Crisis averted? TTC help line a success in the absence of barriers
Sandie Benitah, cp24.com
Published Tuesday, October 4, 2011 4:49PM EDT
This past summer, at least 10 people stood on a TTC subway platform in distress.
Seven of them chose to reach out for help. Three of them chose to jump to their death.
Each life saved is proof that measures against suicide are necessary on our public transit system.
Each life saved is also a reminder that communication and kindness are necessary tools in the fight against suicide.
The TTC's Crisis Link has been a success because it has served as both, a preventative measure and a last-minute helping hand for those caught up in a cloud of despair.
The TTC partnered up with Distress Centres of Toronto and Bell Canada this past June to provide people with a free call to a crisis counsellor. All the person needs to do is press the "Crisis Link" button on any of 141 platform payphones to be automatically connected with one of 450 experienced professionals.
"We're very happy with the program," said TTC spokesperson Brad Ross in a recent interview with CP24.com. "I think it can only be called a success when you're able to -- if nothing else -- talk about the need of awareness for mental health. It brings awareness to the fore.
"If they also pick up that phone and talk to someone then oh boy, that whole program is worth it," Ross continued.
According to the TTC, 108 calls were placed through Crisis Link from the time the program was launched on June 16 until August 31. Ross said it took officials the first four to six weeks to put up posters and install the special payphones on each platform.
Of the 108 calls placed, seven people expressed thoughts of committing suicide, prompting counsellors to initiate a level-three response. Transit authorities were immediately contacted and staff was dispatched to the platform where the call was made to console the caller while trains were told to slow down as they made their way into the station.
Seventeen calls were from people who said they were feeling distressed, though not necessarily suicidal. Those callers were forwarded onto other counsellors in order to free the Crisis Link line.
Of course, there were also the predictable prank calls – 65 to be exact.
"We anticipated we'd get that when we started," said Ross.
But still, Crisis Link, as helpful as it may be, is nowhere near as effective as full-proof platform barriers.
Records show that in the first six months of 2011, seven people chose to end their life by jumping in front of a subway train in Toronto. Twenty-six people did the same in 2010 and the year before that, 18 people chose death by suicide on the TTC platform.
Ross, taking the lead of mental health professionals, doesn't like to talk about the subway as a means of death in the event it encourages others to end their life in the same way, but understanding the stats is key to the discussion about prevention.
After all, Ross and other city officials know new signs and free calls are not enough to make a real difference.
City staff have said in the past the subway is in dire need of platform screen doors that keep passengers away from the train until it is fully parked on the platform.
In fact, a staff report tabled in February 2010 recommended the city put money for these barriers in the 2011 – 2015 Capital Budget submission.
Barriers would not only keep people from committing suicide on the tracks but would also help prevent people from falling or being pushed in the path of an oncoming train.
"Platform Screen Doors (PSDs) are considered very effective as they actually eliminate the hazard or prevent any track level intrusion situation from occurring," the report says.
Various types of this barrier are already effectively used in several cities around the world, such as Copenhagen, Barcelona, Dubai, Singapore, Tokyo, Rome and Paris.
Putting up these barriers also helps prevent against other delays caused by blowing garbage on the tracks. This garbage is often sparked by the electric rail, causing smoke at track level. TTC Chair Karen Stintz recently said during a speech at the Economic Club of Canada that smoke at track level is the number one source of delay on the TTC.
There's no question suicide is an issue for humanity but for the country's largest public transit system, suicide is also a matter of bad business.
Aside from the sheer tragedy of having an individual end their life in such a horrific fashion, the TTC is also left to deal with the aftermath.
And the aftermath is expensive.
Staff behind the subway's controls or workers who witness the suicide are often too traumatized to continue their shift. Many take weeks off work to recover and some ask for professional help to help them deal with the shock and grief.
Suicides also force lengthy disruptions to subway service. In 2009, there were 1364 minutes of delay (about 22 hours) on the TTC as a result of the 18 suicides.
Passengers are forced off the train and onto shuttle busses until a preliminary investigation into the incident is complete.
Barriers would certainly help solve these problems but the mere cost of putting up these barriers is crippling for a public transit system that is consistently underfunded and plagued with capital budget shortfalls year after year. The report pegs the cost of the barriers at $10 million per station.
On top of that, the TTC would have to invest in new trains and a new signaling system that would allow trains to stop at a precise spot in front of the barriers. While the Yonge line already has these capabilities and some new trains, the Bloor-Danforth line does not and likely will not for awhile because of a lack of funds.
"It would take a number of years even if those measures were in place, to retrofit each station," said Ross.
On the Bloor Street viaduct, a barrier was the only viable solution, though some academics noted it was not necessarily a solution to suicide prevention.
The bridge, which looks over the busy Don Valley Parkway and the Don Valley forest, was once a choice location for people wanting to end their lives. In fact, it was once considered to be the second most popular destination for suicide in all of North America, after the Golden Gate bridge in San Francisco.
At one point, one person jumped to their death from the viaduct every 22 days on average.
Signs advertising crisis help lines are still posted along the bridge but the city decided posters and payphones were not enough to stop the suicidal.
Their next step was installing a $6 million, 16-foot barrier in 2003.
A recent study concluded barriers, such as the viaduct's so-called "Luminous Veil," are proven to be extremely effecting at stopping suicides – albeit only at that specific location.
The study, which was published last July in the British Medical Journal, looked at the number of suicides in Toronto since the viaduct veil was erected.
"No suicides occurred at Bloor Street Viaduct in the four years after the construction of a barrier; however, suicide rates by jumping in Toronto were unchanged because of a statistically significant increase in suicides by jumping from other bridges and a non-significant increase in suicides by jumping from buildings," the study concluded. "This suggests that the availability of Bloor Street Viaduct was not an essential element for people contemplating suicide by jumping in Toronto."
The study's conclusion suggests the same outcome can be inferred with all barriers, including those put up at subway platforms. While subway barriers might prevent people from jumping in the path of the train, it does not mean that they are providing the passenger with an effective solution to his predicament.
Access to support
Perhaps the solution then does start with crisis counselling and support rather than mere preventative measures.
According to the Mental Health and Addictions Alliance, 20 per cent of Ontarians will experience a mental illness or addiction but access to support and proper care is far from adequate.
Statistics show that only one in three adults and one in four children have access to the proper care in Ontario.
Mental health issues are rampant in young Canadians. One in five youth suffer from a mental health issue, such as depression, anxiety, behavioural problems, eating disorders, ADHD, and development disorders – all of which can push a person to believe that suicide is a solution to their frustration.
"That's probably a low estimate because mental health issues are widely under-reported because of the stigma," said Dennis Long, the Founding Executive Director of Breakaway Addiction Services.
Long said early diagnosis and proper care is essential to saving lives. That's why one of the key focuses for the alliance is improving mental health support for youth.
"The earlier we intervene, the better the prognosis."