Caltrain calls for community-wide mental health effort

Now CalTrain has to get involved? I'd love to the inside scoop on the arm-twisting scenarios that made that happen.

At least they're showing some initiative. Golden Gate Bridge workers and guards are specially trained to watch for and try to avert potential suicides. People have talked about not committing suicide simply because a bridge guard talked to them and they realized someone cared about them and noticed they might jump.

My point is that they aren't responsible. People kill themselves in many, many ways and it's their right to do so. But when it's more pubic, we feel we have to hold someone responsible? That's ridiculous. Put in some emergency phones at each crossing, one at each side and see if that makes a difference.

For the first time I can remember, I saw a police car parked at the Churchill crossing last night.

Is that usual?

No, it's not usual, Evan, unless there's been a suicide.

Hmmm, suicide is not a right. It is a common law crime and some places it is a felony.

[Post removed by Palo Alto Online staff.]

Get the trains underground. It's unnatural to have so many trains barreling through Palo Alto at street level. Too much temptation for hormonal teenagers crossing the tracks to and from school. Caltrain's community outreach program on suicide has been a dismal failure and an excuse for them to do nothing.

Just to be clear those trains would still run fast and on track even if underground. With there being nearly 3 stops in Palo Alto (San Antonio is so close), wouldn't suicidal teens still be able to those tracks if they really wanted to? It saddens me to think that people may be using these tragedies as a reason to further their own agenda such as tunneling. The real focus should be on the mental health of the kids of the community. That's the problem.

If Caltrain would really like to do something to help right now, not months or years from now, they could hire private security guards -- four at each incident-prone crossing to cover both sides in both directions of travel -- to be a last line of physical prevention. Human vigilance, not machines, are the key.

To those who might be getting ready to remind me that this alone won't stop the suicides, let me forestall you by saying that I agree. There have been a lot of good ideas floated. ALL of them need to be done. No single thing will solve this problem.

The larger, longer-term issue is that in 2009, it's utterly inappropriate that the trains should be running along the same route as they did in the 1870's, when the tracks were laid, and there was nothing on the Peninsula but ranches and orchards. Wny is Caltrain permitted to continue to operate this "attractive nuisance"?

Susan - I assert it is a person's right to commit suicide, be it a crime in some places or not.

It is reassuring that the Caltans initiative involves an experienced psychiatrist from Stanford who clearly has read the WHO and CDC recommendations on how to prevent contagious suicides.
"Officials also discouraged excessive publicity, saying sensationalizing the deaths could
"inadvertently contribute to contagion or copycat attempts," said

Shashank Joshi, an assistant professor of psychiatry at Stanford University's School of Medicine who joined a Monday news conference at Caltrain headquarters"Web Link

I hope Dr Joshi continues to speak publicly and often in Palo Alto about this matter as he is an expert in the field and brings a sober, evidence based leadership perspective.

I suggest the psychiatrists also check the mental health of the railroad folk for thinking their only responsibility for safety is to post signs, and the politicians who accept that. There are engineering solutions to all the problems noted above and elsewhere, and not unique, untried solutions. I hate to say it, but it is time for some creative lawsuits.

No one has won a lawsuit against the Golden Gate Bridge Authority because people commit suicide there, the Caltrains situation is the same,they have been running trains here for over 100 years.

There will be lawsuits, no doubt, but they will be linked to violations of the CDC/WHO evidential recommendations and probably the therapists who may have worked with the kids who killed themselves.

There is no engineering solution to suicide, Dr Joshi is right, the issue is implementing solutions that evidence, from the WHO and CDC, shows prevents suicide contagion.

Have the responsible Palo Alto agencies, press, therapists,ETC, done a good job from a human performance/engineering perspective? and how can they learn and improve?
That will be the issue.

Of course there are engineering solutions to a given sort of suicide. Higher barriers on the GG Bridge would lead to a drop in people jumping off the bridge. Inaccessible train tracks would reduce those sort of suicides.

A suicidal state's not a rational one--physical deterrents can and do work because the suicidal state is *transient*.

I'm with Walter.

I took a friend to the hospital after admitting to being suicidal. This person had a plan and a weapon all figured out. I was able to get enough info to drop everything to do whatever I could to make sure suicide wasn't committed. Another friend pitched in and we were very lucky our friend was open to receiving assistance.

Taking someone to the hospital knowing that they are likely to be committed is awful, but we felt there was no other choice but to do so. It would have been worse planning a funeral.

My friend is much improved, is receiving therapy and the right support. This person knows that I will do whatever I can whenever I can when the going gets rough. In this person's case, it was a combination of brain chemistry, extreme stress at home and at work and just feeling the world would honestly be better off without them. They also needed their pain to end. This was not something we could just talk through, but talking and being there in the ER til my friend was taken away made a huge difference. My support continues. I realize that it's like making accommodations for someone who has a limitation that is different than my limitations, so it requires more care and thought, which is fine by me.

Sharon, sometimes attorneys are more innovative than engineers; certainly less constrained by the real world.

P.A. native,
I'm not using personal tragedies to further my "agenda". The suicides (and accidents) speak for themselves. The point is, the tracks are a daily temptation that shouldn't be so accessible to moody teens every day they go to school. We would never accept the status quo if we were looking into sites for schools now. Would you rather move the schools?
I agree with Bob M and Ohlonepar. That is an 1870s right of way that is made for farmland, not a dense urban area. Grade seperation is key.

I've worked in the field of mental health for many years. I'm concerned that the standard lectures on depression and suicide prevention fail to take into account the impulsiveness of teenagers. In my work, I was often called to the ER to interview a teen who had attempted suicide. My first question always was, "Did you want to kill yourself, or did you want to stop feeling how you were feeling in 'that' moment?" Ninety percent of the time the answer was that they just wanted the immediate feeling to stop. They had not been suffering from depression, but something had happened to produce an intensely uncomfortable emotional state and they didn't know any other way to make it stop.
There is a lot of information that can and should be taught about emotional self regulation. This would give our teens tools to help them through those intensely uncomfortable moments. It could help prevent this tragic loss of life and suffering among our community's teen population.

Pro tunnel,

You said, "The point is, the tracks are a daily temptation that shouldn't be so accessible to moody teens every day they go to school. We would never accept the status quo if we were looking into sites for schools now."

I totally disagree. The point should be that teens should not feel "moody" enough to commit suicide in the first place. That should not be the status quo in Palo Alto. For crying out loud, talk to the kids! That's where the problem is.

Just to be clear, I'm not arguing, per se, for a tunnel--just pointing out a reality--accessibility makes a difference in both a particular way--suicide drops at a given site and more general, the overall rate *also* drops. It really isn't the case of a suicide will happen no matter what--many suicides are weirdly impulsive. This is why contagion is even an issue.

Yes, there are some people who are very determined to kill themselves over a period of time, but in many, many cases, it's a stupid, fatal impulse. A really, really bad choice.

When my father was a graduate student at Oxford in the 60s there was an outbreak of " suicide contagion " among undergraduates.
The method was putting their head in a gas over without lighting the gas.
In those days the gas supply in the UK was coal gas with very high levels of carbon monoxide.
After reviewing the usual sociological and psychological theories a consensus developed that the solution was to change the gas supply to natural gas.
This solution completely missed the point.Like the train discussion here.

We now know from the CDC and WHO how to prevent suicide contagion.

It is not rocket science, the fact that a lot the press and a number of therapists completely violate the CDC/WHO guidelines is an outrage.

If this were a contagious viral outbreak and the same agencies ignored the evidence and continued to act in ways that spread the outbreak then they would face serious professional and even criminal consequences.

We need to get a grip and follow the CDC/ WHO recommendations in this matter.

Enough is enough. Dr Joshi, the psychiatrist from Stanford, is right, we all need to take an evidence based approach to stopping this outbreak.

We need to do a little bit of almost everything mentioned, starting with the physical ones. We know how to close roads and build overpasses with a certainty - thankfully we lack the ability to get deeply enough into individual minds to make fundamental behavioral changes.