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Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.


Saturday, June 28, 2014

A Bridge to Cross




The Golden Gate Bridge has been approved for a $76 million suicide safety net. As I recall, installing a protective structure has been in discussion for a lot of years. Families of people who have jumped off the bridge are understandably happy about it. I can certainly see how they'd want to do something proactive to prevent the kind of suffering they and their loved ones have experienced.

But I have a problem with it, and I hope this isn't interpreted as a lack of empathy towards those families, or towards Kevin Hines, who jumped off the bridge in 2000, at age 19, and miraculously survived.

The statistic in the linked article, which is consistent with my understanding, is that 1400 people have died jumping off the "bridge of death" since it opened in 1937. That's roughly 18 people per year. Again, I don't want to minimize the suffering involved, but to put it in perspective, according to the American Suicidology Association, 39, 518 people killed themselves in 2011, the most recent year for which statistics were available on the site. In other words, 0.05% of all suicides in 2011 were committed by jumping off the Golden Gate Bridge.

What I'm curious about is how much money the federal government devotes to suicide prevention. I poked around online, and I found out the the NIH spent $21 million on suicide prevention in 2013, with a projected spending of the same amount for each of 2014 and 2015.

In 2012, the National Strategy for Suicide Prevention Plan devoted $55 million dollars in federal funds to state, tribal and community prevention efforts.

I found a document, I believe from 2001, with some relevant financial figures:

In 2002, the NIMH offered $2.5 million for stigma-related research.

"SAMHSA provide(d) $5.4 million for a three-year collaborative effort with states to develop and evaluate public education approaches for overcoming barriers to mental health treatment and encouraging community participation for persons with psychiatric disabilities."

"SAMHSA provides funding support to Signs of Suicide (SOS), a peer program that teaches students to recognize depression in peers..." (no figure provided)

"By providing $3.0 million in funding annually over three years, SAMHSA sponsors the Hotline Evaluation and Linkage Project (HELP)."

"SAMHSA is overseeing the launch of the National Suicide Prevention Technical Resource Center in late 2002. Funded at $7.5 million over its first three years, the Center will be dedicated exclusively to suicide prevention..."

"Several HHS operating divisions fund technical assistance efforts aimed at suicide prevention." (no figure)

It was hard to find more information about funding. When I googled, the main link was to the Golden Gate Bridge story.

A few more stats:

At the upper end, there were 19,990 suicides by firearms in 2011. At the lower end, 354 suicides by drowning. And a total of 3996 suicides in California.

And in 2011, there were 987,950 non-fatal suicide attempts in the US.

So this is my problem. The federal government is handing over $76 million to build a net that will prevent roughly 18 people per year, NOT from committing suicide, but from committing suicide by jumping off the Golden Gate Bridge.

I think a lot has to do with the iconic nature of the bridge. As it turns out, about 6 people per year jump off the George Washington Bridge. But no one cares about the GW because it's a rubbish bridge.

A jump from the Golden Gate is dramatic, no doubt. I don't quite understand how people get there on foot. There's Golden Gate Park on one side, and Sausalito on the other, and it's been a while since I've been in the Bay Area, but I think you pretty much have to drive to get close. What I'm trying to say is that it takes some planning.

I just think they're building the wrong kind of net. It's a dramatic gesture for a dramatic structure, but I doubt it'll accomplish much. I think the money would be better spent on catching people before they purchase guns, or down a bottle of pills, or set foot on the Golden Gate, or any other bridge.