lethal means” (barriers), the Lifeline recognizes that “promoting access to lifesaving means”—such as signage or other public education media near bridges that promotes awareness of hotlines (such as 273-TALK) or other suicide prevention services—is a  supplement to bridge barriers.

To read and download the full position paper containing background, research and rationale supporting this recommendation, click here.

I don’t think I ever imagined that I would one day author a position paper that argues against the use of hotlines as a key suicide intervention in any situation.  Of course, we know that suicide hotlines are not always the best intervention for every suicide-sensitive situation.  However, with so many opportunities for applying the suicide prevention benefits of hotlines in circumstances where they are truly needed, why should the National Suicide Prevention Lifeline staff and committee members spend any of our valuable time focusing on areas where hotlines are relatively less beneficial?  Specifically, why does the Lifeline believe it is so important to support the installation of bridge barriers on suicide-prone bridges rather than installing hotline call boxes at those locations? Even if one were to agree with this paper’s recommendation supporting barriers, he or she may very reasonably argue that promoting the use of bridge barriers is typically the function of other suicide prevention organizations and advocacy groups.  In nearly all cases, I would likely be the first to agree with such concerns.  But not in this case.

A lot of the background explaining why the Lifeline felt it necessary to officially post a position on bridge barriers, bridge phones and related signage is clearly explained in the paper.  However, what is not noted in the paper was the “last straw”-the catalyst-that moved me to take the issue to the Steering Committee.

I received a call from a man in the Santa Barbara area last fall, who identified himself as a member of “Friends of the Bridge”, a community group formed to prevent the local bridge authority (CalTrans) from moving forward with their plans to install a barrier on the nearby Cold Spring Canyon Arch Bridge.  This bridge-an undeniably glorious structure-has been the site of 31 suicides in the past 25 years.  At the time of his call to me, I had no knowledge of this situation and the heated community debate surrounding the proposed barrier installation.  However, it wasn’t long into the conversation before the man’s bold and sometimes disturbing statements enveloped me in the same debate that has gripped the Santa Barbara community over the past two years. “I believe that beauty trumps suicide” was among a few of his comments that underscored our extreme differences within this lengthy exchange.  However, it was the reason that he was calling me that disturbed me the most.  He had read about the “highly successful, innovative bridge phone/public education model” that had been implemented in New York State by the New York State Bridge Authority, utilizing the Lifeline number.  He noted that CalTrans had voted in favor of the bridge barrier “before the word had gotten out on this wonderful new model”. Surely if they knew about it, he insisted, they would scrap their more “costly, bridge-defacing barrier solution” in favor of the Lifeline bridge phone model deployed by the NYSBA.  He was surprised to hear that I did not agree with him and instead supported the barrier proposal as the most effective suicide prevention approach.  However, he planned to advocate for this so-called “human barrier” (bridge phone) solution, nonetheless. This is why I took the issue to the Steering Committee which, inevitably, led to the Committee’s consensus opinion and support for the development of this unusual “position paper”.

Some of the Lifeline centers will one day be approached (if you haven’t already been approached) by bridge authorities seeking to install bridge phones.  Certainly, the Lifeline will be contacted again on this issue.  In the event any of us are asked to consult with bridge or transportation authorities in the future, this position paper can provide some evidence-based guidance for all parties to consider.  You may certainly make your own decision on whether or not to share this paper in such circumstances.  You are free to agree or disagree with this paper, and your center and your local bridge authorities will arrive at whatever solution is most appropriate for your local community, given available resources.  In fact, it is entirely possible that—as was the case with the NYSBA and Lifeline collaboration—that environmental, maintenance and/or cost issues may present prohibitions for barrier installation, and therefore, bridge phones and/or signage may be the only solution (eg., some suicide prevention is better than none at all).

In any case, we do hope this paper will be of some use to you.  As for the Cold Spring bridge barrier debate in Santa Barbara, I understand that this paper has already begun to register a reaction among anti-barrier advocates.  This paper has also been received at the Bridge Rail Foundation, and I have been informed that it will soon be a part of the continuing dialogues in the Bay Area community’s consideration towards installing a barrier on the Golden Gate Bridge.

As for the future, the Lifeline plans to continue to devote our energies to what we do best: informing all of those interested in suicide prevention about the benefits of including hotlines in their planning efforts.

Link:  Suicide Prevention On Bridges: The National Suicide Prevention Lifeline Position – full position paper

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