Could the two persons who have fallen from two buildings recently here been prevented from doing so?

The first question to be asked is did they fall on purpose?

We have had two recent incidents in Cayman.

The first one was when Shakira Taylor’s body was found outside an eight-storey apartment block in the Seven Mile Beach area on May 29^th.

No one has publicly said Ms Taylor fell to the ground on purpose meaning she jumped. Our local police said there were no suspicious circumstances.

We have learnt now that the deceased had battled with bi-polar disorder and depression.

Now on Tuesday (2) another female has fallen from the observation tower at Camana Bay.

Although at the time of writing this the lady is still alive her condition is described as ‘critical’.

Again the police have said there are “no suspicious circumstances at this time.

An unconfirmed report I received was that the woman’s fall was partially broken when she hit a roof of a close by lower building.

On tall buildings should safety barriers be erected – full height bars or screens?

These would make it more difficult for persons to fall or take it upon themselves to jump.

The thought of jumping or falling from a tall structure terrifies me. I have a huge aversion to heights and I have had thankfully infrequent nightmares of actually falling from one myself.

The second question is of mental disorder.

How much has mental disorder taken part in this?

With the first incident it seems very likely. Bi-polar disease and depression. A pretty horrific combination and one that requires a lot of medical help. However, the patient is the one that has to take the prescribed medication.

I have been researching the subject of suicide by jumping off tall structures and found a very interesting article by Scott Anderson on The New York Times titled “The urge to end it all”.

The article states “The National Institute of Mental Health says that 90 percent of all suicide “completers” display some form of diagnosable mental disorder.”

The writer asks this question, “But if so, why have advances in the treatment of mental illness had so little effect? In the past 40 years, whole new generations of antidepressant drugs have been developed; crisis hotline centers have been established in most every American city; and yet today the nation’s suicide rate (11 victims per 100,000 inhabitants) is almost precisely what it was in 1965.

“Little wonder, then, that most of us have come to regard suicide with an element of resignation, even as a particularly brutal form of social Darwinism: perhaps through luck or medication or family intervention some suicidal individuals can be identified and saved, but in the larger scheme of things, there will always be those driven to take their own lives, and there’s really not much that we can do about it. The sheer numbers would seem to support this idea: in 2005, approximately 32,000 Americans committed suicide, or nearly twice the number of those killed by homicide.”

He talks about two doctors who “are among the most often-cited experts on suicide — and specifically on suicide by jumping.”

Mr. Anderson says, “Both readily acknowledged the high degree of impulsivity associated with that method, but also considered that impulsivity as simply another symptom of mental illness. “’Of all the hundreds of jumping suicides I’ve looked at,’” one told me, “’I’ve yet to come across a case where a mentally healthy person was walking across a bridge one day and just went over the side. It just doesn’t happen. There’s almost always the presence of mental illness somewhere.’”

“….one of the most remarkable discoveries about suicide and how to reduce it occurred utterly by chance. It came about not through some breakthrough in pharmacology or the treatment of mental illness but rather through an energy-conversion scheme carried out in Britain in the 1960s and ’70s. Among those familiar with the account, it is often referred to simply as “the British coal-gas story.”

“For generations, the people of Britain heated their homes and fueled their stoves with coal gas. While plentiful and cheap, coal-derived gas could also be deadly; in its unburned form, it released very high levels of carbon monoxide, and an open valve or a leak in a closed space could induce asphyxiation in a matter of minutes. This extreme toxicity also made it a preferred method of suicide. “Sticking one’s head in the oven” became so common in Britain that by the late 1950s it accounted for some 2,500 suicides a year, almost half the nation’s total.

“Those numbers began dropping over the next decade as the British government embarked on a program to phase out coal gas in favor of the much cleaner natural gas. By the early 1970s, the amount of carbon monoxide running through domestic gas lines had been reduced to nearly zero. During those same years, Britain’s national suicide rate dropped by nearly a third, and it has remained close to that reduced level ever since.

“How can this be? After all, if the impulse to suicide is primarily rooted in mental illness and that illness goes untreated, how does merely closing off one means of self-destruction have any lasting effect? At least a partial answer is that many of those Britons who asphyxiated themselves did so impulsively. In a moment of deep despair or rage or sadness, they turned to what was easy and quick and deadly — “the execution chamber in everyone’s kitchen,” as one psychologist described it — and that instrument allowed little time for second thoughts. Remove it, and the process slowed down; it allowed time for the dark passion to pass.

“Quite inadvertently, the British gas conversion proved that the incidence of suicide across an entire society could be radically reduced, upending the conventional wisdom about suicide in the process. Or rather it should have upended the conventional wisdom, for what is astonishing today is how little-known the British coal-gas story is even among mental-health professionals who deal with suicide.”

The article quotes Richard Seiden, a professor emeritus and clinical psychologist at the University of California at Berkeley School of Public Health, who is probably best known for his pioneering work on the study of suicide.

“’At the risk of stating the obvious,’ Seiden said, ‘people who attempt suicide aren’t thinking clearly. They might have a Plan A, but there’s no Plan B. They get fixated. They don’t say, ‘Well, I can’t jump, so now I’m going to go shoot myself.’ And that fixation extends to whatever method they’ve chosen. They decide they’re going to jump off a particular spot on a particular bridge, or maybe they decide that when they get there, but if they discover the bridge is closed for renovations or the railing is higher than they thought, most of them don’t look around for another place to do it. They just retreat.’

“Seiden cited a particularly striking example of this, a young man he interviewed over the course of his Golden Gate research. The man was grabbed on the eastern promenade of the bridge after passers-by noticed him pacing and growing increasingly despondent. The reason? He had picked out a spot on the western promenade that he wanted to jump from, but separated by six lanes of traffic, he was afraid of getting hit by a car on his way there.

“’Crazy, huh?’ Seiden chuckled. ‘But he recognized it.’ When he told me the story, we both laughed about it.”

This tends to support my reasoning that some form of barrier may have prevented both incidents from happening.

The article continues:

“In September 2000, Kevin Hines, a 19-year-old college student suffering from bipolar disorder, leapt from the Golden Gate. Along with Ken Baldwin, he is one of only 29 known survivors of the fall. Today Hines controls his bipolar disorder with medication and a strictly controlled regimen of diet and exercise and sleep, even while maintaining a frenetic schedule. Having recently married, he is frequently on the road lecturing for a suicide-prevention network while simultaneously working toward a psychology degree. One of his most intense ambitions, though, is to finally see a suicide barrier erected on the Golden Gate.”

If anyone thinks falling from a building is a quick and easy way to commit suicide they had better think again. It is horrific with no guarantee it will be successful. The second incident is a clear example of that.

At the weekend an experienced Cirque du Soleil performer died in an accidental fall during a show in Las Vegas. The audience could hear the performer screaming as she plummeted down to an open pit below the stage.

A spectator said, “”Initially, a lot of people in the audience thought it was part of the show. But you could hear screaming, then groaning, and we could hear a female artist crying from the stage.”

Let us hope these are the last stories we hear for some time about falls from tall structures.

If you want to read the whole of Scott Anderson’s article go to:

http://www.nytimes.com/2008/07/06/magazine/06suicide-t.html?pagewanted=all