Health Impact Assessment of proposed suicide prevention measures at Bridge A: A model for other high-risk locations

OBJECTIVES: Suicide in public places remains a public health challenge. In Ireland, 512 suicides were recorded in 2021, almost one third in public places. Bridge A was identified as a high-risk site for suicide by jumping. This study aimed to apply Health Impact Assessment (HIA) methods to evaluate proposed structural suicide-prevention interventions and examine the utility of HIA in informing suicide prevention decision-making. METHODS: A project-level HIA was conducted by the Health Service Executive National Health Improvement team, with multi-agency input, following Institute of Public Health guidance. The four stages - screening, scoping, analysis and reporting - were informed by a literature review, a site visit, population health profiling, and analysis of incident data from An Garda Síochána. RESULTS: Between January 2020 and April 2025, there were 20 suicide attempts and one death at Bridge A, most involving women under 35, contrasting with national and international trends. Parts of the surrounding area showed higher levels of disadvantage, contributing to population 'sensitivity'. The 'magnitude' of the health impact was assessed as high, and the intervention was judged to reduce 'Injury risk' and improve 'Road or Route Safety' in a way that is 'significant'. The proposed structural modifications, alongside non-structural measures including suicide prevention training and crisis support signage, were recommended. CONCLUSIONS: This study demonstrates the utility of HIA in informing multi-agency suicide prevention decision-making in public places. The findings support implementation of the proposed measures and highlight the potential for HIA to be applied to other high-risk locations.