title: The effectiveness of structural interventions at suicide hotspots: a meta-analysis.
abstract: BACKGROUND
  Certain sites have gained notoriety as 'hotspots' for suicide by jumping. Structural interventions (e.g. barriers and safety nets) have been installed at some of these sites. Individual studies examining the effectiveness of these interventions have been underpowered.
  
  
  METHODS
  We conducted a meta-analysis, pooling data from nine studies.
  
  
  RESULTS
  Following the interventions, there was an 86% reduction in jumping suicides per year at the sites in question (95% CI 79% to 91%). There was a 44% increase in jumping suicides per year at nearby sites (95% CI 15% to 81%), but the net gain was a 28% reduction in all jumping suicides per year in the study cities (95% CI 13% to 40%).
  
  
  CONCLUSIONS
  Structural interventions at 'hotspots' avert suicide at these sites. Some increases in suicide are evident at neighbouring sites, but there is an overall gain in terms of a reduction in all suicides by jumping.
authors.affiliation: Centre for Health Policy, Programs and Economics, Melbourne School of Population Health, University of Melbourne, Melbourne, Victoria, Australia. j.pirkis@unimelb.edu.au
authors.forename: Jane
authors.initials: J
authors.lastname: Pirkis
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Spittal
authors.forename: Georgina
authors.initials: G
authors.lastname: Cox
authors.forename: Jo
authors.initials: J
authors.lastname: Robinson
authors.forename: Yee Tak Derek
authors.initials: YT
authors.lastname: Cheung
authors.forename: David
authors.initials: D
authors.lastname: Studdert
mesh_terms: D001107:Architectural Accessibility; D004779:Environment Design; D006801:Humans; D012449:Safety; D000092864:Suicide Prevention