A PUBLIC DEATH

Suicide may be the loneliest of acts but at times people take their own lives in view of others, causing trauma for the witnesses.

More than 31,000 Americans kill themselves each year, but typically only public suicides or deaths of prominent people are publicized in the media. In one notable exception, The San Francisco Chronicle no longer reports on jumps from the Golden Gate Bridge, a popular destination for suicides.

The Orange County (Calif.) Register posed questions about why to University of California, Irvine, psychiatrist Aaron Kheriaty, who has studied suicide prevention.

Q: Why do some people choose public places?

A: Suicide is very often impulsive. The person is often ambivalent. People who jumped and survived, when asked what they were thinking, it's typically, "What did I just do? I can't believe I did this." You can put up a barrier, if it slows them down, if it makes them think, if they have to struggle more to do it, that may be enough to prevent them in that moment.

In terms of a freeway overpass, the reason for that is it simply appears to people to be really accessible. They can walk onto an overpass and a police officer isn't going to stop them from jumping, most likely. Probably they just look around and say, "What's the highest spot I can gain pedestrian access to?"

Most suicidal people are suicidal because they're very seriously depressed. When you're depressed you often don't have energy to come up with a complete and elaborate plan of how to do anything, including how to kill yourself.

The person who is considering suicide very often doesn't consider how their method is going to affect other people. If they can jump in front of a subway going 50 mph as it comes out of a tunnel, that probably seems the easiest and most surefire thing to do.

My suspicion is it's more, Will this work? Is it fairly readily available? That's probably more the motivation than making some sort of symbolic gesture.

Q: Why has the Golden Gate Bridge become a popular place for suicide?

A: It seems like there are certain suicide spots in the world that have become sort of romanticized. People have this aesthetic, romantic vision of how the suicide is going to go.

For some reason jumping from the Golden Gate Bridge, this is how I can go out in a blaze of glory, which I wouldn't get if I jumped from the Bay Bridge, which would be sort of tacky in comparison. It may sound strange. Suicidal thinking can get very strange.

It's pretty easy to jump from the Golden Gate Bridge. It's pretty deadly; it works. The same thing happened in Japan. There's a volcano, Mount Mihara. Back in the 1930s there was a Japanese celebrity who went out there with another person who wanted to commit suicide and this other person ended up jumping into the volcano. This celebrity came back and basically told people about it.

It started this rash of suicides. People started going out there and jumping from this volcano. An entrepreneur ran a steamship that would take suicidal people out there, although he never admitted what he was doing. ... He would take tourists out there to watch people jump into the volcano. It's really awful. It's hard for me to imagine.

This went on for years. People made the argument these people want to kill themselves. If you erect some kind of barrier on this volcano they'll find another place to do it. They found when they finally did put a suicide barrier up there, the total number of local suicides did decline.

There's something about having the availability of these things that really increases the total number of deaths. Suicide seems to be a behavior that can be a little bit socially contagious. After a celebrity suicide, you'll have a few copycats, especially when these suicides are well publicized.

Q: Has anyone ever studied the effect on the people who find the bodies, such as hotel maids?

A: Not that I know of. I imagine there's got to be significant rates of post-traumatic stress disorder among people like a train conductor that runs over someone. I imagine that would produce quite a bit of psychological trauma. The hotel maid, they're usually going to find someone lying in the bathtub who has cut their wrists or lying on the bed overdosed on medication. It's traumatic but not necessarily violently traumatic.

Q: What responsibility do institutions have to suicide-proof public buildings and structures?

A: People typically think there's only one side of the equation and that's the decision on the part of the person. The person needs to not only have the decision and resolve, but they have to have the means available. If the means aren't immediately available or they think it's not going to work - they may botch it - then they're likely not to act on the suicidal thoughts.

If they have a loaded gun in the drawer they're in much greater danger than if they have to think for a long time about how to access adequate means.

The Eiffel Tower was a hot spot until they erected a barrier. St. Peter's Basilica was a hot spot. The Empire State Building was a hot spot. Suicides went down to very few to zero at these places when they did something about it.

Where to get help

National Suicide Prevention Lifeline: 800-273-8255, www.suicidepreventionlifeline.org

American Foundation for Suicide Prevention, www.afsp.org

Suicide Awareness Voices of Education, www.save.org

Trevor Project Gay Teen Helpline: 866-488-7386, trevorproject.org