title: Installation of a bridge barrier as a suicide prevention strategy in Montréal, Québec, Canada.
abstract: OBJECTIVE
  We investigated whether the installation of a suicide prevention barrier on Jacques-Cartier Bridge led to displacement of suicides to other jumping sites on Montréal Island and Montérégie, Québec, the 2 regions it connects.
  
  
  METHODS
  Suicides on Montréal Island and Montérégie were extracted from chief coroners' records. We used Poisson regression to assess changes in annual suicide rates by jumping from Jacques-Cartier Bridge and from other bridges and other sites and by other methods before (1990-June 2004) and after (2005-2009) installation of the barrier.
  
  
  RESULTS
  Suicide rates by jumping from Jacques-Cartier Bridge decreased after installation of the barrier (incidence rate ratio [IRR] = 0.24; 95% confidence interval [CI] = 0.13, 0.43), which persisted when all bridges (IRR = 0.39; 95% CI = 0.27, 0.55) and all jumping sites (IRR = 0.66; 95% CI = 0.54, 0.80) in the regions were considered.
  
  
  CONCLUSIONS
  Little or no displacement to other jumping sites may occur after installation of a barrier at an iconic site such as Jacques-Cartier Bridge. A barrier's design is important to its effectiveness and should be considered for new bridges with the potential to become symbolic suicide sites.
authors.affiliation: Direction de Santé Publique de Montréal, Québec, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Perron
authors.forename: Stephanie
authors.initials: S
authors.lastname: Burrows
authors.forename: Michel
authors.initials: M
authors.lastname: Fournier
authors.forename: Paul-André
authors.initials: PA
authors.lastname: Perron
authors.forename: Frédéric
authors.initials: F
authors.lastname: Ouellet
mesh_terms: D003252:Construction Materials; D004779:Environment Design; D006801:Humans; D016012:Poisson Distribution; D011792:Quebec; D013405:Suicide / Q000706:statistics & numerical data; D000092864:Suicide Prevention