Removing bridge barriers stimulates suicides: an unfortunate natural experiment.

Objectives: Safety barriers to prevent suicide by jumping were removed from Grafton Bridge in Auckland, New Zealand, in 1996 after having been in place for 60 years. This study compared the number of suicides due to jumping from the bridge after the reinstallation of safety barriers in 2003. Methods: National mortality data for suicide deaths were compared for three time periods: 1991-1995 (old barrier in place); 1997-2002 (no barriers in place); 2003-2006 (after barriers were reinstated). Results: Removal of barriers was followed by a fivefold increase in the number and rate of suicides from the bridge. These increases led to a decision to reinstall safety barriers. Since the reinstallation of barriers, of an improved design, in 2003, there have been no suicides from the bridge. Conclusions: This natural experiment, using a powerful a-b-a (reversal) design, shows that safety barriers are effective in preventing suicide: their removal increases suicides; their reinstatement prevents suicides. [ABSTRACT FROM AUTHOR]