The Act and Follow-through of Suicide: Part II

The British Coal-Gas Story

According to Scott Anderson’s NYT article, the little-known British coal-gas story — even among mental health professionals — is a good example of how suicides can be prevented if one takes away the means:

Coal-gas ovenFor generations, the people of Britain heated their homes and fueled their stoves with coal gas. While plentiful and cheap, coal-derived gas could also be deadly; in its unburned form, it released very high levels of carbon monoxide, and an open valve or a leak in a closed space could induce asphyxiation in a matter of minutes. This extreme toxicity also made it a preferred method of suicide. “Sticking one’s head in the oven” became so common in Britain that by the late 1950s it accounted for some 2,500 suicides a year, almost half the nation’s total.

Those numbers began dropping over the next decade as the British government embarked on a program to phase out coal gas in favor of the much cleaner natural gas. By the early 1970s, the amount of carbon monoxide running through domestic gas lines had been reduced to nearly zero. During those same years, Britain’s national suicide rate dropped by nearly a third, and it has remained close to that reduced level ever since.

Experts seems to insist that committing suicide is proof of an underlying mental illness. Suicide that stems from impulsivity, among these experts, is also considered part of a mental illness. Anderson subtly argues against this, and I find myself agreeing with him:

How can this be? After all, if the impulse to suicide is primarily rooted in mental illness and that illness goes untreated, how does merely closing off one means of self-destruction have any lasting effect? At least a partial answer is that many of those Britons who asphyxiated themselves did so impulsively. In a moment of deep despair or rage or sadness, they turned to what was easy and quick and deadly — “the execution chamber in everyone’s kitchen,” as one psychologist described it — and that instrument allowed little time for second thoughts. Remove it, and the process slowed down; it allowed time for the dark passion to pass.

Would this mean that if people had less access to suicidal means that promoted “ease, speed, and certainty of death” (ESCOD), a number of suicides could be averted? It appears so. Anderson continues to make a case using the Ellington Bridge in Northwest Washington as an example:

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.

suicide barriers (ellington 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.

So why the Ellington more than the Taft? … 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.

Dr. Richard Seiden, professor emeritus and clinical psychologist at the University of California at Berkeley School of Public Health noted:

“At the risk of stating the obvious, 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 hits the nail on the head when it comes to premeditation. If I’m planning on hanging myself, being thwarted from that action somehow breaks down my nerve to try anything else. However, in my mixed-mood episodes, which
much of my impulsivity stems from, I’ll try or do anything to kill myself — from wrapping a cell phone cord around my neck to running into the kitchen to take a swig of Drano.

“At the risk of stating the obvious, people who attempt suicide aren’t thinking clearly.”

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