Psychiatr News July 7, 2006
Volume 41, Number 13, page 9
© 2006 American Psychiatric Association
Suicide Prevention vs. Aesthetics: Maine's Capital Divided
Mark Moran
Between 1960 and 2005, 14 people in Augusta, Maine, committed suicide by
leaping from a local bridge. After a suicide barrier was constructed in 1983,
that grim tally dropped to zero.
Citizens in Augusta, Maine, have until next month to garner enough
signatures to put replacement of a suicide barrier on the city's Memorial
Bridge put to a citywide vote.
The city's eight-member city council voted in December 2005 and again in
April of this year to rebuild the barrier—after it was taken down when
the bridge was renovated—and the State Department of Transportation,
which has jurisdiction over the bridge, has already agreed to reinstitute the
barrier at no cost to the city.
But some citizens, including one city council member, want the question put
to a citywide vote.
The 2,100 foot bridge spans the kennebec River, which bisects Maine's
capital city, and has two lanes for traffic and a sidewalk for pedestrians on
each side of the roadway; at its central point the bridge is approximately 100
feet above the water.
In 1983 an 11-foot-high fence was installed on each side of the bridge to
prevent people from jumping from it, but it was removed last year when the
bridge was closed for renovation.
City Appears Divided
With the reopening of the bridge to auto and pedestrian traffic, a movement
has emerged to scrap the suicide barrier. The controversy pits public safety
and protection of people with mental illness from impulsive suicide against
concerns about aesthetics and what some in the city regard as defacement of a
landmark.
"People hated that fence, but they didn't know they hated it until it
came down," city council member Donna Lerman, who voted against
rebuilding the barrier, told Psychiatric News. "We didn't
realize the negative impact of the fence on the city's mental wellbeing, but
when it came down, people began to say, `This is really a beautiful town.' The
bridge is the highest point from which to view the city. We had really lost
touch with what was good about our city."
Lerman said she also believes the suicide barrier diverts attention from
the need for community-based services for people with mental illness in the
city.
"We have a lot of people living in the community with inadequate
support," she noted. "The fence on the bridge is a way people can
address that problem and feel that they have no further responsibility toward
making sure that people have adequate support."
She added that suicides occur in other ways—from gunshot wounds and
drug overdoses—but that many of them are largely invisible to the
public. "It's not so much suicide that people are concerned about as the
visibility of people who jump from the bridge."
Barrier Fulfilled Its Mission
But advocates of the barrier, including the Maine Association of
Psychiatric Physicians (MAPP), point out that during the 22 years in which the
barrier was in place, there were no suicides from Memorial Bridge. A study
completed in March by Andrew Pelletier, M.D., a medical epidemiologist at the
federal Centers for Disease Control and Prevention, found that from April 1,
1960, through July 31, 2005, 14 suicides from Memorial Bridge occurred, all of
them prior to construction of the suicide barrier in 1983.
"Results of this study indicated that the safety fence installed in
1983 was effective in preventing further suicides from the Memorial
Bridge," Pelletier said. "The number of suicides related to
jumping from other structures in Augusta remained unchanged following
installation of the fence, suggesting that suicidal individuals did not seek
alternative sites. The larger decline in the suicide rate for the city
compared with the state further suggests that the fence was probably effective
in lowering the overall suicide rate in Augusta."
Lawrence Mutty, M.D., told Psychiatric News that patients with
mental illness come from all over Maine to be treated at the 92-bed state
psychiatric hospital and various outpatient mental health clinics on either
side of—and in close proximity to—the Memorial Bridge. In addition
to the state hospital on the east side of the bridge, there are two other busy
inpatient psychiatric services, Maine General Medical Center and the vA
Medical Center Togus.
"There is a pedestrian traffic across the bridge that is uniquely at
risk," said Mutty, a past president of MAPP and currently a councilor to
its executive committee. He is also immediate past president of the Maine
Medical Association.
He added that many of the state's medical leaders, including leaders of the
Maine Medical Association, have supported reconstruction of the barrier.
The controversy over rebuilding the barrier echoes themes that surround
debate about building a similar barrier on San Francisco's Golden Gate Bridge,
which has for many years been a favored destination of those in the Bay area
seeking to end their lives (Psychiatric News, April 1, 2005).
Psychiatrists with the Northern California Psychiatric Foundation have led
a groundswell of support for erecting a barrier on the storied bridge in the
face of public apprehension that such a barrier would deface one of the
world's most extraordinary structures. Barrier design studies are under
way.
In Toronto a similar debate occurred around construction of a barrier at
the city's Bloor Street viaduct. In 2003, after nearly six years of
discussion, a barrier was built that has dramatically reduced the number of
suicides there.
In Augusta, comments from people on both sides of the issue seem to
indicate that the barrier at Memorial Bridge was less than aesthetically
appealing. Mutty said the state opted for the least-costly option, a
chain-link cyclone fence that had rusted over the years.
City Manager William Bridgeo told Psychiatric News that the state
Department of Transportation has already agreed to replace the barrier with a
similar one, but that if the city wants something more aesthetically
appealing, it will have to pay the additional costs. He said those costs would
be approximately $250,000.
 
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No suicides occurred on the Memorial Bridge in Augusta, Maine, while the
suicide barriers were in place.
Maine Department of Transportation
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Bridgeo explained that in a council meeting last month, a group of citizens
led by Lerman lodged a formal request for the question about the bridge
barrier to be put before city voters in a referendum.
He said that under city law, if the citizens group can garner a number of
signatures equal to 20 percent of the number of voters in the last
gubernatorial election— or approximately 1,500 signatures—the
question will be placed on the ballot. They have 60 days since last month's
city council meeting to do so, or until the first week in August. 
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