There are some arguments embedded in here...

From an article at the New York Times on suicide - some things that raise some questions about things:

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.

After three people leapt from the Ellington in a single 10-day period in 1985, a consortium of civic groups lobbied for a suicide barrier to be erected on the span. Opponents to the plan, which included the National Trust for Historic Preservation, countered with the same argument that is made whenever a suicide barrier on a bridge or landmark building is proposed: that such barriers don’t really work, that those intent on killing themselves will merely go elsewhere. In the Ellington’s case, opponents had the added ammunition of pointing to the equally lethal Taft standing just yards away: if a barrier were placed on the Ellington, it was not at all hard to see exactly where thwarted jumpers would head.

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.

What makes looking at jumping suicides potentially instructive is that it is a method associated with a very high degree of impulsivity, and its victims often display few of the classic warning signs associated with suicidal behavior. In fact, jumpers have a lower history of prior suicide attempts, diagnosed mental illness (with the exception of schizophrenia) or drug and alcohol abuse than is found among those who die by less lethal methods, like taking pills or poison. Instead, many who choose this method seem to be drawn by a set of environmental cues that, together, offer three crucial ingredients: ease, speed and the certainty of death.

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.

But how do you prove that those thwarted from the Ellington, or by any other suicide barrier, don’t simply choose another method entirely? As it turns out, one man found a clever way to do just that. With a somewhat whimsical manner and the trace of a grin constantly working at one corner of his mouth, Richard Seiden has the appearance of someone always in the middle of telling a joke. It’s not what you might expect considering that Seiden, a professor emeritus and clinical psychologist at the University of California at Berkeley School of Public Health, is probably best known for his pioneering work on the study of suicide. Much of that work has focused on the bridge that lies just across San Francisco Bay from campus, the Golden Gate.

Since its opening in 1937, the bridge has been regarded as one of the architectural and engineering marvels of the 20th century. For nearly as long, the Golden Gate has had the distinction of being the most popular suicide magnet on earth, a place where an estimated 2,000 people have ended their lives. Over the years, there have been a number of civic campaigns to erect a suicide barrier on the bridge, but all have foundered on the same “they’ll just find another way” belief that made the Ellington barrier so contentious.

In the late 1970s, Seiden set out to test the notion of inevitability in jumping suicides. Obtaining a Police Department list of all would-be jumpers who were thwarted from leaping off the Golden Gate between 1937 and 1971 — an astonishing 515 individuals in all — he painstakingly culled death-certificate records to see how many had subsequently “completed.” His report, “Where Are They Now?” remains a landmark in the study of suicide, for what he found was that just 6 percent of those pulled off the bridge went on to kill themselves. Even allowing for suicides that might have been mislabeled as accidents only raised the total to 10 percent.

“That’s still a lot higher than the general population, of course,” Seiden, 75, explained to me over lunch in a busy restaurant in downtown San Franciso. “But to me, the more significant fact is that 90 percent of them got past it. They were having an acute temporary crisis, they passed through it and, coming out the other side, they got on with their lives.”

In Seiden’s view, a crucial factor in this boils down to the issue of time. In the case of people who attempt suicide impulsively, cutting off or slowing down their means to act allows time for the impulse to pass — perhaps even blocks the impulse from being triggered to begin with. What is remarkable, though, is that it appears that the same holds true for the nonimpulsive, with people who may have been contemplating the act for days or weeks.

“At the risk of stating the obvious,” Seiden said, “people who attempt suicide aren’t thinking clearly. They might have a Plan A, but there’s no Plan B. They get fixated. They don’t say, ‘Well, I can’t jump, so now I’m going to go shoot myself.’ And that fixation extends to whatever method they’ve chosen. They decide they’re going to jump off a particular spot on a particular bridge, or maybe they decide that when they get there, but if they discover the bridge is closed for renovations or the railing is higher than they thought, most of them don’t look around for another place to do it. They just retreat.”

Seiden cited a particularly striking example of this, a young man he interviewed over the course of his Golden Gate research. The man was grabbed on the eastern promenade of the bridge after passers-by noticed him pacing and growing increasingly despondent. The reason? He had picked out a spot on the western promenade that he wanted to jump from, but separated by six lanes of traffic, he was afraid of getting hit by a car on his way there.

“Crazy, huh?” Seiden chuckled. “But he recognized it. When he told me the story, we both laughed about it.”

The offices of the Injury Control Research Center are on the third floor of the Harvard School of Public Health building in Boston. The center, directed by David Hemenway, consists of an internationally renowned team of public-health officials, social scientists and statisticians, and over the past decade they have been in the vanguard of a movement that looks at suicide prevention in a new and very different way: call it the Band-Aid approach.

“One of the differences between us and those in mental health,” Hemenway explained, “is that we focus on the ‘how’ of suicide. What are the methods used? Is there a way to mitigate them? And that’s where examples like the British coal-gas story are very instructive, because they show that if you can somehow remove or complicate a method, you have the potential of saving a tremendous number of lives.”

Animating their efforts is one of the most peculiar — in fact, downright perverse — aspects to the premeditation-versus-passion dichotomy in suicide. Put simply, those methods that require forethought or exertion on the actor’s part (taking an overdose of pills, say, or cutting your wrists), and thus most strongly suggest premeditation, happen to be the methods with the least chance of “success.” Conversely, those methods that require the least effort or planning (shooting yourself, jumping from a precipice) happen to be the deadliest. The natural inference, then, is that the person who best fits the classic definition of “being suicidal” might actually be safer than one acting in the heat of the moment — at least 40 times safer in the case of someone opting for an overdose of pills over shooting himself.

As illogical as this might seem, it is a phenomenon confirmed by research. According to statistics collected by the Injury Control Research Center on nearly 4,000 suicides across the United States, those who had killed themselves with firearms — by far the most lethal common method of suicide — had a markedly lower history of depression, schizophrenia, bipolar disorder, previous suicide attempts or drug or alcohol abuse than those who died by the least lethal methods. On the flip side, those who ranked the highest for at-risk factors tended to choose those methods with low “success” rates.

“We’re always going to have suicide,” Hemenway said, “and there’s probably not that much to be done for the ones who are determined, who succeed on their 4th or 5th or 25th try. The ones we have a good chance of saving are those who, right now, succeed on their first attempt because of the lethal methods they’ve chosen.”

Inevitably, this approach means focusing on the most common method of suicide in the United States: firearms. Even though guns account for less than 1 percent of all American suicide attempts, their extreme fatality rate — anywhere from 85 percent and 92 percent, depending on how the statistics are compiled — means that they account for 54 percent of all completions. In 2005, the last year for which statistics are available, that translated into about 17,000 deaths. Public-health officials like Hemenway can point to a mountain of research going back 40 years that shows that the incidence of firearm suicide runs in close parallel with the prevalence of firearms in a community. In a 2007 study that grouped the 15 states with the highest rate of gun ownership alongside the six states with the lowest (each group had a population of about 40 million), Hemenway and his associates found that when it came to all nonfirearm methods, the two populations committed suicide in nearly equal numbers. The more than three-times-greater prevalence of firearms in the “high gun” states, however, translated into a more than three-times-greater incidence of firearm suicides, which in turn translated into an annual suicide rate nearly double that of the “low gun” states. In the same vein, their 2004 study of seven Northeastern states found that the 3.5 times greater rate of gun suicides in Vermont than in New Jersey exactly matched the difference in gun ownership between the two states (42 percent of all households in Vermont opposed to 12 percent in New Jersey). From these and other such studies, the Injury Control Research Center has extrapolated that a 10 percent reduction in firearm ownership in the United States would translate into a 2.5 percent reduction in the overall suicide rate, or about 800 fewer deaths a year.

Beyond sheer lethality, however, what makes gun suicide attempts so resistant to traditional psychological suicide-prevention protocols is the high degree of impulsivity that often accompanies them. In a 1985 study of 30 people who had survived self-inflicted gunshot wounds, more than half reported having had suicidal thoughts for less than 24 hours, and none of the 30 had written suicide notes. This tendency toward impulsivity is especially common among young people — and not only with gun suicides. In a 2001 University of Houston study of 153 survivors of nearly lethal attempts between the ages of 13 and 34, only 13 percent reported having contemplated their act for eight hours or longer. To the contrary, 70 percent set the interval between deciding to kill themselves and acting at less than an hour, including an astonishing 24 percent who pegged the interval at less than five minutes.

The element of impulsivity in firearm suicide means that it is a method in which mechanical intervention — or “means restriction” — might work to great effect. As to how, Dr. Matthew Miller, the associate director of the Injury Control Research Center, outlined for me a number of very basic steps. Storing a gun in a lockbox, for example, slows down the decision-making process and puts that gun off-limits to everyone but the possessor of the key. Similarly, studies have shown that merely keeping a gun unloaded and storing its ammunition in a different room significantly reduces the odds of that gun being used in a suicide.

“The goal is to put more time between the person and his ability to act,” Miller said. “If he has to go down to the basement to get his ammunition or rummage around in his dresser for the key to the gun safe, you’re injecting time and effort into the equation — maybe just a couple of minutes, but in a lot of cases that may be enough.”

It reminded me of what Richard Seiden said about people thwarted from jumping off the Golden Gate Bridge. When I mentioned this to Miller, he smiled. “It’s very much the same,” he said. “The more obstacles you can throw up, the more you move it away from being an impulsive act. And once you’ve done that, you take a lot of people out of the game. If you look at how people get into trouble, it’s usually because they’re acting impulsively, they haven’t thought things through. And that’s just as true with suicides as it is with traffic accidents.”