Where Are They Now? A Follow-up
Study of Suicide Attempters from
the Golden Gate Bridge
Richard H. Seiden, Ph.D., M.P.H.
University of California at Berkeley
ABSTRACT: The Golden Gate Bridge is
currently the number one suicide location in the world. From the opening day,
May 18, 1937 to April 1, 1978, there have been 625 officially reported suicide
deaths and perhaps more than 200 others which have gone unseen and unreported.
Proposals for the construction of a hardware ant suicide barrier have been
challenged with the untested contention that “they’ll just go someplace
else” This research tests the contention by describing and evaluating the
long-term mortality experience of the 515 persons who had attempted suicide
from the Golden Gate Bridge but were restrained, from the opening day through
the year 1971 plus a comparison group of 1-84 persons who made no bridge
suicide attempts during 1956-57 and were treated at the emergency room of a
large metropolitan hospital and were also followed through the close of 1971.
Results of the follow up study are directed toward answering the important
question: “Will a person who is prevented from suicide in one location
inexorably tend to attempt and commit suicide elsewhere?”
The Golden Gate Bridge, situated at the point where San Francisco Bay
meets the Pacific Ocean, is a leading tourist attraction. The most
photographed structure in the United States, it is an engineering marvel, a
thing of beauty and a joy to behold. Yet, lurking beneath these accolades is
the sinister realization that it is currently the world’s leading site for
On May 28, 1937, the Golden Gate Bridge
was first opened. Less than three months later, on August 8, 1937, the first
known suicide from the Golden Gate Bridge occurred. As of April 1, 1978, a
period of some 40 years, the official number of suicides from the Golden. Gate
Bridge was 625. The true number of persons who have leaped to their deaths
from this bridge is even higher since darkness, rain, fog, and a swift ocean
bound current may have concealed from us more than 200 additional suicides. To
remedy this morbid situation there has been considerable pressure to construct
a hardware suicide prevention barrier by extending the present 3½-foot
railings to a height of eight feet. Although there is strong support from many
segments of the Bay Area community, the Golden Gate Bridge Board of
Directors has consistently dragged its feet on this issue ever since the
barrier concept was first proposed over 30 years ago. Many reasons have been
given for the delaying tactics but a major argument against constructing a
barrier has been that it just wouldn’t work. Why wouldn’t it work? Because
“common sense” tells us that if a person is bent upon suicide lie will
find a way and inexorably go someplace else to kill himself. So goes the
Review of the Literature
With the growing amount
of suicidal behavior from the Golden Gate Bridge, there has been increasing
attention paid to the problem (Brown, 1965; Rosen, 1975; Seiden, 1967, 1970,
1973, 1974, 1975, 1977; Seiden & Tauber, 1970; Snyder & Snow, 1967).
While these are the only reports directly concerned with Golden Gate suicide
there has been complementary research dealing with the broader question of
specific locations, which develop magnetic reputations for suicidal behavior.
Derobert et al. (1965) Analyzed the information on fatal leaps from French monuments including the Eiffel Tower, which was the site for 339 suicides between 1889 and 1965. McWilliams (1936) reported on the Arroyo Seco Bridge of Pasadena, California, where 80 suicides were recorded during the years 1913-1936. Shneidman (1963) discussed 25 suicides, which occurred through leaps from the windows of a single general hospital in the period 1955-1961. Ellis and Allen (1961) describe an array of suicide landmarks including the Empire State Building, which was the site for 16 suicides from 1931-47, and the infamous Mt. Mihara volcano on the Japanese island of Oshima where during the early 1930s many hundreds of persons killed themselves by jumping into the smoking volcanic crater.
However, these examples
differ from the Golden Gate Bridge story in one very significant respect. In
every other instance the rash of suicides led to the construction of suicide
barriers, which dramatically reduced or ended the incidence of suicides. Of
all the suicide landmarks, the Golden Gate Bridge alone has failed to solve
the problem with a protective hardware suicide deterrent.
There are two major and conflicting
viewpoints regarding the question. Will suicides be prevented or reduced by
restricting the availability of a particular means? Or will such a move simply
result in a transfer to other more available methods? The conflict is best
illustrated by the current debate concerning the significantly reduced British
suicide rates, that is, about a one-third reduction from 1963 to the present
following the introduction of less toxic natural gas to replace the highly
lethal coke gas previously in domestic use. Those who discount the importance
of this change in previously available methods (Fox, 1975; Bagley, 1973)
assert that an individual who is prevented from suicide by a particular means
will simply choose an alternative, available method. Relative to the Golden
Gate Bridge, a consequence of this belief is that there would be little to
gain from a hardware ant suicide barrier since “they’d just go someplace
else.” On the other hand, there are those who hold a contrary view, namely,
that a switch to less lethal agents would reduce suicides or that when a
person is unable to kill himself in a particular way it may be enough to tip
the vital balance from death to life in a situation already characterized by
strong ambivalence (Brown, 1977; Hassal & Trethowan, 1972; Kreitman, 1976;
Malleson, 1973a, 1973b; Survivors Anonymous, n.d.). The fact is that the
British rates have remained reduced for the past 15 years, and that there has
been an almost one-to-one correspondence between the reduction of suicides and
the number of persons who had used coke gas in prior years. There has been no
change to more available methods such as hanging, drowning, etc.
One way to test the unverified assumption that persons
frustrated from suicide on the bridge would simply and inexorably go
someplace else to commit the act is to follow the subjects who were restrained
at the bridge. What was their mortality experience over the years and how does
it compare with a sample of no bridge suicide attempters? To answer these
questions we collected data on 515 subjects who made suicide attempts from the
day the Golden Gate Bridge (GGB) opened (May 28, 1937) through the end of
calendar year 1971. For purposes of general comparison we also followed
through the close of 1971, the cohort of 184 persons who were treated for no
bridge suicide attempts at the San Francisco General Hospital (SFGH) emergency
room during the years 1956-57.
“Suicide attempt” was operationally defined for the hospital group by the diagnosis made by the emergency room physician. For the bridge group we employed the criteria used by the California Highway Patrol who investigate, classify and record all instances of suicidal behavior on the bridge. They defined attempted suicide as “any incident in which a subject commits an overt act toward an attempt to commit suicide.” This definition probably underestimates the true magnitude of events somewhat since it does not include several varieties of “suspicious” behavior, such as persons apprehended walking “suspiciously” around the parking lots, toll booths, etc.
defined our populations of bridge and hospital suicide attempters and recorded
all available demographic information from the hospital records and Highway
Patrol files, we submitted the relevant information (name; age, sex; social
security number; date last known to be alive, that is, the date of their
recorded attempt) to the State of California Office of Vital Statistics for a
death certificate search. While this method has advantages in terms of
centralized data retrieval, it also has some disadvantages. The major
liability of this method is that it rests upon the assumption that the suicide
attempters continued to reside in California during the period of follow up
study. Nonresidents and residents who died in California would be counted. So
would California residents dying out of state since there are reciprocal
agreements between the states on this matter but we would miss nonresidents
who died out of state. Since there is no federal death registry we cannot be
sure of how many cases were missed; however, the use of California vital
statistics represents the best estimate of cases particularly since 90% or
more of bridge attempters were residents of California. Nonetheless, there are
always such problems in long-term follow up studies so that we have endeavored
to compensate for such “slippage” by interpreting the results of our epidemiological
analyses in an extremely conservative manner.
Table 1 indicates the follow up periods for
the two study groups. The Golden Gate Bridge group (GGB) included all cases of
suicide attempts from the day the bridge opened on May 28, 1937, until the end
of calendar year 1971, a period of 34 years and 7 months, during which time
there were 515 cases with the median case occurring 26 years, 7 months after
the bridge was opened to the public.
The San Francisco General
Hospital study group (SFGH) consisted of all cases of suicide attempt treated
at the emergency room during calendar years 1956 and 1957. These 184 cases
were followed until the close of calendar year 1971, a period of 16 years from
start to close with a median follow up period of 15 years.
Closing date 12—31—71 12—31—71
Duration of study
period 34 yrs., 7 mos.
Median follow-up period 26 yrs. 7 mos.
Suicide Attempts. GGB. 1937-71
Years f cf
1937—41 8 8
1942—46 4 12
1947—51 20 32
1952—56 61 93
1957—61 112 205
1962—66 178 383
1967—71 132 515
describes the frequency and cumulative frequency of suicide attempts at the
Golden Gate Bridge.
The number of suicide attempts has accelerated rapidly over the 34-plus years with half of the cases occurring during the last 8 years of the study period. (Incidentally, the actual suicide deaths from the bridge have shown a similar parallel acceleration over the years, r =.72.) This frequency distribution dramatically illustrates the continuing trend, which has resulted in the bridge’s unhappy reputation as the world’s leading suicide location.
Figure 1 graphs the cumulative
frequency of Golden Gate Bridge suicide attempts over time illustrating the
rapid increase of Golden Gate Bridge suicide attempts detailed in Table 2.
Table 3 indicates the
distribution by sex of the two study groups and reveals an interesting
reversal from expected norms in the Golden Gate Bridge group. Whereas the San
Francisco General Hospital cases follow the usual distribution of relatively
greater numbers of suicide attempts by females (sex ratio = 61), the
Golden Gate Bridge group yields an atypical distribution with a preponderance
of males (sex ratio = 233); a situation more closely approximating the
sex ratio found among completed suicides. The difference in sex distribution
between the two groups is significant at beyond the .001 level and confounds
any direct comparability between the study groups. Why should the GGB group
demonstrate this reversal of form? Previous studies (Seiden, 1977; Lester
& Lester, 1971) have speculated
FIGURE 1. Cumulative
frequency of suicide attempts. GGB, 1937-71.
that women make more attempts but
fewer completions because they use methods which are less violent, less
disfiguring and less lethal. All of these factors may play a part in the
present situation, however lethality appears to be the major factor. Although
jumping from the GGB at a height of over 200 feet usually results in a
violent, disfiguring death from massive traumatic injury these facts are not
generally appreciated. Instead, the popular mythology holds that one is gently
swallowed by the waves to die by drowning. On the other hand, the lethality of
the bridge is widely acknowledged since it is well known that only a handful
of persons have survived the leap-some 12 people out of more than 600 jumpers
have lived to tell the tale. In other words, the jump is fatal more than 98%
of the time. As such, it suggests that relatively more men are drawn to the
bridge because of its extreme lethality.
During the period of
study there were 64 deaths recorded in the GGB group (12.5%) and 47 deaths in
the SFGH group (25.5%). The distribution of these deaths by mode (following
the usual NASH scheme) is depicted in Table 4. For the GGB group about half
the deaths (50.7%) occurred violently, and for the SFGH group, almost half
(42.6%) were violent in nature. In fact, even many of the so-called
“natural” deaths in our study groups were indicative of self-destructive
tendencies. For example, about 20% of each group died from fatty livers, a
typical consequence of alcohol abuse. The distinction between accident and
suicide was even more contentious and often seemed arbitrary at best. For
instance, cases of barbiturate overdose, alcohol poisoning and one-car
accidents were categorized as “accidental.” Accordingly, it appeared
appropriate to collapse the categories of accident, suicide and homicide under
the general rubric of “Violent Deaths” as defined by the National Center
for Health Statistics Ventura, 1975).
compares the percentages in each of the study groups with the population
distribution for the United States at large in 1960. Inspection of the table
discloses that only seven percent of all U.S. deaths were violently caused as
opposed to approximately half of all deaths in the two study groups. Both
groups departed from U.S. population expectations at beyond the .001 level
of significance indicating that the prospect of violent death is considerably
enhanced for suicide attempters as compared to the general population.
Having made a suicide attempt, what are the
comparable survival experiences for men and women? Are attempts by men more
successful than those by women? And, if so, do they tend to die more violently?
As Tables 6 and 7 indicate the answer to both questions is
Despite the fact that the male and female suicide attempters did not differ
appreciably in the ages at which they made their suicide attempts (males 45.1,
females 42.6), the male suicide attempters were apt to be more successful than
female suicide attempters. While it is well known that women have a greater
life expectancy than men, this has been attributed to biological reasons;
however, the overrepresentation of male violent deaths bespeaks a psychosocial
susceptibility as well.
For purposes of identifying high-risk
subjects, it is instructive to look at the ages at which they made their
suicide attempts. Table 8 reveals that for both groups the average age of
survivors was slightly below the average for their study group and that the
average age of non-survivors was considerably higher. This is no surprise
since the mortality rate increases with chronological age. What makes for a
more interesting comparison is an analysis of the mode of death by age at
attempt. That is, having made a suicide attempt does the age at which it was
made bear any relationship to whether one’s subsequent death will be natural
or violent? Table 9 indicates that age does play an important part and that
persons who will die violently made their attempts at significantly younger
ages than did their counterparts who died nonviolently
Once having attempted suicide is there
any relationship between the years of life remaining and the mode of death?
Table 10 suggests that there is such a relationship in the Golden Gate Bridge
group and that 0GB suicide attempters who will die violently will do so in a
considerably shorter period of time than those who will die natural deaths.
In terms of clinical management,
one must be able to identify periods of high risk in order to conserve resources
and expend them when they will do the most good. Prior research indicates that
the high-risk period for suicide attempters occurs within 90 days after
discharge from the hospital (Shneidman and Farberow, 1957). Table 11 reveals a
similar pattern among the GGB group where almost one-third (10 out of 32) of the
violent deaths occurred within six months of their suicide attempts. None of the
natural deaths in either group occurred within six months nor did any of the
violent SFGH deaths occur within six months. What appears to be happening here
seems a consequence of the way 0GB suicide attempters are treated once apprehended.
Compared to the hospital group which is identified and frequently entered into
treatment programs, the bridge attempters are, more often than not, left to
their own devices. Frequently they are simply sent home, sometimes with friends
or relatives, sometimes by themselves. In some other cases they are sent to the
local catchments area mental health facility but this seems to occur on a
nonsystematic basis. What actually happens when a person is apprehended
attempting suicide on the Bridge? The California Highway Patrol exercises
discretionary responsibility in these cases. Although attempted suicide is not a
crime in California, a person can be restrained for as much as 72 hours for
observation if he or she is considered to be a danger to himself/herself or
others. The Highway Patrol uses this procedure, but only in cases they consider
to be “overt acts.” There are other times when the patrolmen may be
concerned but not absolutely sure of the person’s suicide potential although
he or she is acting suspiciously enough to warrant intervention. These cases are
frequently not sent to treatment facilities and are logged in the records as
“reportable incidents” rather than bona fide suicide attempts. Even when
people are delivered to the local catchments facility, they may be released upon
the discretion of the intake staff. As such there are two levels at which
slippage occurs; first, by the highway patrolmen on the bridge, and second, by
the intake worker at the treatment facility. Consequently we are dealing often
with an untreated population whose subsequent quick and violent (largely
suicidal) deaths may be attributed to the failure to heed their “cries for
Table 12 gives the rates of suicide and
other violent modes of death for the two study groups and indicates a suicide
rate which is many times higher than the general U.S. population (approximately
11 per 100,000) but comparable to the extremely high rate for persons who have
made prior suicide attempts (Dorpat & Ripley, 1967).
Finally, in Table 13 we have the
proportion of persons in each study group who subsequently committed suicide or
died from other violent causes. What this table discloses is that after 26-plus
years the vast majority of GGB suicide attempters (about 94%) are still alive or
have died from natural causes. The comparison group of hospital cases has had
similar experiences; 89% are still alive or are dead from natural means after 15
years. Conversely, only five to seven percent killed themselves and some six to
11% had died from all violent causes combined. Even if we compensate for
under-enumeration by doubling our frequencies it still means that about 90% of
the study subjects were alive or had come to a natural non-violent end.
Analysis of the results leads to the
following conclusions about the study populations of suicide attempters:
1. Compared to the general population, a greater proportion is likely to die from violent, that is, accidental, suicidal, and homicidal modes of death.
2. Males have a greater risk of mortality than do females for all modes of death.
3. Younger persons were more likely to come to a violent end than their older counterparts.
4. Following a bridge suicide attempt, violent deaths occurred within a brief time span; almost one-third took place within six months.
5. Subsequent rates of suicide and other violent death are much higher than for the general population.
6. Despite the high rates vis-a-vis the general population, still about 90% do not die of suicide or by other violent means.
The major hypothesis under test, that
Golden Gate Bridge attempters will surely and inexorably “just go someplace
else,” is clearly unsupported by the data. Instead, the findings confirm
previous observations that suicidal behavior is crisis-oriented and acute in
nature. Accordingly, the justification for prevention and intervention such as
building a suicide prevention barrier is warranted and the prognosis for suicide
attempters is, on balance, relatively hopeful.
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 Suicide and Life
Threatening Behavior, Vol. 8 (4), Winter 1978
0363-0234/78/1600-0203$00.951978 Human Sciences Press
The above article is not complete with, several tables were not included as illustrated in the report given by Dr. Richard Seiden. The text above is complete in content.
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