Suicide and the - International Parking Institute

Suicide and the
INTRODUCTION
During the course of your lunch break today,
three or four Americans will probably succeed
in killing themselves. Each day 86 Americans
take their own lives and over 1,500 attempt
suicide. In 2008 alone, an estimated 8.3 million
adults worldwide had serious thoughts of
suicide, 2.3 million made a suicide plan, and
1.1 million attempted suicide. Thousands of
people attempt suicide by jumping every year,
resulting in hundreds of deaths. Although it is
unclear how many of those deaths by jumping
occurred in a parking garage, 34.3 percent of
suicide deaths by jumping occurred at a transport
area such as a parking garage, highway or
train station between 2005 and 2007.
Because we in the parking industry have
heard stories about suicide jumpers jumping
from parking garages and may have even witnessed
one of these stories, we feel the topic
needs to be addressed. Certainly the family of
the individual is tragically impacted, but so
too are customers and garage employees on
duty at the time of the incident. Perhaps what
is more tragic is that to some degree, many
30 September 2010 l International Parking Institute
suicides are preventable. Why does suicide
from jumping happen? Where is suicide from
jumping most likely to occur? How do we as
parking professionals handle this situation if it
does occur in our garage? How can parking
professionals help prevent suicide from happening?
We hoped to answer some of these
questions for ourselves and share them with
you. Although this can be an extremely sensitive,
controversial and painful subject, it is one
that the parking profession needs to be prepared
for.
WHY DOES SUICIDE FROM
JUMPING HAPPEN?
Assurance. In an article by Emily Friedman
titled “Inside the Mind of a Suicide Jumper,”
Adam Kaplan, an assistant professor of psychiatry
at Johns Hopkins Medical Institute,
observes that “Jumping is sort of like using a
gun – once you make that decision to [kill
yourself], it’s pretty much a done deal.” In the
same article, Richard McKeon, a clinical psychologist
at the Substance Abuse and Mental
Health Services Administration speculates
that “Many people who die by suicide, as best
we can determine, may have had some level of
ambivalence right up until that final moment
… If you use a less lethal means like an overdose,
there is still a possibility of taking it
back [by calling for help]. But with a firearm,
once someone pulls the trigger the likelihood
that they'll be mortally wounded is high. Similarly,
jumping off a bridge or a high story of a
skyscraper has a high likelihood of death.”
Convenience. Another reason according to
Madelyn Gould, a clinical psychologist and a
suicide expert, is that jumping from tall structures
is often chosen by suicidal people simply
as a matter of convenience. Chuck Cullen, a
parking consultant with The Integrity Group,
points out the chilling practicality of suicide
by jumping: “Jumping from a building is less
costly and can be done without delays. Most
office buildings, however, are closed at night,
have sealed windows, and security in the lobby.
Hence a garage provides a solution. The garage
has open sides for ventilation, will usually allow
customers to enter without any security check,
and will have fewer people walking around.”

WHERE DOES SUICIDE FROM
JUMPING MOST COMMONLY
OCCUR?
A simple Google search on “Suicide by Parking
Garage” yielded over two million results.
According to data collected by the National
Violent Death Reporting System (NVDRS),
the most common circumstances among people
who died by suicide from jumping was
mental illness. Nearly 60 percent had a current
mental health problem and nearly 53 percent
had been previously treated for a mental health
condition. Therefore, hospital parking operations
are highly prone to suicide by jumping. A
parking professional from a hospital in the
Midwest shared the following story with us:
“In 2009, a psych patient from [our hospital]
asked to go for a walk with his family. He
went to the roof of an adjacent parking
garage and jumped five stories to his death,
onto a bike rack full of bikes. The bike rack
Parking Garage
was located approximately 100 feet from one
of our hourly cashier booths with one of our
employees inside …The person jumped off
the garage while [his] son and wife stood
next to him.” A study conducted in June 2009
by the Office of Mental Health depicts suicide
by jumping the number one method of
sentinel event (SE) suicide. Office of Mental Health
Suicide is the second-leading cause of death
among college students, which makes campus
parking operations prone to suicide by
jumping. Between 1952 and 1995, the incidence
of suicide among adolescents and young
adults nearly tripled. More teenagers and
young adults die from suicide than from
cancer, heart disease, AIDS, birth defects,
stroke, pneumonia, influenza and chronic lung
disease, combined. A recent study by the
American Psychological Association reveals
that over half of American college students
have considered suicide at some points in
their lives. By contrast, only 15.3 percent of
Americans have contemplated suicide. The
study indentified increasing levels of stress
among college students with diminishing
resources to handle suicide prevention. However,
one college campus that was continuously
affected by suicide restricted access to tall
buildings, windows, and balconies. The
campus alarmed the doors leading to rooftops,
installed telephones that dialed 911 directly,
and posted hotline numbers at all roof exits.
HOW DO WE AS PARKING
PROFESSIONALS HANDLE THIS
SITUATION IF IT DOES OCCUR IN
OUR GARAGE?
Preparation. Elana Premack Sandler, a prevention
specialist with the Suicide Prevention
Center, states, “Establishing a relationship
with local police and first responders
(EMTs, crisis intervention officers) is a first
step. Additionally, participating in or establishing
a relationship with a local or state suicide
prevention coalition can help inform parking
garage managers about what’s happening in
suicide prevention locally or statewide. You
may be able to help increase the sources of
support for your staff so that they have a network
of resources to turn to in a crisis. In
addition, these groups should be able to help
parking garage managers develop a protocol
for responding to a suicide.”
Call for Help. Call 911 immediately. For
every suicide death, there are five hospitalizations
and 22 emergency department visits.
Of the adults who attempted suicide in the
past year, 62.3 percent (678,000 persons)
received medical attention and 46 percent
(500,000 persons) stayed overnight or longer
in a hospital for their suicide attempts. “Time
is the key factor with anyone that has jumped
to commit suicide. If someone witnesses
someone attempt suicide or happens to find
someone that has jumped, the first thing they
should do is call 911. It is important not to
move the patient until qualified medical personnel
are on the scene as this could exacerbate
any injuries. If the first person on scene
knows basic life support it would be beneficial
to start the process by talking with the
Isaiah Mouw and Andy Troth, CAPP
person and checking a pulse on a non-bloody
site unless the person has personal protective
equipment. It is a good idea for parking
garage workers to have training in basic life
support and have personal protective equipment
nearby (i.e. non latex gloves and CPR
mask). With falls from heights, people are at
increased risk for brain, spinal cord or
extremity injuries. The higher the fall, the
greater the risk. But with a fall from any
height, the person could be at risk for a brain
injury,” warns Robert D. Hales, D.O. In addition
to calling 911 for emergency personnel
to respond, it's also important to consider
legal matters and police investigations.
According to Sergeant Anthony Easter of the
Chattanooga Police Department, “It may be
apparent that a body found on the ground next
to a tall structure is a suicide victim, but police
must always consider homicide and foul play
as possible cause of death. The medical
examiner's office has to conduct an autopsy to
determine the true cause of death and must be
contacted in any suicide-by-jumping case.
Police have to establish a crime scene in a
timely fashion in order to secure evidence and
prevent crime scene contamination.”
The Press. A parking professional in the
midwest told us that it would be wise to tell
your employees not to comment to the press,
but to direct all questions to the police
department. The less media coverage, the
less likely the parking facility will become
attractive to other suicide jumpers. Premack
Sandler comments that “Particularly with
high-profile suicides, media coverage can
contribute to contagion, so it is important to
work with the media to inform the public
without sensationalizing suicide.” The
Suicide Prevention Resource Center (SPRC)
offers recommendations on its Web site
(www.sprc.org) for safe reporting on suicide
with media professionals who are interested
in covering a suicide death.
Counseling. If you had employees who
witnessed the incident, make sure to talk to
the parking professional l www.parking.org/tpp l September 2010 31

your human resource department about offering
counseling or any other help needed for the
employees. The Washington D.C. Metro rail
system, following a number of suicides on its
rail system in 2009, launched a partnership
with a local suicide prevention group to help
employees understand and cope with their own
reactions to the tragedies they witnessed, as
well as to help them prevent future suicides.
Other transit systems such as the Toronto
Transit in Canada and the Massachusetts
Bay Transit Authority in Boston have used
similar prevention programs. Training for staff
can usually be accessed locally through a
coalition or a non-profit organization focused
on suicide prevention.
HOW CAN WE HELP PREVENT
SUICIDE FROM HAPPENING?
Two effective but costly methods of preventing
suicide by jumping from parking garages are
installing pedestrian access control readers and
suicide barriers. Having pedestrian access control
readers not only limits vandalism in the
garages, but it could save lives. Several parking
facilities that have had a history of suicide
jumpers have installed suicide barriers such as
netting and fencing. Critics of the barriers and
other such restriction methods argue that a suicidal
person will simply find another building to
jump from; however, several studies have found
that putting up a barrier at a popular suicide site
will not drive suicidal individuals to find another
site. In this way, a barrier is effective not only
in preventing suicide at one site, but may help
prevent suicide overall in a geographic area.
SOURCES
Berman, Alan L., et al. National Strategy for Suicide Prevention: Goals and Objectives for
Action. Rockville: Public Health Service, 2001.
Friedman, Emily. “Inside the Mind of a Suicide Jumper.” ABC News. 2 July 2008. 15 June
2010. http://abcnews.go.com/Health/MindMoodNews/story?id=5294404&page=1.
Friend, Tad. “Letter from California Jumpers.” The New Yorker. 13 October 2003. 15 June
2010. www.newyorker.com/archive/2003/10/13/031013fa_fact?currentPage=1.
Halverson, Julie. “Restricting Access to Lethal Means at Colleges and Universities.” Means
Matter. 4 December 2008. 15 June 2010. www.sprc.org/grantees/campus/2009/PDF/
C2BLethalMeansSPRC.pdf.
Hogan, Michael, et al. “Incident Reports and Root Cause Analyses 2002-2008: What They
Reveal About Suicide.”
June 2009. 15 June 2010. www.omh.state.ny.us/omhweb/statistics/suicide_incident_rpt.
32 September 2010 l International Parking Institute
A rather inexpensive but highly effective
method is training parking structure personnel
to recognize the signs of a person thinking about
suicide. Sometimes a person will pace back and
forth. “Sometimes someone will be obviously
emotional and crying. It’s important for staff to
feel comfortable approaching someone and asking
if they’re okay,” says Premack Sandler. A
parking garage security officer in Houston was
able to save the life of a person contemplating
suicide after he noticed a woman leaning over
the edge of a parking garage. A parking manager
in Michigan was able to save the life of a
person thinking about committing suicide
because he simply recognized the individual in
a wheelchair heading towards the elevators as a
previous jumper. Kevin Briggs, a patrolman for
the Golden Gate Bridge, has coaxed in more
than two hundred potential jumpers without
losing one over the side. Simply knowing the
signs, being alert and walking your facilities
could lead to saving a life.
Other ideas are posting prevention signs in
high probability locations such as “Contemplating
Suicide? Call 1-800-273-TALK” or “Prevent
Suicide Now: 1-800-SUICIDE NOW (1-800-
784-2433).” You can also contact your state for
ideas — State Suicide Prevention Plans already
exist or are currently being created in over 20
states. For more information, visit the Suicide
Prevention Resource Center at www.sprc.org.
“While some suicides are carefully planned,
many appear to be more impulsive. If we can
put in place measures during the crisis period
that restrict the means of suicide, it is even more
preventable. On a large scale, means restriction
can have quite an impact on suicide prevention,”
notes Premack Sandler.
CONCLUSION
Every suicide is a tragedy that requires us to
acknowledge its high human cost in anguish
and pain and take measures to prevent a similar
recurrence. While it may be true that some individuals
cannot be deterred from their attempts
to kill themselves, many attempts can be
thwarted, allowing troubled people to get help
before making a rash decision they will not be
able to undo. “Suicide is preventable. That
message is perhaps the most important to convey,
as many believe that suicide is inevitable
for people who are considering suicide,” says
Premack Sandler. One of the most powerful
stories we came across is that of Kevin Hines,
who jumped from the Golden Gate Bridge in
2000. He was pacing the bridge back and forth,
sobbing. No one asked him if he was okay. “I
was like ‘F*** this, nobody cares.’” He jumped
and was one of only twenty-six people out of
the estimated 1,200 plus to ever jump off the
Golden Gate Bridge and survive. His first
thought after jumping was: “What the hell did I
just do? I don’t want to die.” ■
Isaiah Mouw is a current CAPP candidate and
works for Republic Parking System. He can be
reached at imouw@republicparking.com or
413.231.4411.
Andy Troth, CAPP, is the Director of Parking &
Transportation at Baylor University Medical
Center. He can be reached at andrew.troth@baylorhealth.com
or 214.820.6884.
Johnson, Alex. “Half of college students consider suicide.” MSNBC News. 18 August 2008.
15 June 2010.
www2.universitybusiness.com/newssummary.aspx?news=yes&postid=16547.
Halverson, Julie. “Restricting Access to Lethal Means at Colleges and Universities.” Means
Matter. 4 December 2008. 15 June 2010. www.sprc.org/grantees/campus/2009/PDF/2B
LethalMeansSPRC.pdf.
National Survey on Drug Use and Health. “Suicidal Thoughts and Behaviors among
Adults.” The NSDUH Report. 17 September 2009. 15 June 2010.
www.oas.samhsa.gov/2k9/165/Suicide.htm.
Rein, Lisa. “Metro Turns To Suicide Prevention Groups for Help.” The Washington Post.
9 September 2009. 15 June 2010. www.washingtonpost.com/wp-dyn/content/article/2009/09/18/AR2009091803429.html