Evaluation of a bridge-based suicide intervention programme: findings from a qualitative study with volunteers and professional staff

Background

Suicide is a preventable, but complex public health issue. Around one-third of suicides take place in a public location. Easy access to means of self-harm in public spaces, such as bridges, increases risk. While physical modifications (e.g., barriers) are effective for means reduction, they are not always feasible to implement. Bridge Watch is a suicide prevention initiative that uses trained volunteers to patrol public spaces around bridges in the City of London. The volunteers aim to identify and engage with individuals in distress to reduce suicide incidents (attempts and suicide deaths).

Methods

This qualitative study explores the implementation barriers and facilitators, and the perceived effectiveness of Bridge Watch. We conducted 27 semi-structured interviews with professionals who have had some involvement with Bridge Watch (n = 8) and current Bridge Watch volunteers (n = 19). Data collection was supplemented by analysing 16 volunteer diary entries completed post-patrol. Data were analysed using framework analysis.

Results

Volunteers and professionals reported examples of how the Bridge Watch programme had identified and supported individuals in acute crises, as well as intervening with people who might otherwise have gone unnoticed. The programme was seen to provide a range of secondary public health impacts, including supporting and signposting for vulnerable individuals, and raising public awareness of suicide prevention. Emergency service staff suggested that Bridge Watch can help reduce pressure on services by de-escalating situations. Robust, relevant and frequent training which reflects the conditions of the Bridge Watch role is crucial for preparing volunteers. The Bridge Watch programme faces several operational challenges, including volunteer recruitment and capacity to provide 24-hour coverage. While positive relationships exist with statutory services (e.g., police), there is a need for improved awareness and stronger integration.

Conclusions

Bridge Watch appears to be a promising, acceptable, and valued suicide prevention strategy. It offers benefits through direct interventions and broader public health contributions. Its key strengths are its proactive, visible, immediate, human-centred approach and its ability to support statutory services. However, in the development of such interventions, consideration needs to be given to potential unintended consequences, including the risk of drawing attention to specific locations as sites of suicide.