Effect of a barrier at Bloor Street Viaduct on suicide rates in Toronto: natural experiment

BMJ. 2010 Jul 6:341:c2884. doi: 10.1136/bmj.c2884.

Abstract

Objective: To determine whether rates of suicide changed in Toronto after a barrier was erected at Bloor Street Viaduct, the bridge with the world's second highest annual rate of suicide by jumping after Golden Gate Bridge in San Francisco.

Design: Natural experiment.

Setting: City of Toronto and province of Ontario, Canada; records at the chief coroner's office of Ontario 1993-2001 (nine years before the barrier) and July 2003-June 2007 (four years after the barrier).

Participants: 14 789 people who completed suicide in the city of Toronto and in Ontario.

Main outcome measure: Changes in yearly rates of suicide by jumping at Bloor Street Viaduct, other bridges, and buildings, and by other means.

Results: Yearly rates of suicide by jumping in Toronto remained unchanged between the periods before and after the construction of a barrier at Bloor Street Viaduct (56.4 v 56.6, P=0.95). A mean of 9.3 suicides occurred annually at Bloor Street Viaduct before the barrier and none after the barrier (P<0.01). Yearly rates of suicide by jumping from other bridges and buildings were higher in the period after the barrier although only significant for other bridges (other bridges: 8.7 v 14.2, P=0.01; buildings: 38.5 v 42.7, P=0.32).

Conclusions: Although the barrier prevented suicides at Bloor Street Viaduct, the rate of suicide by jumping in Toronto remained unchanged. This lack of change might have been due to a reciprocal increase in suicides from other bridges and buildings. This finding suggests that Bloor Street Viaduct may not have been a uniquely attractive location for suicide and that barriers on bridges may not alter absolute rates of suicide by jumping when comparable bridges are nearby.

MeSH terms

  • Adult
  • Environment Design*
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ontario
  • Protective Devices
  • Residence Characteristics
  • Suicide / statistics & numerical data
  • Suicide Prevention*