title: Crisis Phones - Suicide Prevention Versus Suggestion/Contagion Effects.
abstract: BACKGROUND
  There has been no systematic work on the short- or long-term impact of the installation of crisis phones on suicides from bridges. The present study addresses this issue.
  
  
  METHODS
  Data refer to 219 suicides from 1954 through 2013 on the Skyway Bridge in St. Petersburg, Florida. Six crisis phones with signs were installed in July 1999.
  
  
  RESULTS
  In the first decade after installation, the phones were used by 27 suicidal persons and credited with preventing 26 or 2.6 suicides a year. However, the net suicide count increased from 48 in the 13 years before installation of phones to 106 the following 13 years or by 4.5 additional suicides/year (t =3.512, p < .001).
  
  
  CONCLUSIONS
  Although the phones prevented some suicides, there was a net increase after installation. The findings are interpreted with reference to suggestion/contagion effects including the emergence of a controversial bridge suicide blog.
authors.affiliation: 1 Department of Psychiatry and Department of Criminology, Wayne State University, Detroit, MI, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Stack
mesh_terms: D003419:Crisis Intervention; D004779:Environment Design; D005431:Florida; D015277:Hotlines; D006801:Humans; D013405:Suicide / Q000706:statistics & numerical data; D013689:Telephone; D000092864:Suicide Prevention
keywords: bridge suicide; contagion; imitation suicide; jumping as a method; prevention; suicide