Existing law requires the Department of Transportation to install screening on state freeway overpasses to prevent objects from being dropped or thrown upon vehicles passing underneath, as provided.

This bill would require, on or before July 1, 2028, the department to identify best practices for the implementation of suicide countermeasures designed to deter suicide attempts on bridges and overpasses, as provided.

Existing law requires the Department of Transportation to install screening on state freeway overpasses to prevent objects from being dropped or thrown upon vehicles passing underneath, as provided.

This bill would require, on or before July 1, 2028, the department to identify best practices for the implementation of suicide countermeasures designed to deter suicide attempts on bridges and overpasses, as provided.

Existing law authorizes the State Department of Public Health to establish the Office of Suicide Prevention. Existing law authorizes the office, if established, to perform certain functions, including, among others, conducting state-level assessment of regional and statewide suicide prevention policies and practices and reporting on progress to reduce rates of suicide.

This bill would require the office to identify state bridges and roadways that have a history of a relatively high number of suicide-related deaths. The bill would also require the office to work with the Department of Transportation to identify cost-effective strategies to reduce suicides and suicide attempts on the states bridges and roadways. This bill would require the office to prepare and submit a report to the Legislature and the relevant specified policy committees on the strategies that it identifies on or before December 31, 2026. 2027. The bill would repeal its provisions on January 1, 2028. 2029.

Existing law vests the Department of Transportation with full possession and control of the state highway system and requires the department to improve and maintain the state highways.

Existing law authorizes the State Department of Public Health to establish the Office of Suicide Prevention within the department. Existing law authorizes the office, if established, to perform certain functions, including, among others, sharing and receiving data from all entities, including state agencies, with data relevant to the responsibilities and objectives of the office.

This bill would require the Department of Transportation to develop a policy to address suicide on the state highway system and, as part of that policy, to develop a framework for how to mitigate the risk of suicide on areas of the state highway system that pose a potential danger for suicide. The bill would require the Department of the California Highway Patrol to report all cases of suicide that it investigates on the state highway system to the Department of Transportation. The bill would require the Department of Transportation to report all cases of suicide committed on the state highway system to the Office of Suicide Prevention. The bill would require projects proposed under the policy to be considered public health emergencies and be considered for expedited development.

Existing law requires the department to prepare a state highway operation and protection program for the expenditure of transportation funds for major capital improvements that are necessary to preserve and protect the state highway system, excluding projects that add a new traffic lane to the system.

This bill would expressly provide that projects authorized to be included in the program may include suicide prevention and deterrence measures.

Existing law requires a project study report or project study report equivalent that is prepared for any new project involving the construction of a new bridge, or the replacement of a bridge with a history of documented suicides, which is included in a regional transportation improvement program, the interregional transportation improvement program, or the state highway operation and protection program, to include a document demonstrating that a suicide barrier was a feature considered during the projects planning process.

This bill would also require that document to include additional information relating to reducing the risk of, or mitigating, the potential for suicide.

CONCURRENCE IN SENATE AMENDMENTS

CSA1 Bill Id:AB 440

Author:(Ramos)

As Amended Ver:September 3, 2025

Majority vote

SUMMARY

Requires the Department of Transportation (CalTrans), on or before July 1, 2028, to identify best practices for the implementation of suicide countermeasures designed to deter suicide attempts on bridges and overpasses. Requires CalTrans to consider feedback from local jurisdictions and other stakeholders in evaluating appropriate physical infrastructure, design features, and related deterrent measures. Requires CalTrans to consult with the State Department of Public Health (DPH), behavioral health experts, and other relevant stakeholders in implementation.

Senate Amendments

1. Strike the previous contents of the bill directing DPH to work in consultation with CalTrans to identify cost-effective strategies to reduce suicides and suicide attempts on state bridges and roadways and instead directs CalTrans to identify best practices for the implementation of suicide countermeasures on bridges and overpasses.
2. Require CalTrans to consider feedback from local jurisdictions and other stakeholders in evaluating appropriate physical infrastructure, design features, and related deterrent measures.
3. Require CalTrans to consult with DPH, behavioral health experts, and other relevant stakeholders in implementation.
4. State that establishing best practices pursuant to this bill is not considered a "mandatory duty" under an existing law, which provides that failure to discharge such duty could result in liability.
5. Delete the reporting requirement.
6. Add coauthors.

COMMENTS

Suicide and Self-Harm in California. According to a January 2025 data brief from DPH, suicide is the leading cause of violent death, and self-harm is the third leading cause of injury-related emergency department (ED) visits. Men consistently have higher rates of suicide than women, and in 2022 men account for more than three-fourths of suicides. Use of firearms was the most common mechanism for suicide in 2021 and 2022. Youth under the age of 10 had a statistically significant increase in self-harm ED visit rates from 1.9 per 100,000 Californians in this age group in 2021 to 2.7 in 2022. Although there was a small number of black people who visited the ED for self-harm injury, this group is at elevated risk for self-harm. Self-harm by poisoning was the most common mechanism of self-harm injury leading to ED visits, followed by cutting/piercing and, when combined, both accounted for approximately 85% of self-harm ED visits. Other mechanisms of self-harm combined, including fall, firearm, and hanging/suffocation, made up 2% of self-harm ED visits.

The brief also highlights opportunities for prevention, such as advancing protective factors as a part of prevention programming to build resilience and foster support at the individual, relationship, and community level to help decrease suicide risk. While the brief notes that prevention efforts should focus on the most common and lethal means of suicide (firearms and intentional drug overdoses), it also highlights the 2024 National Strategy for Suicide Prevention, which contains several goals, such as integrating suicide prevention into the culture of the workplace and into other community settings, and implementing research-informed suicide prevention communication activities in diverse populations, using best practices from communication science.

988. As of July 16, 2022, the National Suicide Prevention Lifeline number transitioned to 988, providing an easy to remember number that anyone can call, text, or chat to receive support when experiencing a suicidal, mental health and/or substance use related crisis. When Californians dial 988, they are directed to one of 12 Lifeline crisis call centers. California's call centers are part of the broader 988 Lifeline crisis center network. If a local crisis center is unable to take the call, the caller is automatically routed to a national backup crisis center. According to the 988 California Crisis Center Consortium, 988 routed 342,394 calls with an average answer speed of 34 seconds, answer rate of 85%, and call length of 12 minutes in 2023.

Striving for Zero. In 2019, pursuant to AB 114, Chapter 38, Statutes of 2017, the Mental Health Services Oversight and Accountability Commission (now the Behavioral Health Services Oversight and Accountability Commission, or BHSOAC) adopted Striving for Zero, California's Strategic Plan for Suicide Prevention, 2020-2025. The 2020-21 Budget Act authorized the Behavioral Health Services Oversight and Accountability Commission (BHSOAC) to allocate $2 million support suicide prevention efforts consistent with the plan. The Behavioral Health Services Act (SB 326 [Eggman], Chapter 790, Statutes of 2023), requires the Office of Suicide Prevention (OSP), if established, to consult with the BHSOAC to implement suicide prevention efforts consistent with the strategic plan.

Suicide barriers can be effective. A review published in 2024 in the Journal of Preventive Medicine Reports titled, "Effectiveness of physical barriers to prevent suicide from high-risk bridges" identified that physical barriers work and are effective at reducing suicides by jumping from high-risk areas. The review also found that physical deterrent generally did not result in the substitution of a place or method. Over a longitudinal period, some areas even reduced their suicide rates to zero. Suicide barriers deter individuals who are at risk from jumping and buy additional time for intervention from bystanders and law enforcement.

Suicide deterrent infrastructure in California. In January 2024, a continuous physical suicide barrier was installed on the full length of the 1.7-mile span of the Golden Gate Bridge. Since its installation, the Golden Gate Bridge has seen a reduction of suicides by 73% and suicide attempts by 34%. The total project cost was approximately $224 million and was funded through federal and state grants, bridge tolls, Proposition 63 monies, and individual and foundation donations.

CalTrans is currently developing a suicide deterrent system (estimated at $124 million) for the San Diego-Coronado Bay Bridge (SDCBB). Although official figures have not been maintained, it is widely believed that approximately 400 deaths by suicide have occurred since opening in 1969. After the Golden Gate Bridge, SDCBB is recognized as the second most frequently used bridge for suicide in the state. The standard operating procedure for responding to suicide attempts is bridge closure. In response, interim measures to address suicide incidents were implemented by installing four inch spikes on top of the bridge rail in 2019. Multiple suicides and suicide attempts have occurred since, resulting in bridge closures that have heavily affected travel time for residents of San Diego County.

In addition to the San Diego-Coronado Bay Bridge, CalTrans is also working on installing a suicide deterrent system across the Arroyo Simi Overhead Bridge on State Route 118. More than 20 documented attempts and suicides have occurred since 1994, with a majority of incidents occurring since 2009. The project is anticipated to be completed in December 2025. The total project cost is approximately $10 million, according to the proposed State Highway Operation and Protection Program Fiscal Year 2024-25.

According to the Author

This bill aims to continue California's goal of working towards achieving zero suicides. The author says that, in order to do so, we must begin identifying areas of potential harm for at-risk individuals. Specifically, such harms are on our state's bridges and overpasses. It is the hope of the author that that this bill will help prevent a future tragedy from striking communities and to protect those in need.

Arguments in Support

Didi Hirsch Mental Health Services is sponsoring this bill and states in support that CalTrans does not have a statewide suicide prevention policy in place for their bridges and roadways and that the state should not have to wait for a tragedy to strike to begin the process of developing safety measures in areas that possess a clear and present danger to any at-risk individual that may be considering taking their own life. Didi Hirsch says this legislation aims to protect at-risk individuals and help provide families with some relief knowing their state is being proactive about their loved one's safety.

Arguments in Opposition

None.

FISCAL COMMENTS

The current version of this bill has not been analyzed by a fiscal committee.

VOTES:

ASM HEALTH: 15-0-0

YES: Bonta, Chen, Addis, Aguiar-Curry, Arambula, Carrillo, Flora, Mark González, Krell, Patel, Celeste Rodriguez, Sanchez, Schiavo, Sharp-Collins, Stefani

ASM APPROPRIATIONS: 14-0-1

YES: Wicks, Arambula, Calderon, Caloza, Dixon, Elhawary, Fong, Mark González, Hart, Pacheco, Pellerin, Solache, Ta, Tangipa

ABS, ABST OR NV: Sanchez

ASSEMBLY FLOOR: 79-0-0

YES: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Arambula, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Chen, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Garcia, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Kalra, Krell, Lackey, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Nguyen, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Ransom, Celeste Rodriguez, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

UPDATED

VERSION: April 10, 2025

CONSULTANT: Logan Hess / HEALTH / (916) 319-2097 FN: 0001896

 THIRD READING  

Bill No: AB 440

Author: Ramos (D), et al.

Amended: 9/3/25 in Senate

Vote: 21

SENATE HEALTH COMMITTEE: 11-0, 6/25/25

AYES: Menjivar, Valladares, Durazo, Gonzalez, Grove, Limón, Padilla, Richardson, Rubio, Weber Pierson, Wiener

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/29/25

AYES: Caballero, Seyarto, Cabaldon, Dahle, Grayson, Richardson, Wahab

ASSEMBLY FLOOR: 79-0, 6/2/25 - See last page for vote

SUBJECT: State bridges and overpasses: suicide prevention

SOURCE: Didi Hirsch Mental Health Services

DIGEST:

This bill requires the California Department of Transportation (Caltrans), by July 1, 2028, to consult with the California Department of Public Health (CDPH), behavioral health experts, and other relevant stakeholders to develop best practices for the consideration of suicide countermeasures designed to deter suicide attempts on bridges and overpasses, including evaluating appropriate physical infrastructure and design features.

Senate Floor Amendments of 9/3/25 recast provisions of the bill to switch the lead versus consulting roles to require Caltrans, instead of the Office of Suicide Prevention, within CDPH, to develop best practices of suicide prevention strategies and physical countermeasures for possible implementation on bridges and overpasses; and delete the reporting requirement.

ANALYSIS:

Existing law:

1. Grants Caltrans the full possession and control of all state highways and all property and rights in property acquired for state highway purposes.
2. Requires Caltrans to install screening on state freeway overpasses to prevent objects from being dropped or thrown upon vehicles passing underneath, as provided.
3. Establishes CDPH to be vested with all the duties, powers, purposes, functions, responsibilities, and jurisdiction as they relate to public health, as specified

This bill:

1. Requires Caltrans, by July 1, 2028, to develop best practices for the consideration of suicide countermeasures designed to deter suicide attempts on bridges and overpasses.
2. Requires Caltrans to consider feedback from local jurisdictions and other stakeholders when evaluating appropriate physical infrastructure, design features, and related deterrent measures.
3. Requires Caltrans to consult with CDPH, behavioral health experts, and other relevant stakeholders in implementing provisions of this bill.
4. Declares that any implementation of such countermeasures shall be as determined by Caltrans to be appropriate.
5. Declares that provisions of this bill do not impose a mandatory duty pursuant to current public entity liability law.

Comments:

1. Purpose of this bill. According to the author, “AB 440 reflects our state’s continued commitment to protecting vulnerable community members and proactively addressing suicide on our state’s bridges and overpasses. It is essential that suicide prevention remains a top priority in any future highway project. This legislation directs the Department of Transportation, in collaboration with the Department of Public Health, to develop best practices for the planning and design of suicide countermeasures on bridges and overpasses—ensuring that input from local leaders and behavioral health experts is meaningfully incorporated into those practices.”
2. Suicide and Self-Harm in California. According to a January 2025 data brief from CDPH, suicide is the leading cause of violent death, and self-harm is the third leading cause of injury-related emergency department (ED) visits. Men consistently have higher rates of suicide than women, and in 2022 men account for more than three-fourths of suicides. Use of firearms was the most common mechanism for suicide in 2021 and 2022. Youth under the age of 10 had a statistically significant increase in self-harm ED visit rates from 1.9 per 100,000 Californians in this age group in 2021 to 2.7 in 2022. Self-harm by poisoning was the most common mechanism of self-harm injury leading to ED visits, followed by cutting/piercing and, when combined, both accounted for approximately 85% of self-harm ED visits. Other mechanisms of self-harm combined, including fall, firearm, and hanging/suffocation, made up 2% of self-harm ED visits.

The brief also highlights opportunities for prevention, such as advancing protective factors as a part of prevention programming to build resilience and foster support at the individual, relationship, and community level to help decrease suicide risk. While the brief notes that prevention efforts should focus on the most common and lethal means of suicide (firearms and intentional drug overdoses), it also highlights the 2024 National Strategy for Suicide Prevention, which contains several goals, such as integrating suicide prevention into the culture of the workplace and into other community settings, and implementing research-informed suicide prevention communication activities in diverse populations, using best practices from communication science.

1. Suicide and self-harm on roadways. Road–related methods of suicide include jumping off or on to road infrastructure, stepping into the path of a moving vehicle, or driving off or into road infrastructure or into another vehicle. A 2023 study entitled Factors Prompting and Deterring Suicides on the Roads, by researchers from Middlesex University in London investigated the factors prompting and deterring the decision to attempt suicide on the roads. They conducted interviews with people who had lived experience of suicidal ideation or behavior at a bridge or road location. They found that people perceived a road-related suicide to be quick, lethal, easy and accessible and to have the potential to appear accidental. The proportion of people who described their thoughts and attempts as impulsive appeared to be higher than had been observed with other method choices. The potential impact on other people was a strongly dissuasive factor.

The researchers concluded that “measures designed to prevent access to potentially lethal sites may be particularly important, given that many participants described their thoughts and behavior as impulsive. In addition, fostering a culture of care and consideration for other road users may help to dissuade people from taking action on the roads.”

1. Tragedy in San Bernardino County. Over a few weeks last fall, two high-school students took their own lives on the Haven Avenue overpass on State Route (SR) 210, in the City of Rancho Cucamonga. According to the city, “The rising number of suicide incidents from freeway overpasses is not only a profound tragedy for individuals and families but also a serious public safety concern for motorists, first responders, and the broader community. In the past six months alone, multiple suicides and attempts have occurred along the 210 Freeway overpasses, including the heartbreaking loss of two high school students at the same location – 1.5 weeks apart from one another. In December, another individual from outside the area also died by suicide at a Rancho Cucamonga overpass. While some attempts have been prevented, each represents a crisis that could have ended in another devastating loss. These incidents underscore the urgent need for intervention. No family, school, or community should have to endure such unimaginable grief. It is imperative that we take immediate action to implement preventive measures that provide hope, support, and protection for those in distress.”
2. Statewide prevention efforts – 988. As of July 16, 2022, the National Suicide Prevention Lifeline number transitioned to 988, providing an easy to remember number that anyone can call, text, or chat to receive support when experiencing a suicidal, mental health and/or substance use related crisis. When Californians dial 988, they are directed to one of twelve Lifeline crisis call centers. California’s call centers are part of the broader 988 Lifeline crisis center network. If a local crisis center is unable to take the call, the caller is automatically routed to a national backup crisis center. According to the 988 California Crisis Center Consortium, 988 routed 342,394 calls with an average answer speed of 34 seconds, answer rate of 85%, and call length of 12 minutes in 2023.
3. Rancho Cucamonga is also working on prevention. The City of Rancho Cucamonga has been committed to mental health services and suicide prevention for many years. In 2008, the City Council launched the Healthy RC initiative, which connects “planning, program, policy, and partnership efforts that work across sectors and priority areas to promote community health and wellness.”

Mental health is a major part of the initiative with the city noting its high priority in the community. Since the start of Healthy RC, suicide and self-inflicted injury hospitalization rates have decreased by 19%.

Additionally, last year the city launched Community Outreach and Support Team (COAST), which is a multi-disciplinary mobile mental health crisis response team. The team consists of a social worker from the Department of Behavioral Health, a law enforcement officer, and a fire safety employee with a service dog trained in crisis response. The purpose of the team is to engage with those experiencing a mental health crisis in order to provide alternative services including the ability to follow-up with individuals for continuum of care, provide a better treatment option for those in crisis, provide community outreach and education, and prevent further crises through follow-up. COAST can respond in lieu of, or relieve, police and fire resources to keep those units available for emergency response.

The city has also been working directly with Caltrans to help prevent future deaths at the SR 210 location and others throughout the area. According to Caltrans, they are working with the city to assess the bridge overpass area and work on erecting fencing to block access. Currently, the overpass in question has fencing on the bridge deck but people have still been able to climb up the side to access the bridge. The city would like to add four additional fences to close off the access points. Additionally, for added prevention, Caltrans and the city have erected signage at the overpass location that state, “there is hope, we can help,” and lists the 988 lifeline number.

1. AB 440 focuses on identifying best practices for suicide countermeasures on state highways. Currently, Caltrans is required to install screening on state freeway overpasses where pedestrians are allowed to prevent objects from being dropped or thrown upon vehicles passing underneath. The locations are up to Caltrans’ discretion, but first consideration must be given to overpasses in urban areas. The Caltrans Highway Design Manual contains requirements for bridge barriers and railings. The railings are spirited into four classes based on their preventative function, vehicle barrier railings, combination vehicle barrier and pedestrian railings, pedestrian railings, and bicycle railings. According to Caltrans, overpasses with pedestrian access include fencing. As noted above, the overpass on the SR 210 does have pedestrian fencing on the bridge deck.

AB 440 requires Caltrans, by July 1, 2028, to work with CDPH, behavioral health experts, and other relevant stakeholders, to develop best practices for the consideration of suicide countermeasures on bridges and overpasses. The bill also requires Caltrans to evaluate appropriate physical infrastructure, and design features to help deter suicides and suicide attempts. Recent amendments recast provisions of AB 440 to work in conjunction with SB 800 (Reyes), which requires Caltrans and CDPH to incorporate suicide deterrent considerations in the updates of applicable guidance documents, such as the Highway Design Manual.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

SUPPORT: (Verified 9/3/25)

Didi Hirsch Mental Health Services (source)

California Academy of Child and Adolescent Psychiatry
California Alliance of Child and Family Services
California Behavioral Health Association
California Hospital Association
California Police Chiefs Association
Children Now
City of Rancho Cucamonga
County Behavioral Health Directors Association
Helpline Youth Counseling, INC.
Hillsides Pasadena
National Alliance on Mental Illness (NAMI-CA)
Office of Los Angeles County Supervisor Lindsey P. Horvath

OPPOSITION: (Verified 9/3/25)

None received

ARGUMENTS IN SUPPORT: Didi Hirsch Mental Health Services, as the sponsor, and other supporters cite that Caltrans does not have a statewide suicide prevention policy in place for their bridges and roadways, and strongly believe that the state should not have to wait for a tragedy to strike to begin the process of developing safety measures in areas that possess a clear and present danger to any at-risk individual that may be considering taking their own life.

ASSEMBLY FLOOR: 79-0, 6/2/25

AYES: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Arambula, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Chen, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Garcia, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Kalra, Krell, Lackey, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Nguyen, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Ransom, Celeste Rodriguez, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

Prepared by: Melissa White / TRANS. / (916) 651-4121, Isabelle LaSalle / TRANS. / (916) 651-4121

9/6/25 10:24:28

**** END ****

 THIRD READING  

Bill No: AB 440

Author: Ramos (D)

Amended: 4/10/25 in Assembly

Vote: 21

SENATE HEALTH COMMITTEE: 11-0, 6/25/25

AYES: Menjivar, Valladares, Durazo, Gonzalez, Grove, Limón, Padilla, Richardson, Rubio, Weber Pierson, Wiener

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/29/25

AYES: Caballero, Seyarto, Cabaldon, Dahle, Grayson, Richardson, Wahab

ASSEMBLY FLOOR: 79-0, 6/2/25 - See last page for vote

SUBJECT: Suicide prevention

SOURCE: Didi Hirsch Mental Health Services

DIGEST:

This bill requires the Office of Suicide Prevention (OSP) to work in consultation with the Department of Transportation to reduce suicides and suicide attempts on the state’s bridges and roadways. Requires OSP to prepare a report on these strategies and submit, on or before December 31, 2027, to the Legislature, the Assembly Committee on Health, the Assembly Committee on Transportation, the Senate Committee on Health, and the Senate Transportation Committee. Repeals these requirements on January 1, 2029.

ANALYSIS:

Existing law:

1. Establishes the California Department of Public Health (CDPH) to be vested with all the duties, powers, purposes, functions, responsibilities, and jurisdiction as they relate to public health, as specified. [ Health and Safety Code (HSC) §131050]
2. Authorizes CDPH to establish the OSP with responsibilities that include:
   1. Providing information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs;
   2. Conducting state-level assessments of regional and statewide suicide prevention policies and practices, as specified;
   3. Monitoring and disseminating data to inform prevention efforts at the state and local levels;
   4. Convening experts and stakeholders, as specified, to encourage collaboration and coordination of resources for suicide prevention; and,
   5. Reporting on progress to reduce suicide rates. [HSC §131300]
3. Requires OSP to consult with the Behavioral Health Services Oversight and Accountability Commission (BHSOAC) to implement suicide prevention efforts. Specifies that OSP is not authorized to perform specified duties required by the BHSOAC. [HSC §131315]
4. Requires each county, pursuant to the Behavioral Health Services Act, to establish and administer an early intervention program that is designed to prevent mental illnesses and substance use disorders from becoming severe and disabling; to reduce disparities in behavioral health; and, to emphasize the reduction of the likelihood of:
5. Suicide and self-harm;
6. Incarcerations;
7. School, including early childhood 0 to 5 years of age, inclusive, TK-12, and higher education, suspension, expulsion, referral to an alternative or community school, or failure to complete;
8. Unemployment;
9. Prolonged suffering;
10. Homelessness;
11. Removal of children from their homes;
12. Overdose; and,
13. Mental illness in children and youth from social, emotional, developmental, and behavioral needs in early childhood. [Welfare and Institutions Code (WIC) §5840(a) and (d)]
14. Establishes the California Suicide Prevention Act of 2000 and permits DHCS, contingent upon appropriation in the annual Budget Act, to establish and implement a suicide prevention, education, and gatekeeper-training program to reduce the severity, duration, and incidence of suicidal behavior. [WIC §4098.2]

This bill:

1. Requires OSP to work in consultation with the California Department of Transportation (Caltrans) to:
2. Identify cost-effective strategies to reduce suicides and suicide attempts on the state’s bridges and roadways, including, but not limited to, infrastructure and other prevention strategies; and,
3. Prepare a report on the strategies it identifies, and submit it, on or before December 31, 2027, to the Legislature, the Assembly Committee on Health, the Assembly Committee on Transportation, the Senate Committee on Health, and the Senate Transportation Committee.
4. Repeals these requirements on January 1, 2029.

Comments

According to the author of this bill:

This bill continues California’s commitment to achieving zero suicides by proactively addressing parts of our state’s infrastructure—such as bridges and overpasses—which have historically been used by individuals in crisis to take their own lives. This bill directs the OSP and Caltrans to develop solutions that safeguard those at risk. The hope is that this bill will prevent future tragedies in our communities and offer protection and support to those in crisis.

Background

Suicide in general. According to the BHSOAC website, suicide is a complex public health challenge involving many biological, psychological, social, and cultural determinants. The major risk factors for suicide are a prior suicide attempt; substance use disorder; mood disorders, such as depression; medical illness; and access to the methods to attempt suicide. The common factors that reduce risk for suicide are access to effective medical and mental health care; connectedness to others; problem-solving skills; and caring contacts, such as postcards or letters from service providers and caregivers. Prevention efforts are challenged by misconceptions about suicidal behavior, despite advancements in the study of suicide and its prevention. BHSOAC further states these pervasive myths may prevent people at risk from seeking help and discourage people from asking loved ones about thoughts of suicide. The internal suffering that accompanies the desire to die may remain hidden unless a person is directly asked about their thoughts and needs. Risk factors may be missed in the absence of uniform suicide screening and assessment by mental health and substance use disorder providers, who often are delivering services in separate and uncoordinated systems. Interventions, such as physical barriers on bridges, locking doors on railways, and locking windows at lethal heights prevent accidental and intentional falling. Likewise, safely storing guns in the home prevents accidental and intentional injury and death among children and adults.

Suicide among California youth. According to CDPH’s website, suicide is a public health crisis with multiple, complex, contributing factors. Rates among youth have risen over the past decades, and both national and statewide data show suicide to be the third-leading cause of death among young people aged 15 to 24. CDPH further states suicide is preventable, and addressing the problem requires comprehensive, cross-sector commitments focused on both risk and protective factors at the individual, family, community, and systems levels. From the youth suicide deaths dashboard, based on state-level data for 2010 through 2023, the California rate of youth suicide in 2023 was 8.9 per 100,000 for those aged 15 to 24. In comparison, the national rate for the same population was 13.5 per 100,000 in 2023. California has maintained its rate below the national level consistently throughout the data time period.

California’s recent efforts. OSP is toward the end of administering two youth suicide prevention projects (they end around the Summer of 2025) as part of the California Health and Human Services Agency-sponsored Children and Youth Behavioral Health Initiative:

The Youth Suicide Prevention Media and Outreach Campaign: established through one-time funding in the Governor’s 2022–2023 Budget to develop and implement a data-driven, targeted, community-based, youth suicide prevention media and outreach campaign for youth at increased risk of suicide. The goal of the campaign is to reduce suicide, suicide attempts, and rates of self-harm among three disproportionately impacted populations:

• American Indian/Alaska Native youth, who experienced the highest suicide rate from

2016-2021 (16.4 per 100,000 individuals);

• Black/African-American youth, who experienced the greatest increase in rate from 2016-2021 (33% increase); and,
• Hispanic/Latinx youth, who experienced the highest number of suicides from 2016-2021 (1,435 suicide deaths).

As part of an intersectional approach to health equity, the campaign is also inclusive of youth from the populations listed above who identify as having mental health and/or substance use disorder challenges, having been impacted by the foster care system, and/or identify as 2S/LGBTQ+. The organizations selected to receive grants for the project were chosen in part based on their experience working with the campaign’s primary audience, helping to ensure media and programming efforts are culturally appropriate and youth-led.

The campaign, known as “Never a Bother,” seeks to prevent suicide among youth and young adults up to age 25 in California. This campaign tells youth experiencing thoughts of suicide that they are never a bother when reaching out to friends, trusted adults, and other types of support (such as the 988 suicide hotline). At the same time, it asks peer and adult allies to make sure young people in their lives know they are there for them and can reach out for help anytime. The Never a Bother concept was co-created with and selected by youth, based on its welcoming feel, visual appeal, and messaging that authentically validates youth-at-risks’ experiences and state of mind with clear encouragement to reach out for support before, during, and after a crisis.

The Youth Suicide Reporting and Crisis Response Pilot Program: established through one-time funding in the Governor’s 2022–2023 Budget, develops and tests models for making youth suicide and attempted suicide reportable events. The pilot also supports models for rapidly and comprehensively responding to these events by providing crisis services and follow-up support in school and community settings. This program involves developing and testing approaches to report youth suicide and attempted suicide so that rapid and comprehensive crisis services and follow-up support can be offered where the deaths or attempts occurred. Ten counties were selected to participate in the program based on youth suicide rates, counts, rate increases over time, and racial/ethnic diversity. Counties with small, medium, and large populations, as well as a mix of counties that are urban, suburban, or rural were selected.

Striving for Zero: in 2019, pursuant to AB 114 (Committee on Budget, Chapter 38, Statutes of 2017) the Mental Health Services Oversight and Accountability Commission (now the BHSOAC) adopted “Striving for Zero: California’s Strategic Plan for Suicide Prevention, 2020-2025 (the Plan).” The 2020-21 Budget Act authorized the BHSOAC to allocate $2 million to support suicide prevention efforts consistent with the plan. As noted in the Plan, effective prevention efforts must recognize that risk factors can be dynamic, changing over a person’s lifetime. Researchers are exploring the variability in risk and protective factors among vulnerable groups, and much remains unknown. Deficiencies in data collection also limit understanding of the full extent of suicidal behavior. For example, determining suicidal intent after a drug overdose can be difficult, resulting in underreporting and limited information to support prevention efforts. The Plan also notes suicide prevention requires engagement of private and public partners across multidisciplinary fields, which requires a commitment to wide-scale collaborations that integrate planning and coordinate actions. Efforts are further complicated by inconsistent definitions of suicidal behavior, which affect data monitoring. Lastly, assessing for risk is not a uniform practice in California. This leads to inconsistency in suicide risk detection, which also is constrained by significant ethical, training, and legal considerations.

Bridge suicide deterrent systems. According to the Golden Gate Bridge (GGB) Highway and Transportation District (District), there were 14 confirmed suicides from people jumping off the bridge in 2023 when the GGB suicide deterrent net began construction. Two decades prior, the average number of GGB suicides per year was 30. As of January 1, 2024, the GGB now has a continuous physical suicide barrier installed the full length of the 1.7-mile span, contributing to lowering suicides at the GGB to eight—a reduction to the annual number of suicides by 73%. The suicide deterrent system, also known as “the net,” has been installed on the east and west sides to reduce the number of deaths associated with individuals jumping. The net is a proven design that deters people from jumping, serves as a symbol of care and hope to despondent individuals, and, if necessary, offers people a second chance. The net drew inspiration from similar barriers erected to deter suicides on tall buildings and bridges around the world. Attempts have also declined since the net was completed. In a typical year before the net, the District’s staff would successfully intervene with up to 200 individuals at the GGB. In 2024, our staff performed only 132 successful interventions.

Caltrans is currently working on a suicide deterrent system for the San Diego-Coronado Bay Bridge (SDCBB). Although official figures have not been maintained since its opening in 1969, it is widely believed that approximately 400 deaths by suicide have occurred from the SDCBB. Per the San Diego County Medical Examiner’s website, 18 fatalities occurred in 2017, 17 fatalities in 2018, and 15 fatalities in 2019. After the GGB, the SDCBB is recognized as the second most frequently used bridge for suicide in the state. It does not have a permanent physical suicide deterrent system. The current Caltrans standard operating procedure for suicide attempts is closing the bridge, which causes disruption for many hours. Non-physical suicide deterrence measures have been implemented on the bridge, along with the addition of 4-inch spikes installed on top of the bridge rail in early 2019 as an interim measure, yet multiple suicides and suicide attempts have still occurred. Since fatalities caused by suicide do not qualify under the current federal Highway Safety Improvement Program (HSIP) criteria, suicide deterrent projects are not eligible for HSIP funding.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Senate Appropriations Committee:

• The California Department of Public Health (CDPH) estimates annual General Fund costs of $380,000 in 2026-27 and 2027-28, and $190,000 in 2028-29 for staffing resources to conduct a comprehensive review of existing research and literature related to suicides and suicide attempts occurring on the state's bridges and roadways, consult with the Department of Transportation and suicide prevention subject matter experts, assess the current understanding of the cost-effectiveness of suicide prevention strategies, and complete the report to the Legislature.
• Caltrans estimates a one-time cost of approximately $250,000 (State Highway Account) for staffing for data collection and sharing, and performing analysis to assist the Office of Suicide Prevention. Caltrans also notes potential significant cost pressures to the State Highway Account/Road Maintenance and Rehabilitation Account to the extent the recommendations would be implemented.

SUPPORT: (Verified 8/27/25)

Didi Hirsch Mental Health Services (Source)

Bridge Rail Foundation

California Academy of Child and Adolescent Psychiatry

California Alliance of Child and Family Services

California Association of Social Rehabilitation Agencies

California Behavioral Health Services

California Hospital Association

California Indian Nations College

California Police Chiefs Association

California State Association of Psychiatrists

Children Now

City of Rancho Cucamonga

County Behavioral Health Directors Association

County of San Bernardino

Helpline Youth Counseling, Inc.

Hillsides Pasadena

Los Angeles County Supervisor, Lindsey P. Horvath

National Alliance on Mental Illness – California

Sycamores

Wayfinder Family Services

OPPOSITION: (Verified 8/27/25)

None received

ARGUMENTS IN SUPPORT: Didi Hirsch Mental Health Services, as the sponsor, and other supporters cite that Caltrans does not have a statewide suicide prevention policy in place for their bridges and roadways, and strongly believe that the state should not have to wait for a tragedy to strike to begin the process of developing safety measures in areas that possess a clear and present danger to any at-risk individual that may be considering taking their own life. Supporters further state that this bill would require OSP to identify areas that are considered “hot spot” areas with a history of suicide-related deaths, as well as provide recommendations to Caltrans on potential solutions that would reduce the risk of future incidents. This legislation aims to protect at-risk individuals and help provide families with some relief knowing their state is being proactive about their loved one’s safety.

ASSEMBLY FLOOR: 79-0, 6/2/25

AYES: Addis, Aguiar-Curry, Ahrens, Alanis, Alvarez, Arambula, Ávila Farías, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Caloza, Carrillo, Castillo, Chen, Connolly, Davies, DeMaio, Dixon, Elhawary, Ellis, Flora, Fong, Gabriel, Gallagher, Garcia, Gipson, Jeff Gonzalez, Mark González, Hadwick, Haney, Harabedian, Hart, Hoover, Irwin, Jackson, Kalra, Krell, Lackey, Lee, Lowenthal, Macedo, McKinnor, Muratsuchi, Nguyen, Ortega, Pacheco, Papan, Patel, Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Ransom, Celeste Rodriguez, Michelle Rodriguez, Rogers, Blanca

Rubio, Sanchez, Schiavo, Schultz, Sharp-Collins, Solache, Soria, Stefani, Ta, Tangipa, Valencia, Wallis, Ward, Wicks, Wilson, Zbur, Rivas

Prepared by: Reyes Diaz / HEALTH / (916) 651-4111

8/29/25 20:38:53

**** END ****

SENATE COMMITTEE ON APPROPRIATIONS

Senator Anna Caballero, Chair

2025 - 2026 Regular Session

AB 440 (Ramos) - Suicide prevention

Bill Summary:

• AB 440 would require the Office of Suicide Prevention to work in consultation with the Department of Transportation to identify cost-effective strategies to reduce suicides and suicide attempts on the state’s bridges and roadways.

Fiscal Impact:

• The California Department of Public Health (CDPH) estimates annual General Fund costs of $380,000 in 2026-27 and 2027-28, and $190,000 in 2028-29 for staffing resources to conduct a comprehensive review of existing research and literature related to suicides and suicide attempts occurring on the state's bridges and roadways, consult with the Department of Transportation and suicide prevention subject matter experts, assess the current understanding of the cost-effectiveness of suicide prevention strategies, and complete the report to the Legislature.
• Caltrans estimates a one-time cost of approximately $250,000 (State Highway Account) for staffing for data collection and sharing, and performing analysis to assist the Office of Suicide Prevention. Caltrans also notes potential significant cost pressures to the State Highway Account/Road Maintenance and Rehabilitation Account to the extent the recommendations would be implemented.

Background:

Current law authorizes CDPH to establish the Office of Suicide Prevention and specifies that the responsibilities of the office may include the following:

• Providing information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs.
• Conducting state level assessment of regional and statewide suicide prevention policies and practices, including other states’ suicide prevention policies, and including specific metrics and domains as appropriate.
• Monitoring and disseminating data to inform prevention efforts at the state and local levels.
• Convening experts and stakeholders, including, but not limited to, stakeholders representing populations with high rates of suicide, to encourage collaboration and coordination of resources for suicide prevention.
• Reporting on progress to reduce rates of suicide.

Current law provides that the Office of Suicide Prevention may share and receive data from all entities with data relevant to the responsibilities and objectives of the office, including, but not limited to, state, federal, local, and private and nongovernmental agencies or organizations.

Currently, Caltrans is required to install screening on state freeway overpasses where pedestrians are allowed to prevent objects from being dropped or thrown upon vehicles passing underneath. The locations are up to Caltrans’ discretion but first consideration must be given to overpasses in urban areas. The Caltrans Highway Design Manual contains requirements for bridge barriers and railings. The railings are categorized into four classes based on their preventative function: vehicle barrier railings, combination vehicle barrier and pedestrian railings, pedestrian railings, and bicycle railings. According to Caltrans, overpasses with pedestrian access include fencing.

Proposed Law:

Specific provisions of the bill would:

• Require the Office of Suicide Prevention to do both of the following:
  • Work in consultation with the Department of Transportation to identify cost-effective strategies to reduce suicides and suicide attempts on the state’s bridges and roadways, including, but not limited to, infrastructure and other prevention strategies.
  • Prepare a report on the strategies it identifies and submit that report on or before December 31, 2027, to the Legislature, the Assembly Committee on Health, the Assembly Committee on Transportation, the Senate Committee on Health, and the Senate Transportation Committee.
• Repeal the provisions on January 1, 2029.

Related Legislation:

SB 800 (Reyes) would require the Department of Transportation to: assess and determine appropriate mitigation measures to help prevent suicides on locally owned overpasses that have a history of suicide-related deaths, cross over state highways, and are in the state’s right-of-way; consult with the Office of Suicide Prevention; and submit a report to the Legislature. The bill is currently in the Assembly Transportation Committee.

-- END --

SENATE COMMITTEE ON HEALTH

Senator Caroline Menjivar, Chair

BILL NO: AB 440

SUBJECT: Suicide prevention

SUMMARY:

Requires the Office of Suicide Prevention (OSP) to work in consultation with the Department of Transportation to reduce suicides and suicide attempts on the state’s bridges and roadways. Requires OSP to prepare a report on these strategies and submit, on or before December 31, 2027, to the Legislature, the Assembly Committee on Health, the Assembly Committee on Transportation, the Senate Committee on Health, and the Senate Transportation Committee. Repeals these requirements on January 1, 2029.

Existing law:

1. Establishes the California Department of Public Health (CDPH) to be vested with all the duties, powers, purposes, functions, responsibilities, and jurisdiction as they relate to public health, as specified. [HSC §131050]
2. Authorizes CDPH to establish the OSP with responsibilities that include:
   1. Providing information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs;
   2. Conducting state-level assessments of regional and statewide suicide prevention policies and practices, as specified;
   3. Monitoring and disseminating data to inform prevention efforts at the state and local levels;
   4. Convening experts and stakeholders, as specified, to encourage collaboration and coordination of resources for suicide prevention; and,
   5. Reporting on progress to reduce suicide rates. [HSC §131300]
3. Requires OSP to consult with the Behavioral Health Services Oversight and Accountability Commission (BHSOAC) to implement suicide prevention efforts. Specifies that OSP is not authorized to perform specified duties required by the BHSOAC. [HSC §131315]
4. Requires each county, pursuant to the Behavioral Health Services Act, to establish and administer an early intervention program that is designed to prevent mental illnesses and substance use disorders from becoming severe and disabling; to reduce disparities in behavioral health; and, to emphasize the reduction of the likelihood of:
5. Suicide and self-harm;
6. Incarcerations;
7. School, including early childhood 0 to 5 years of age, inclusive, TK-12, and higher education, suspension, expulsion, referral to an alternative or community school, or failure to complete;
8. Unemployment;
9. Prolonged suffering;
10. Homelessness;
11. Removal of children from their homes;
12. Overdose; and,
13. Mental illness in children and youth from social, emotional, developmental, and behavioral needs in early childhood. [WIC §5840(a) and (d)]
14. Establishes the California Suicide Prevention Act of 2000 and permits DHCS, contingent upon appropriation in the annual Budget Act, to establish and implement a suicide prevention, education, and gatekeeper-training program to reduce the severity, duration, and incidence of suicidal behavior. [WIC §4098.2]

This bill:

1. Requires OSP to work in consultation with the California Department of Transportation (Caltrans) to:
2. Identify cost-effective strategies to reduce suicides and suicide attempts on the state’s bridges and roadways, including, but not limited to, infrastructure and other prevention strategies; and,
3. Prepare a report on the strategies it identifies, and submit it, on or before December 31, 2027, to the Legislature, the Assembly Committee on Health, the Assembly Committee on Transportation, the Senate Committee on Health, and the Senate Transportation Committee.
4. Repeals these requirements on January 1, 2029.

FISCAL EFFECT:

According to the Assembly Appropriations Committee, CDPH estimates General Fund (GF) costs of $380,000 per year in (FY) 2026-27 and 2027-28 for two full-time staff to identify and develop cost-effective strategies, culminating in the preparation of a detailed report for the Legislature. GF costs to Caltrans of an unknown, but likely absorbable amount, to work with CDPH’s OSP on the study.

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, this bill continues California’s commitment to achieving zero suicides by proactively addressing parts of our state’s infrastructure—such as bridges and overpasses—which have historically been used by individuals in crisis to take their own lives. This bill directs the OSP and Caltrans to develop solutions that safeguard those at risk. The hope is that this bill will prevent future tragedies in our communities and offer protection and support to those in crisis.
2. Suicide in general. According to the BHSOAC website, suicide is a complex public health challenge involving many biological, psychological, social, and cultural determinants. The major risk factors for suicide are a prior suicide attempt; substance use disorder; mood disorders, such as depression; medical illness; and access to the methods to attempt suicide. The common factors that reduce risk for suicide are access to effective medical and mental health care; connectedness to others; problem-solving skills; and caring contacts, such as postcards or letters from service providers and caregivers. Prevention efforts are challenged by misconceptions about suicidal behavior, despite advancements in the study of suicide and its prevention. BHSOAC further states these pervasive myths may prevent people at risk from seeking help and discourage people from asking loved ones about thoughts of suicide. The internal suffering that accompanies the desire to die may remain hidden unless a person is directly asked about their thoughts and needs. Risk factors may be missed in the absence of uniform suicide screening and assessment by mental health and substance use disorder providers, who often are delivering services in separate and uncoordinated systems. Interventions, such as physical barriers on bridges, locking doors on railways, and locking windows at lethal heights prevent accidental and intentional falling. Likewise, safely storing guns in the home prevents accidental and intentional injury and death among children and adults.
3. Suicide among California youth. According to CDPH’s website, suicide is a public health crisis with multiple, complex, contributing factors. Rates among youth have risen over the past decades, and both national and statewide data show suicide to be the third-leading cause of death among young people aged 15 to 24. CDPH further states suicide is preventable, and addressing the problem requires comprehensive, cross-sector commitments focused on both risk and protective factors at the individual, family, community, and systems levels. From the youth suicide deaths dashboard, based on state-level data for 2010 through 2023, the California rate of youth suicide in 2023 was 8.9 per 100,000 for those aged 15 to 24. In comparison, the national rate for the same population was 13.5 per 100,000 in 2023. California has maintained its rate below the national level consistently throughout the data time period.
4. California’s recent efforts. OSP is toward the end of administering two youth suicide prevention projects (they end around the Summer of 2025) as part of the California Health and Human Services Agency-sponsored Children and Youth Behavioral Health Initiative:

The Youth Suicide Prevention Media and Outreach Campaign: established through one-time funding in the Governor’s 2022–2023 Budget to develop and implement a data-driven, targeted, community-based, youth suicide prevention media and outreach campaign for youth at increased risk of suicide. The goal of the campaign is to reduce suicide, suicide attempts, and rates of self-harm among three disproportionately impacted populations:

1. American Indian/Alaska Native youth, who experienced the highest suicide rate from

2016-2021 (16.4 per 100,000 individuals);

1. Black/African-American youth, who experienced the greatest increase in rate from 2016-2021 (33% increase); and,
2. Hispanic/Latinx youth, who experienced the highest number of suicides from 2016-2021 (1,435 suicide deaths).

As part of an intersectional approach to health equity, the campaign is also inclusive of youth from the populations listed above who identify as having mental health and/or substance use disorder challenges, having been impacted by the foster care system, and/or identify as 2S/LGBTQ+. The organizations selected to receive grants for the project were chosen in part based on their experience working with the campaign’s primary audience, helping to ensure media and programming efforts are culturally appropriate and youth-led.

The campaign, known as “Never a Bother,” seeks to prevent suicide among youth and young adults up to age 25 in California. This campaign tells youth experiencing thoughts of suicide that they are never a bother when reaching out to friends, trusted adults, and other types of support (such as the 988 suicide hotline). At the same time, it asks peer and adult allies to make sure young people in their lives know they are there for them and can reach out for help anytime. The Never a Bother concept was co-created with and selected by youth, based on its welcoming feel, visual appeal, and messaging that authentically validates youth-at-risks’ experiences and state of mind with clear encouragement to reach out for support before, during, and after a crisis.

The Youth Suicide Reporting and Crisis Response Pilot Program: established through one-time funding in the Governor’s 2022–2023 Budget, develops and tests models for making youth suicide and attempted suicide reportable events. The pilot also supports models for rapidly and comprehensively responding to these events by providing crisis services and follow-up support in school and community settings. This program involves developing and testing approaches to report youth suicide and attempted suicide so that rapid and comprehensive crisis services and follow-up support can be offered where the deaths or attempts occurred. Ten counties were selected to participate in the program based on youth suicide rates, counts, rate increases over time, and racial/ethnic diversity. Counties with small, medium, and large populations, as well as a mix of counties that are urban, suburban, or rural were selected.

Striving for Zero: in 2019, pursuant to AB 114 (Committee on Budget, Chapter 38, Statutes of 2017) the Mental Health Services Oversight and Accountability Commission (now the BHSOAC) adopted “Striving for Zero: California’s Strategic Plan for Suicide Prevention, 2020-2025 (the Plan).” The 2020-21 Budget Act authorized the BHSOAC to allocate $2 million to support suicide prevention efforts consistent with the plan. As noted in the Plan, effective prevention efforts must recognize that risk factors can be dynamic, changing over a person’s lifetime. Researchers are exploring the variability in risk and protective factors among vulnerable groups, and much remains unknown. Deficiencies in data collection also limit understanding of the full extent of suicidal behavior. For example, determining suicidal intent after a drug overdose can be difficult, resulting in underreporting and limited information to support prevention efforts. The Plan also notes suicide prevention requires engagement of private and public partners across multidisciplinary fields, which requires a commitment to wide-scale collaborations that integrate planning and coordinate actions. Efforts are further complicated by inconsistent definitions of suicidal behavior, which affect data monitoring. Lastly, assessing for risk is not a uniform practice in California. This leads to inconsistency in suicide risk detection, which also is constrained by significant ethical, training, and legal considerations.

1. Bridge suicide deterrent systems. According to the Golden Gate Bridge (GGB) Highway and Transportation District (District), there were 14 confirmed suicides from people jumping off the bridge in 2023 when the GGB suicide deterrent net began construction. Two decades prior, the average number of GGB suicides per year was 30. As of January 1, 2024, the GGB now has a continuous physical suicide barrier installed the full length of the 1.7-mile span, contributing to lowering suicides at the GGB to eight—a reduction to the annual number of suicides by 73%. The suicide deterrent system, also known as “the net,” has been installed on the east and west sides to reduce the number of deaths associated with individuals jumping. The net is a proven design that deters people from jumping, serves as a symbol of care and hope to despondent individuals, and, if necessary, offers people a second chance. The net drew inspiration from similar barriers erected to deter suicides on tall buildings and bridges around the world. Attempts have also declined since the net was completed. In a typical year before the net, the District’s staff would successfully intervene with up to 200 individuals at the GGB. In 2024, our staff performed only 132 successful interventions.

Caltrans is currently working on a suicide deterrent system for the San Diego-Coronado Bay Bridge (SDCBB). Although official figures have not been maintained since its opening in 1969, it is widely believed that approximately 400 deaths by suicide have occurred from the SDCBB. Per the San Diego County Medical Examiner’s website, 18 fatalities occurred in 2017, 17 fatalities in 2018, and 15 fatalities in 2019. After the GGB, the SDCBB is recognized as the second most frequently used bridge for suicide in the state. It does not have a permanent physical suicide deterrent system. The current Caltrans standard operating procedure for suicide attempts is closing the bridge, which causes disruption for many hours. Non-physical suicide deterrence measures have been implemented on the bridge, along with the addition of 4-inch spikes installed on top of the bridge rail in early 2019 as an interim measure, yet multiple suicides and suicide attempts have still occurred. Since fatalities caused by suicide do not qualify under the current federal Highway Safety Improvement Program (HSIP) criteria, suicide deterrent projects are not eligible for HSIP funding.

1. Related legislation. SB 800 (Reyes) requires Caltrans to establish and administer a pilot program to install suicide deterrents on 10 freeway overpasses in the County of San Bernardino, including such things as suicide prevention signage and a physical barrier designed to prevent a person from falling or intentionally jumping from the overpass. SB 800 is set for hearing on July 14, 2025, in the Assembly Transportation Committee.
2. Prior legislation. SB 326 (Eggman, Chapter 790, Statutes of 2023), among other things, requires OSP to consult with the BHSOAC to implement suicide prevention efforts consistent with the BHSOAC’s “Striving for Zero” suicide prevention report.

AB 2112 (Ramos, Chapter 142, Statutes of 2020) authorized CDPH to establish OSP to, among other functions, provide information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs.

SB 656 (Hueso, Chapter 651, Statutes of 2019) requires the Caltrans director to select members for an advisory committee to provide input into the selection of a physical suicide deterrent system for the SDCBB.

AB 114 (Committee on Budget, Chapter 38, Statutes of 2017) appropriated $100,000 from the Mental Health Services Fund for the BHSOAC to develop a statewide suicide prevention plan.

1. Support. Didi Hirsch Mental Health Services, as the sponsor, and other supporters cite that Caltrans does not have a statewide suicide prevention policy in place for their bridges and roadways, and strongly believe that the state should not have to wait for a tragedy to strike to begin the process of developing safety measures in areas that possess a clear and present danger to any at-risk individual that may be considering taking their own life. Supporters further state that this bill would require OSP to identify areas that are considered “hot spot” areas with a history of suicide-related deaths, as well as provide recommendations to Caltrans on potential solutions that would reduce the risk of future incidents. This legislation aims to protect at-risk individuals and help provide families with some relief knowing their state is being proactive about their loved one’s safety.

SUPPORT AND OPPOSITION:

Support: Didi Hirsch Mental Health Services (sponsor)

Bridge Rail Foundation

California Alliance of Child and Family Services

California Association of Social Rehabilitation Agencies

California Hospital Association

California Indian Nations College

California Police Chiefs Association

California State Association of Psychiatrists

Children Now

County Behavioral Health Directors Association

County of San Bernardino

Helpline Youth Counseling, Inc.
Hillsides Pasadena

National Alliance on Mental Illness – California

Sycamores

Wayfinder Family Services

Oppose: None received

-- END --

SENATE COMMITTEE ON HEALTH

Senator Caroline Menjivar, Chair

BILL NO: AB 440

SUBJECT: Suicide prevention

SUMMARY:

Requires the Office of Suicide Prevention (OSP) to work in consultation with the Department of Transportation to reduce suicides and suicide attempts on the state’s bridges and roadways. Requires OSP to prepare a report on these strategies and submit, on or before December 31, 2027, to the Legislature, the Assembly Committee on Health, the Assembly Committee on Transportation, the Senate Committee on Health, and the Senate Transportation Committee. Repeals these requirements on January 1, 2029.

Existing law:

1. Establishes the California Department of Public Health (CDPH) to be vested with all the duties, powers, purposes, functions, responsibilities, and jurisdiction as they relate to public health, as specified. [HSC §131050]
2. Authorizes CDPH to establish the Office of Suicide Prevention (OSP) with responsibilities that include:
   1. Providing information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs;
   2. Conducting state-level assessments of regional and statewide suicide prevention policies and practices, as specified;
   3. Monitoring and disseminating data to inform prevention efforts at the state and local levels;
   4. Convening experts and stakeholders, as specified, to encourage collaboration and coordination of resources for suicide prevention; and,
   5. Reporting on progress to reduce suicide rates. [HSC §131300]
3. Requires OSP to consult with the Behavioral Health Services Oversight and Accountability Commission (BHSOAC) to implement suicide prevention efforts. Specifies that OSP is not authorized to perform specified duties required by the BHSOAC. [HSC §131315]
4. Requires each county, pursuant to the Behavioral Health Services Act, to establish and administer an early intervention program that is designed to prevent mental illnesses and substance use disorders from becoming severe and disabling; to reduce disparities in behavioral health; and, to emphasize the reduction of the likelihood of:
5. Suicide and self-harm;
6. Incarcerations;
7. School, including early childhood 0 to 5 years of age, inclusive, TK-12, and higher education, suspension, expulsion, referral to an alternative or community school, or failure to complete;
8. Unemployment;
9. Prolonged suffering;
10. Homelessness;
11. Removal of children from their homes;
12. Overdose; and,
13. Mental illness in children and youth from social, emotional, developmental, and behavioral needs in early childhood. [WIC §5840(a) and (d)]
14. Establishes the California Suicide Prevention Act of 2000 and permits DHCS, contingent upon appropriation in the annual Budget Act, to establish and implement a suicide prevention, education, and gatekeeper-training program to reduce the severity, duration, and incidence of suicidal behavior. [WIC §4098.2]

This bill:

1. Requires OSP to work in consultation with the California Department of Transportation (CalTrans) to:
2. Identify cost-effective strategies to reduce suicides and suicide attempts on the state’s bridges and roadways, including, but not limited to, infrastructure and other prevention strategies; and,
3. Prepare a report on the strategies it identifies, and submit it, on or before December 31, 2027, to the Legislature, the Assembly Committee on Health, the Assembly Committee on Transportation, the Senate Committee on Health, and the Senate Transportation Committee.
4. Repeals these requirements on January 1, 2029.

FISCAL EFFECT:

According to the Assembly Appropriations Committee, CDPH estimates General Fund (GF) costs of $380,000 per year in (FY) 2026-27 and 2027-28 for two full-time staff to identify and develop cost-effective strategies, culminating in the preparation of a detailed report for the Legislature. GF costs to CalTrans of an unknown, but likely absorbable amount, to work with CDPH OSP on the study.

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, this bill continues California’s commitment to achieving zero suicides by proactively addressing parts of our state's infrastructure—such as bridges and overpasses—which have historically been used by individuals in crisis to take their own lives. This bill directs the OPS and CalTrans to develop solutions that safeguard those at risk. The hope is that this bill will prevent future tragedies in our communities and offer protection and support to those in crisis.
2. Suicide in general. According to the Behavioral Health Services Oversight & Accountability Committee (BHSOAC) website, suicide is a complex public health challenge involving many biological, psychological, social, and cultural determinants. The major risk factors for suicide are a prior suicide attempt; substance use disorder; mood disorders, such as depression; medical illness; and access to the methods to attempt suicide. The common factors that reduce risk for suicide are access to effective medical and mental health care; connectedness to others; problem-solving skills; and caring contacts, such as postcards or letters from service providers and caregivers. Prevention efforts are challenged by misconceptions about suicidal behavior, despite advancements in the study of suicide and its prevention. BHSOAC further states these pervasive myths may prevent people at risk from seeking help and discourage people from asking loved ones about thoughts of suicide. The internal suffering that accompanies the desire to die may remain hidden unless a person is directly asked about their thoughts and needs. Risk factors may be missed in the absence of uniform suicide screening and assessment by mental health and substance use disorder providers, who often are delivering services in separate and uncoordinated systems. Interventions, such as physical barriers on bridges, locking doors on railways, and locking windows at lethal heights prevent accidental and intentional falling. Likewise, safely storing guns in the home prevents accidental and intentional injury and death among children and adults.
3. Suicide among California youth. According to CDPH’s website, suicide is a public health crisis with multiple, complex, contributing factors. Rates among youth have risen over the past decades, and both national and statewide data show suicide to be the third-leading cause of death among young people aged 15 to 24. CDPH further states suicide is preventable, and addressing the problem requires comprehensive, cross-sector commitments focused on both risk and protective factors at the individual, family, community, and systems levels. From the youth suicide deaths dashboard, based on state-level data for 2010 through 2023, the California rate of youth suicide in 2023 was 8.9 per 100,000 for those aged 15 to 24. In comparison, the national rate for the same population was 13.5 per 100,000 in 2023. California has maintained its rate below the national level consistently throughout the data time period.
4. California’s recent efforts. OSP is toward the end of administering two youth suicide prevention projects (they end around the Summer of 2025) as part of the California Health and Human Services Agency-sponsored Children and Youth Behavioral Health Initiative:

The Youth Suicide Prevention Media and Outreach Campaign: established through one-time funding in the Governor’s 2022–2023 Budget to develop and implement a data-driven, targeted, community-based, youth suicide prevention media and outreach campaign for youth at increased risk of suicide. The goal of the campaign is to reduce suicide, suicide attempts, and rates of self-harm among three disproportionately impacted populations:

1. American Indian/Alaska Native youth, who experienced the highest suicide rate from

2016-2021 (16.4 per 100,000 individuals);

1. Black/African-American youth, who experienced the greatest increase in rate from 2016-2021 (33% increase); and,
2. Hispanic/Latinx youth, who experienced the highest number of suicides from 2016-2021 (1,435 suicide deaths).

As part of an intersectional approach to health equity, the campaign is also inclusive of youth from the populations listed above who identify as having mental health and/or substance use disorder challenges, having been impacted by the foster care system, and/or identify as 2S/LGBTQ+. The organizations selected to receive grants for the project were chosen in part based on their experience working with the campaign’s primary audience, helping to ensure media and programming efforts are culturally appropriate and youth-led.

The campaign, known as “Never a Bother,” seeks to prevent suicide among youth and young adults up to age 25 in California. This campaign tells youth experiencing thoughts of suicide that they are never a bother when reaching out to friends, trusted adults, and other types of support (such as the 988 suicide hotline). At the same time, it asks peer and adult allies to make sure young people in their lives know they are there for them and can reach out for help anytime. The Never a Bother concept was co-created with and selected by youth, based on its welcoming feel, visual appeal, and messaging that authentically validates youth-at-risks’ experiences and state of mind with clear encouragement to reach out for support before, during, and after a crisis.

The Youth Suicide Reporting and Crisis Response Pilot Program: established through one-time funding in the Governor’s 2022–2023 Budget, develops and tests models for making youth suicide and attempted suicide reportable events. The pilot also supports models for rapidly and comprehensively responding to these events by providing crisis services and follow-up support in school and community settings. This program involves developing and testing approaches to report youth suicide and attempted suicide so that rapid and comprehensive crisis services and follow-up support can be offered where the deaths or attempts occurred. Ten counties were selected to participate in the program based on youth suicide rates, counts, rate increases over time, and racial/ethnic diversity. Counties with small, medium, and large populations, as well as a mix of counties that are urban, suburban, or rural were selected.

Striving for Zero: in 2019, pursuant to AB 114 (Committee on Budget, Chapter 38, Statutes of 2017) the Mental Health Services Oversight and Accountability Commission (now the BHSOAC) adopted “Striving for Zero: California’s Strategic Plan for Suicide Prevention, 2020-2025 (the Plan).” The 2020-21 Budget Act authorized the BHSOAC to allocate $2 million to support suicide prevention efforts consistent with the plan. As noted in the Plan, effective prevention efforts must recognize that risk factors can be dynamic, changing over a person’s lifetime. Researchers are exploring the variability in risk and protective factors among vulnerable groups, and much remains unknown. Deficiencies in data collection also limit understanding of the full extent of suicidal behavior. For example, determining suicidal intent after a drug overdose can be difficult, resulting in underreporting and limited information to support prevention efforts. The Plan also notes suicide prevention requires engagement of private and public partners across multidisciplinary fields, which requires a commitment to wide-scale collaborations that integrate planning and coordinate actions. Efforts are further complicated by inconsistent definitions of suicidal behavior, which affect data monitoring. Lastly, assessing for risk is not a uniform practice in California. This leads to inconsistency in suicide risk detection, which also is constrained by significant ethical, training, and legal considerations.

1. Bridge suicide deterrent systems. According to the Golden Gate Bridge (GGB) Highway and Transportation District (District), there were 14 confirmed suicides from people jumping off the bridge in 2023 when the GGB suicide deterrent net began construction. Two decades prior, the average number of GGB suicides per year was 30. As of January 1, 2024, the GGB now has a continuous physical suicide barrier installed the full length of the 1.7-mile span, contributing to lowering suicides at the GGB to eight—a reduction to the annual number of suicides by 73%. The suicide deterrent system, also known as “the net,” has been installed on the east and west sides to reduce the number of deaths associated with individuals jumping. The net is a proven design that deters people from jumping, serves as a symbol of care and hope to despondent individuals, and, if necessary, offers people a second chance. The net drew inspiration from similar barriers erected to deter suicides on tall buildings and bridges around the world. Attempts have also declined since the net was completed. In a typical year before the net, the District’s staff would successfully intervene with up to 200 individuals at the GGB. In 2024, our staff performed only 132 successful interventions.

CalTrans is currently working on a suicide deterrent system for the San Diego-Coronado Bay Bridge (SDCBB). Although official figures have not been maintained since its opening in 1969, it is widely believed that approximately 400 deaths by suicide have occurred from the SDCBB. Per the San Diego County Medical Examiner’s website, 18 fatalities occurred in 2017, 17 fatalities in 2018, and 15 fatalities in 2019. After the GGB, the SDCBB is recognized as the second most frequently used bridge for suicide in the state. It does not have a permanent physical suicide deterrent system. The current CalTrans standard operating procedure for suicide attempts is closing the bridge, which causes disruption for many hours. Non-physical suicide deterrence measures have been implemented on the bridge, along with the addition of 4-inch spikes installed on top of the bridge rail in early 2019 as an interim measure, yet multiple suicides and suicide attempts have still occurred. Since fatalities caused by suicide do not qualify under the current federal Highway Safety Improvement Program (HSIP) criteria, suicide deterrent projects are not eligible for HSIP funding.

1. Related legislation. SB 800 (Reyes) requires CalTrans to establish and administer a pilot program to install suicide deterrents on 10 freeway overpasses in the County of San Bernardino, including such things as suicide prevention signage and a physical barrier designed to prevent a person from falling or intentionally jumping from the overpass. SB 800 is set for hearing on July 14, 2025, in the Assembly Transportation Committee.
2. Prior legislation. SB 326 (Eggman, Chapter 790, Statutes of 2023), among other things, requires OSP to consult with the BHSOAC to implement suicide prevention efforts consistent with the BHSOAC’s “Striving for Zero” suicide prevention report.

AB 2112 (Ramos, Chapter 142, Statutes of 2020) authorized CDPH to establish OSP to, among other functions, provide information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs.

SB 656 (Hueso, Chapter 651, Statutes of 2019) requires the Caltrans director to select members for an advisory committee to provide input into the selection of a physical suicide deterrent system for the SDCBB.

AB 114 (Committee on Budget, Chapter 38, Statutes of 2017) appropriated $100,000 from the Mental Health Services Fund for the BHSOAC to develop a statewide suicide prevention plan.

1. Support. Didi Hirsch Mental Health Services, as the sponsor, and other supporters cite that CalTrans does not have a statewide suicide prevention policy in place for their bridges and roadways, and strongly believe that the state should not have to wait for a tragedy to strike to begin the process of developing safety measures in areas that possess a clear and present danger to any at-risk individual that may be considering taking their own life. Supporters further state that this bill would require OSP to identify areas that are considered “hot spot” areas with a history of suicide-related deaths, as well as provide recommendations to CalTrans on potential solutions that would reduce the risk of future incidents. This legislation aims to protect at-risk individuals and help provide families with some relief knowing their state is being proactive about their loved one’s safety.

SUPPORT AND OPPOSITION:

Support: Didi Hirsch Mental Health Services (sponsor)

Bridge Rail Foundation

California Alliance of Child and Family Services

California Association of Social Rehabilitation Agencies

California Hospital Association

California Indian Nations College

California Police Chiefs Association

California State Association of Psychiatrists

Children Now

County Behavioral Health Directors Association

County of San Bernardino

Helpline Youth Counseling, Inc.
Hillsides Pasadena

National Alliance on Mental Illness – California

Sycamores

Wayfinder Family Services

Oppose: None received

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 440

Author:(Ramos)

As Amended Ver:April 10, 2025

Majority vote

SUMMARY

Requires the Office of Suicide Prevention (OSP) within the Department of Public Health (DPH) to work with the Department of Transportation (CalTrans) to identify cost-effective strategies to reduce suicides and suicide attempts on the state's bridges and roadways. Requires OSP to prepare and submit a report to the Senate and Assembly Health and Transportation policy committees on the strategies that it identifies on or before December 31, 2027, and repeals these provisions January 1, 2029.

Major Provisions

COMMENTS

Suicide and Self-Harm in California. According to a January 2025 data brief from DPH, suicide is the leading cause of violent death, and self-harm is the third leading cause of injury-related emergency department (ED) visits. Men consistently have higher rates of suicide than women, and in 2022 men account for more than three-fourths of suicides. Use of firearms was the most common mechanism for suicide in 2021 and 2022. Youth under the age of 10 had a statistically significant increase in self-harm ED visit rates from 1.9 per 100,000 Californians in this age group in 2021 to 2.7 in 2022. Although there was a small number of black people who visited the ED for self-harm injury, this group is at elevated risk for self-harm. Self-harm by poisoning was the most common mechanism of self-harm injury leading to ED visits, followed by cutting/piercing and, when combined, both accounted for approximately 85% of self-harm ED visits. Other mechanisms of self-harm combined, including fall, firearm, and hanging/suffocation, made up 2% of self-harm ED visits.

The brief also highlights opportunities for prevention, such as advancing protective factors as a part of prevention programming to build resilience and foster support at the individual, relationship, and community level to help decrease suicide risk. While the brief notes that prevention efforts should focus on the most common and lethal means of suicide (firearms and intentional drug overdoses), it also highlights the 2024 National Strategy for Suicide Prevention, which contains several goals, such as integrating suicide prevention into the culture of the workplace and into other community settings, and implementing research-informed suicide prevention communication activities in diverse populations, using best practices from communication science.

988. As of July 16, 2022, the National Suicide Prevention Lifeline number transitioned to 988, providing an easy to remember number that anyone can call, text, or chat to receive support when experiencing a suicidal, mental health and/or substance use related crisis. When Californians dial 988, they are directed to one of 12 Lifeline crisis call centers. California's call centers are part of the broader 988 Lifeline crisis center network. If a local crisis center is unable to take the call, the caller is automatically routed to a national backup crisis center. According to the 988 California Crisis Center Consortium, 988 routed 342,394 calls with an average answer speed of 34 seconds, answer rate of 85%, and call length of 12 minutes in 2023.

Children and Youth Behavioral Health Initiative (CYBHI). As part of CYBHI, Department of Health Care Services (DHCS) launched two mobile applications to support youth. BrightLife Kids is designed for parents or caregivers and kids 0-12 years old. It provides free, expert coaching for sleep issues, worry, social skills, and more, as well as live, 1:1 video sessions, secure chat, and on-demand content. Soluna provides confidential support for 13-to 25-year-olds via 1:1 chat with a professional coach, interactive tools to destress, quizzes, videos, forums, and more. Both resources are available regardless of insurance coverage or immigration status.

The Youth Suicide Reporting and Crisis Response Pilot Program is developing and testing models for rapidly reporting and comprehensively responding to youth suicides and suicide attempts at the county level by providing crisis services and follow-up supports within school and community settings. The ten counties selected to participate are: Alameda, El Dorado, Humboldt, Kern, Los Angeles, Riverside, Sacramento, San Diego, San Joaquin, and Solano. The program strives to provide equitable, timely, and culturally responsive services for youth, bolstering local suicide prevention and postvention strategies. The University of California, Los Angeles was selected as the independent evaluator of the pilot and is expected to release a final report in June 2025.

Striving for Zero. In 2019, pursuant to AB 114, Chapter 38, Statutes of 2017, the Mental Health Services Oversight and Accountability Commission (now the Behavioral Health Services Oversight and Accountability Commission, or BHSOAC) adopted Striving for Zero, California's Strategic Plan for Suicide Prevention, 2020-2025. The 2020-21 Budget Act authorized the Behavioral Health Services Oversight and Accountability Commission (BHSOAC) to allocate $2 million support suicide prevention efforts consistent with the plan. The Behavioral Health Services Act (SB 326 (Eggman), Chapter 790, Statutes of 2023), requires OSP, if established, to consult with the BHSOAC to implement suicide prevention efforts consistent with the strategic plan.

According to the Author

This bill aims to continue California's goal of working towards achieving zero suicides. The author says that, in order to do so, we must begin identifying areas of potential harm for at-risk individuals. Specifically, such harms are on our state's bridges and overpasses. It is the hope of the author that that this bill will help prevent a future tragedy from striking communities and to protect those in need.

Arguments in Support

Didi Hirsch Mental Health Services is sponsoring this bill and states in support that Caltrans does not have a statewide suicide prevention policy in place for their bridges and roadways and that the state should not have to wait for a tragedy to strike to begin the process of developing safety measures in areas that possess a clear and present danger to any at-risk individual that may be considering taking their own life. Didi Hirsch says this legislation aims to protect at-risk individuals and help provide families with some relief knowing their state is being proactive about their loved one's safety.

The California State Association of Psychiatrists (CSAP) supports this bill and says that the approach in this bill not only prioritizes the safety and well-being of Californians but also reinforces a broader public health strategy to save lives. CSAP continues that this bill's requirement to submit a report to the Legislature by December 31, 2026, ensures accountability and provides an opportunity to evaluate the effectiveness of the identified strategies.

NAMI California states in support of this bill that the United States is facing a mental health crisis—especially among young people—with alarming rates of suicidal ideation, hopelessness, and depression. NAMI notes that in 2023 more than one in five high school students seriously considered attempting suicide and one in 10 attempted suicide – rates that are even higher for at risk communities, like LGBTQ+ youth. NAMI concludes that this bill aims to protect at-risk individuals considering taking their own life and help provide families with some relief knowing their state is being proactive about their loved one's safety.

Arguments in Opposition

None.

FISCAL COMMENTS

According to the Assembly Appropriations Committee, DPH estimates General Fund costs of $380,000 per year in 2026-27 and 2027-28 for two full-time staff to identify and develop cost-effective strategies, culminating in the preparation of a detailed report for the Legislature.

General Fund costs to CalTrans of an unknown, but likely absorbable amount, to work with DPH OSP on the study.

VOTES

ASM HEALTH: 15-0-0

YES: Bonta, Chen, Addis, Aguiar-Curry, Arambula, Carrillo, Flora, Mark González, Krell, Patel, Celeste Rodriguez, Sanchez, Schiavo, Sharp-Collins, Stefani

ASM APPROPRIATIONS: 14-0-1

YES: Wicks, Arambula, Calderon, Caloza, Dixon, Elhawary, Fong, Mark González, Hart, Pacheco, Pellerin, Solache, Ta, Tangipa

ABS, ABST OR NV: Sanchez

UPDATED

VERSION: April 10, 2025

CONSULTANT: Logan Hess / HEALTH / (916) 319-2097 FN: 0000725

Date of Hearing: April 23, 2025

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Buffy Wicks, Chair

ABPCA Bill Id:AB 440

Author:(Ramos) – As Amended Ver:April 10, 2025

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill requires the Office of Suicide Prevention (OSP) to work with the Department of Transportation (CalTrans) to identify cost-effective strategies to reduce suicides and suicide attempts on the state’s bridges and roadways, and to report its findings to the Legislature on or before December 31, 2027.

FISCAL EFFECT:

The California Department of Public Health (CDPH) estimates General Fund costs of $380,000 per year in 2026-27 and 2027-28 for two full-time staff to identify and develop cost-effective strategies, culminating in the preparation of a detailed report for the Legislature.

General Fund costs to CalTrans of an unknown, but likely absorbable amount, to work with CDPH OSP on the study.

COMMENTS:

1. Purpose. This bill is sponsored by Didi Hirsch Mental Health Services. According to the author:

AB 440 aims to continue California’s goal of working towards achieving zero suicides. In order to do so, we must begin identifying areas of potential harm for at-risk individuals. Specifically, such harms are on our state’s bridges and overpasses. The bill would call on the Office of Suicide Prevention and Caltrans, to begin the work of finding solutions to protect individuals in crisis from using our state’s bridges to take their own life. It is my hope that this bill will help prevent a future tragedy from striking our communities and to protect those in need.

1. Background.

Suicide and Self-Harm in California. According to a January 2025 data brief from CDPH, suicide is the leading cause of violent death, and self-harm is the third leading cause of injury-related emergency department (ED) visits. In 2022, among suicides, falls were the fourth leading mechanism of suicide (5%), after firearms (39%), hanging or suffocation (33%), and poisoning or drug overdose (14%).

The brief also highlights opportunities for prevention, such as advancing protective factors as a part of prevention programming to build resilience and foster support at the individual, relationship, and community level to help decrease suicide risk. The brief suggests prevention efforts should focus on the most common and lethal means of suicide, which are firearms and intentional drug overdoses.

State Efforts to Reduce Suicide. The state has implemented numerous efforts and programs to address mental health and suicide, including:

• 988, the Suicide Prevention Lifeline number.
• As part of the Children and Youth Behavioral Health Initiative (CYBHI), the state launched two mobile applications that feature one-on-one chat with a coach--one to support youth through 12 years and their caregivers, and another for 13- to 25-year-olds.
• The Youth Suicide Reporting and Crisis Response Pilot Program is developing and testing models for rapidly reporting and comprehensively responding to youth suicides and suicide attempts at the county level by providing crisis services and follow-up supports within school and community settings in ten counties.
• The Mental Health Services Oversight and Accountability Commission (now the Behavioral Health Services Oversight and Accountability Commission, BHSOAC) also adopted “Striving for Zero, California’s Strategic Plan for Suicide Prevention, 2020-2025,” pursuant to AB 114, Chapter 38, Statutes of 2017. The Budget Act of 2021 authorized the BHSOAC to allocate $2 million to support suicide prevention efforts consistent with the strategic plan. The Behavioral Health Services Act (SB 326 (Eggman), Chapter 790, Statutes of 2023), requires OSP, if established, to consult with the BHSOAC to implement suicide prevention efforts consistent with the strategic plan.

1. Related Legislation. SB 800 (Reyes) requires CalTrans to establish and administer a pilot program to install suicide deterrents on 10 freeway overpasses in the County of San Bernardino and to prioritize the placement of suicide deterrents on freeway overpasses with the highest rates of documented suicides over the last 20 years. The bill requires the suicide deterrents to include suicide prevention signage and a physical barrier designed to prevent a person from falling or intentionally jumping from the overpass in manner likely to cause death. SB 800 is pending in the Senate Transportation Committee.

Analysis Prepared by: Allegra Kim / APPR. / (916) 319-2081

Date of Hearing: April 8, 2025

ASSEMBLY COMMITTEE ON HEALTH

Mia Bonta, Chair

ABPCA Bill Id:AB 440

Author:(Ramos) – As Amended Ver:March 5, 2025

SUBJECT: Suicide prevention.

SUMMARY: Requires the Office of Suicide Prevention (OSP) to identify state bridges and roadways with a history of a relatively high number of suicide-related deaths and to work with the Department of Transportation (CalTrans) to identify cost-effective strategies to reduce these suicides. Requires OSP to prepare and submit a report to the Legislature and the relevant policy committees on the strategies that it identifies on or before December 31, 2026, and repeals these provisions January 1, 2028.

EXISTING LAW:

1. Authorizes the State Department of Public Health (DPH) to establish OSP and, if established, authorizes the office to perform certain functions including the following:
   1. Providing information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs;
   2. Conducting state-level assessment regional and statewide suicide prevention policies and practices;
   3. Monitoring and disseminating data to inform prevention efforts at the state and local levels;
   4. Convening experts and stakeholders, including, but not limited to, stakeholders representing populations with high rates of suicide, to encourage collaboration and coordination of resources for suicide prevention;
   5. Reporting on progress to reduce rates of suicide. [Health and Safety Code (HSC) § 131300]
2. Authorizes OSP to focus activities on groups with the highest risk, including youth, Native American youth, older adults, veterans, and LGBTQ people; to share and receive data from all entities with data relevant to the responsibilities and objectives of the office, including, but not limited to, state, federal, local, and private and nongovernmental agencies or organizations; and to apply for and utilize federal, state, and foundation grants. [HSC § 131000 et seq.]
3. Requires OSP, if established, to consult with the Behavioral Health Services Oversight and Accountability Commission (BHSOAC) to implement suicide prevention efforts consistent with the Suicide Prevention Report “Striving for Zero.” [HSC § 131315]
4. Establishes the California Suicide Prevention Act of 2000 and permits the Department of Health Care Services (DHCS), contingent upon appropriation in the annual Budget Act, to establish and implement a suicide prevention, education, and gatekeeper training program to reduce the severity, duration, and incidence of suicidal behavior, as specified. [Welfare and Institutions Code (WIC) § 4098.2]
5. Establishes the Children and Youth Behavioral Health Initiative (CYBHI) to be administered by the California Health and Human Services Agency (CalHHS) and its departments. Subject to appropriation by the legislature, authorizes the initiative to include, at a minimum, the following: a behavioral health services and supports virtual platform; school-linked partnership, capacity, and infrastructure grants; incentive payments to qualifying Medi-Cal managed care plans; development and maintenance of a statewide fee schedule for school-linked outpatient mental health and substance use disorder treatment; and investments for behavioral health workforce, education, and training. [WIC § 5961 et seq.]
6. Establishes the Miles Hall Lifeline and Suicide Prevention Act in the state for the purpose of implementing the 988 Suicide and Crisis Line. Requires the Office of Emergency Services to establish a technical advisory board to establish operational standards for 988 and interoperability with 911. Requires CalHHS to develop a five year implementation plan for 988 and coordinate with several other state entities for the operation of 988. Establishes the 988 State Suicide and Behavioral Health Crisis Services Fund for the operation of 988 with funds generated by the 988 surcharge. [Government Code § 53123.1 et seq.]

FISCAL EFFECT: Unknown. This bill has not yet been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, this bill aims to continue California’s goal of working towards achieving zero suicides. The author says that, in order to do so, we must begin identifying areas of potential harm for at-risk individuals. Specifically, such harms are on our state’s bridges and overpasses. It is the hope of the author that that this bill will help prevent a future tragedy from striking communities and to protect those in need.
2. BACKGROUND.
   1. Suicide and Self-Harm in California. According to a January 2025 data brief from DPH, suicide is the leading cause of violent death, and self-harm is the third leading cause of injury-related emergency department (ED) visits. Men consistently have higher rates of suicide than women, and in 2022 men account for more than three-fourths of suicides. Use of firearms was the most common mechanism for suicide in 2021 and 2022. Youth under the age of 10 had a statistically significant increase in self-harm ED visit rates from 1.9 per 100,000 Californians in this age group in 2021 to 2.7 in 2022. Although there was a small number of black people who visited the ED for self-harm injury, this group is at elevated risk for self-harm. Self-harm by poisoning was the most common mechanism of self-harm injury leading to ED visits, followed by cutting/piercing and, when combined, both accounted for approximately 85% of self-harm ED visits. Other mechanisms of self-harm combined, including fall, firearm, and hanging/suffocation, made up 2% of self-harm ED visits.

The brief also highlights opportunities for prevention, such as advancing protective factors as a part of prevention programming to build resilience and foster support at the individual, relationship, and community level to help decrease suicide risk. While the brief notes that prevention efforts should focus on the most common and lethal means of suicide (firearms and intentional drug overdoses), it also highlights the 2024 National Strategy for Suicide Prevention, which contains several goals, such as integrating suicide prevention into the culture of the workplace and into other community settings, and implementing research-informed suicide prevention communication activities in diverse populations, using best practices from communication science.

• 1. 988. As of July 16, 2022, the National Suicide Prevention Lifeline number transitioned to 988, providing an easy to remember number that anyone can call, text, or chat to receive support when experiencing a suicidal, mental health and/or substance use related crisis. When Californians dial 988, they are directed to one of twelve Lifeline crisis call centers. California’s call centers are part of the broader 988 Lifeline crisis center network. If a local crisis center is unable to take the call, the caller is automatically routed to a national backup crisis center. According to the 988 California Crisis Center Consortium, 988 routed 342,394 calls with an average answer speed of 34 seconds, answer rate of 85%, and call length of 12 minutes in 2023.
  2. CYBHI. As part of CYBHI, DHCS launched two mobile applications to support youth. BrightLife Kids is designed for parents or caregivers and kids 0-12 years old. It provides free, expert coaching for sleep issues, worry, social skills, and more, as well as live, 1:1 video sessions, secure chat, and on-demand content. Soluna provides confidential support for 13-to 25-year-olds via 1:1 chat with a professional coach, interactive tools to destress, quizzes, videos, forums, and more. Both resources are available regardless of insurance coverage or immigration status.

The Youth Suicide Reporting and Crisis Response Pilot Program is developing and testing models for rapidly reporting and comprehensively responding to youth suicides and suicide attempts at the county level by providing crisis services and follow-up supports within school and community settings. The ten counties selected to participate are: Alameda, El Dorado, Humboldt, Kern, Los Angeles, Riverside, Sacramento, San Diego, San Joaquin, and Solano. The program strives to provide equitable, timely, and culturally responsive services for youth, bolstering local suicide prevention and postvention strategies. The University of California, Los Angeles was selected as the independent evaluator of the pilot and is expected to release a final report in June 2025.

• 1. Striving for Zero. In 2019, pursuant to AB 114, Chapter 38, Statutes of 2017, the Mental Health Services Oversight and Accountability Commission (now the BHSOAC) adopted Striving for Zero, California’s Strategic Plan for Suicide Prevention, 2020-2025. The 2020-21 Budget Act authorized the BHSOAC to allocate $2 million support suicide prevention efforts consistent with the plan. The Behavioral Health Services Act (SB 326 (Eggman), Chapter 790, Statutes of 2023), requires OSP, if established, to consult with the BHSOAC to implement suicide prevention efforts consistent with the strategic plan.

1. SUPPORT. Didi Hirsch Mental Health Services is sponsoring this bill and states in support that Caltrans does not have a statewide suicide prevention policy in place for their bridges and roadways and that the state should not have to wait for a tragedy to strike to begin the process of developing safety measures in areas that possess a clear and present danger to any at-risk individual that may be considering taking their own life. Didi Hirsch says this legislation aims to protect at-risk individuals and help provide families with some relief knowing their state is being proactive about their loved one’s safety.

The California State Association of Psychiatrists (CSAP) supports this bill and says that the approach in this bill not only prioritizes the safety and well-being of Californians but also reinforces a broader public health strategy to save lives. CSAP continues that this bill’s requirement to submit a report to the Legislature by December 31, 2026, ensures accountability and provides an opportunity to evaluate the effectiveness of the identified strategies.

NAMI California states in support of this bill that the United States is facing a mental health crisis—especially among young people—with alarming rates of suicidal ideation, hopelessness, and depression. NAMI notes that in 2023 more than one in five high school students seriously considered attempting suicide and 1 in 10 attempted suicide – rates that are even higher for at risk communities, like LGBTQ+ youth. NAMI concludes that this bill aims to protect at-risk individuals considering taking their own life and help provide families with some relief knowing their state is being proactive about their loved one’s safety.

1. RELATED LEGISLATION. SB 800 (Reyes) would require CalTrans to establish and administer a pilot program to install suicide deterrents on 10 freeway overpasses in the County of San Bernardino. The bill would also require the suicide deterrents installed under the pilot program to include, but not be limited to, suicide prevention signage and a physical barrier designed to prevent a person from falling or intentionally jumping from the overpass in manner likely to cause death and to prioritize the placement of suicide deterrents on freeway overpasses with the highest rates of documented suicides over the last 20 years. SB 800 is pending in the Senate Transportation Committee.
2. PREVIOUS LEGISLATION.
   1. SB 326 (Eggman), among other things, requires OSP, if established, to consult with the BHSOAC to implement suicide prevention efforts consistent with the Suicide Prevention Report “Striving for Zero.”
   2. AB 988 (Bauer-Kahan) Chapter 747, Statutes of 2022, establishes the Miles Hall Lifeline and Suicide Prevention Act in the state for the purpose of implementing the 988 Suicide and Crisis Line, including a technical advisory board to establish operational standards for 988 and interoperability with 911. Requires the CalHHS to develop a five year implementation plan for 988 and coordinate with several other state entities for the operation of 988 and establishes the 988 State Suicide and Behavioral Health Crisis Services Fund for the operation of 988 with funds generated by the 988 surcharge
   3. AB 133 (Committee on Budget), Chapter 143, Statutes of 2021, removes the limitation that requires OSP, if established, to be carried out with existing staff and resources.
   4. AB 2112 (Ramos), Chapter 142, Statutes of 2020, authorizes DPH to establish OSP to, among other functions, provide information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs and conduct and convene experts and stakeholders to encourage collaboration and coordination of resources for suicide prevention. Provides that if OSP is established, DPH may focus resources on groups with the highest risk, including the youth and Native Americans.
   5. SB 656 (Hueso), Chapter 651, Statutes of 2019, requires the CalTrans director to select members for an advisory committee to provide input into the selection of a physical suicide deterrent system for the San Diego-Coronado Bridge.
   6. AB 114 (Committee on Budget), Chapter 38, Statutes of 2017, appropriated $100,000 from the Mental Health Services Fund for the BHSOAC to develop a statewide suicide prevention plan.
3. AMENDMENTS. The committee may wish to amend this bill to strike the language requiring the identification of bridges and roadways with a relatively high risk of suicide, and to extend the due date for the report by OSP by one year to December 31, 2027, and extend the repeal date to January 1, 2029.

REGISTERED SUPPORT / OPPOSITION:

Support

Didi Hirsch Mental Health Services (Sponsor)
California Alliance of Child and Family Services
California Association of Social Rehabilitation Agencies
California Hospital Association
California State Association of Psychiatrists (CSAP)
Children Now
NAMI California
Sycamores

Opposition

None on file

Analysis Prepared by: Logan Hess / HEALTH / (916) 319-2097

Date of Hearing: April 8, 2025

ASSEMBLY COMMITTEE ON HEALTH

Mia Bonta, Chair

ABPCA Bill Id:AB 440

Author:(Ramos) – As Amended Ver:March 5, 2025

SUBJECT: Suicide prevention.

SUMMARY: Requires the Office of Suicide Prevention (OSP) to identify state bridges and roadways with a history of a relatively high number of suicide-related deaths and to work with the Department of Transportation (CalTrans) to identify cost-effective strategies to reduce these suicides. Requires OSP to prepare and submit a report to the Legislature and the relevant policy committees on the strategies that it identifies on or before December 31, 2026, and repeals these provisions January 1, 2028.

EXISTING LAW:

1. Authorizes the State Department of Public Health (DPH) to establish OSP and, if established, authorizes the office to perform certain functions including the following:
   1. Providing information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs;
   2. Conducting state-level assessment regional and statewide suicide prevention policies and practices;
   3. Monitoring and disseminating data to inform prevention efforts at the state and local levels;
   4. Convening experts and stakeholders, including, but not limited to, stakeholders representing populations with high rates of suicide, to encourage collaboration and coordination of resources for suicide prevention;
   5. Reporting on progress to reduce rates of suicide. [Health and Safety Code (HSC) § 131300]
2. Authorizes OSP to focus activities on groups with the highest risk, including youth, Native American youth, older adults, veterans, and LGBTQ people; to share and receive data from all entities with data relevant to the responsibilities and objectives of the office, including, but not limited to, state, federal, local, and private and nongovernmental agencies or organizations; and to apply for and utilize federal, state, and foundation grants. [HSC § 131000 et seq.]
3. Requires OSP, if established, to consult with the Behavioral Health Services Oversight and Accountability Commission (BHSOAC) to implement suicide prevention efforts consistent with the Suicide Prevention Report “Striving for Zero.” [HSC § 131315]
4. Establishes the California Suicide Prevention Act of 2000 and permits the Department of Health Care Services (DHCS), contingent upon appropriation in the annual Budget Act, to establish and implement a suicide prevention, education, and gatekeeper training program to reduce the severity, duration, and incidence of suicidal behavior, as specified. [Welfare and Institutions Code (WIC) § 4098.2]
5. Establishes the Children and Youth Behavioral Health Initiative (CYBHI) to be administered by the California Health and Human Services Agency (CalHHS) and its departments. Subject to appropriation by the legislature, authorizes the initiative to include, at a minimum, the following: a behavioral health services and supports virtual platform; school-linked partnership, capacity, and infrastructure grants; incentive payments to qualifying Medi-Cal managed care plans; development and maintenance of a statewide fee schedule for school-linked outpatient mental health and substance use disorder treatment; and investments for behavioral health workforce, education, and training. [WIC § 5961 et seq.]
6. Establishes the Miles Hall Lifeline and Suicide Prevention Act in the state for the purpose of implementing the 988 Suicide and Crisis Line. Requires the Office of Emergency Services to establish a technical advisory board to establish operational standards for 988 and interoperability with 911. Requires CalHHS to develop a five year implementation plan for 988 and coordinate with several other state entities for the operation of 988. Establishes the 988 State Suicide and Behavioral Health Crisis Services Fund for the operation of 988 with funds generated by the 988 surcharge. [Government Code § 53123.1 et seq.]

FISCAL EFFECT: Unknown. This bill has not yet been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, this bill aims to continue California’s goal of working towards achieving zero suicides. The author says that, in order to do so, we must begin identifying areas of potential harm for at-risk individuals. Specifically, such harms are on our state’s bridges and overpasses. It is the hope of the author that that this bill will help prevent a future tragedy from striking communities and to protect those in need.
2. BACKGROUND.
   1. Suicide and Self-Harm in California. According to a January 2025 data brief from DPH, suicide is the leading cause of violent death, and self-harm is the third leading cause of injury-related emergency department (ED) visits. Men consistently have higher rates of suicide than women, and in 2022 men account for more than three-fourths of suicides. Use of firearms was the most common mechanism for suicide in 2021 and 2022. Youth under the age of 10 had a statistically significant increase in self-harm ED visit rates from 1.9 per 100,000 Californians in this age group in 2021 to 2.7 in 2022. Although there was a small number of black people who visited the ED for self-harm injury, this group is at elevated risk for self-harm. Self-harm by poisoning was the most common mechanism of self-harm injury leading to ED visits, followed by cutting/piercing and, when combined, both accounted for approximately 85% of self-harm ED visits. Other mechanisms of self-harm combined, including fall, firearm, and hanging/suffocation, made up 2% of self-harm ED visits.

The brief also highlights opportunities for prevention, such as advancing protective factors as a part of prevention programming to build resilience and foster support at the individual, relationship, and community level to help decrease suicide risk. While the brief notes that prevention efforts should focus on the most common and lethal means of suicide (firearms and intentional drug overdoses), it also highlights the 2024 National Strategy for Suicide Prevention, which contains several goals, such as integrating suicide prevention into the culture of the workplace and into other community settings, and implementing research-informed suicide prevention communication activities in diverse populations, using best practices from communication science.

• 1. 988. As of July 16, 2022, the National Suicide Prevention Lifeline number transitioned to 988, providing an easy to remember number that anyone can call, text, or chat to receive support when experiencing a suicidal, mental health and/or substance use related crisis. When Californians dial 988, they are directed to one of twelve Lifeline crisis call centers. California’s call centers are part of the broader 988 Lifeline crisis center network. If a local crisis center is unable to take the call, the caller is automatically routed to a national backup crisis center. According to the 988 California Crisis Center Consortium, 988 routed 342,394 calls with an average answer speed of 34 seconds, answer rate of 85%, and call length of 12 minutes in 2023.
  2. CYBHI. As part of CYBHI, DHCS launched two mobile applications to support youth. BrightLife Kids is designed for parents or caregivers and kids 0-12 years old. It provides free, expert coaching for sleep issues, worry, social skills, and more, as well as live, 1:1 video sessions, secure chat, and on-demand content. Soluna provides confidential support for 13-to 25-year-olds via 1:1 chat with a professional coach, interactive tools to destress, quizzes, videos, forums, and more. Both resources are available regardless of insurance coverage or immigration status.

The Youth Suicide Reporting and Crisis Response Pilot Program is developing and testing models for rapidly reporting and comprehensively responding to youth suicides and suicide attempts at the county level by providing crisis services and follow-up supports within school and community settings. The ten counties selected to participate are: Alameda, El Dorado, Humboldt, Kern, Los Angeles, Riverside, Sacramento, San Diego, San Joaquin, and Solano. The program strives to provide equitable, timely, and culturally responsive services for youth, bolstering local suicide prevention and postvention strategies. The University of California, Los Angeles was selected as the independent evaluator of the pilot and is expected to release a final report in June 2025.

• 1. Striving for Zero. In 2019, pursuant to AB 114, Chapter 38, Statutes of 2017, the Mental Health Services Oversight and Accountability Commission (now the BHSOAC) adopted Striving for Zero, California’s Strategic Plan for Suicide Prevention, 2020-2025. The 2020-21 Budget Act authorized the BHSOAC to allocate $2 million support suicide prevention efforts consistent with the plan. The Behavioral Health Services Act (SB 326 (Eggman), Chapter 790, Statutes of 2023), requires OSP, if established, to consult with the BHSOAC to implement suicide prevention efforts consistent with the strategic plan.

1. SUPPORT. Didi Hirsch Mental Health Services is sponsoring this bill and states in support that Caltrans does not have a statewide suicide prevention policy in place for their bridges and roadways and that the state should not have to wait for a tragedy to strike to begin the process of developing safety measures in areas that possess a clear and present danger to any at-risk individual that may be considering taking their own life. Didi Hirsch says this legislation aims to protect at-risk individuals and help provide families with some relief knowing their state is being proactive about their loved one’s safety.

The California State Association of Psychiatrists (CSAP) supports this bill and says that the approach in this bill not only prioritizes the safety and well-being of Californians but also reinforces a broader public health strategy to save lives. CSAP continues that this bill’s requirement to submit a report to the Legislature by December 31, 2026, ensures accountability and provides an opportunity to evaluate the effectiveness of the identified strategies.

NAMI California states in support of this bill that the United States is facing a mental health crisis—especially among young people—with alarming rates of suicidal ideation, hopelessness, and depression. NAMI notes that in 2023 more than one in five high school students seriously considered attempting suicide and 1 in 10 attempted suicide – rates that are even higher for at risk communities, like LGBTQ+ youth. NAMI concludes that this bill aims to protect at-risk individuals considering taking their own life and help provide families with some relief knowing their state is being proactive about their loved one’s safety

1. RELATED LEGISLATION. SB 800 (Reyes) would require CalTrans to establish and administer a pilot program to install suicide deterrents on 10 freeway overpasses in the County of San Bernardino. The bill would also require the suicide deterrents installed under the pilot program to include, but not be limited to, suicide prevention signage and a physical barrier designed to prevent a person from falling or intentionally jumping from the overpass in manner likely to cause death and to prioritize the placement of suicide deterrents on freeway overpasses with the highest rates of documented suicides over the last 20 years. SB 800 is pending in the Senate Transportation Committee.
2. PREVIOUS LEGISLATION.
   1. SB 326 (Eggman), among other things, requires OSP, if established, to consult with the BHSOAC to implement suicide prevention efforts consistent with the Suicide Prevention Report “Striving for Zero.”
   2. AB 988 (Bauer-Kahan) Chapter 747, Statutes of 2022, establishes the Miles Hall Lifeline and Suicide Prevention Act in the state for the purpose of implementing the 988 Suicide and Crisis Line, including a technical advisory board to establish operational standards for 988 and interoperability with 911. Requires the CalHHS to develop a five year implementation plan for 988 and coordinate with several other state entities for the operation of 988 and establishes the 988 State Suicide and Behavioral Health Crisis Services Fund for the operation of 988 with funds generated by the 988 surcharge
   3. AB 133 (Committee on Budget), Chapter 143, Statutes of 2021, removes the limitation that requires OSP, if established, to be carried out with existing staff and resources.
   4. AB 2112 (Ramos), Chapter 142, Statutes of 2020, authorizes DPH to establish OSP to, among other functions, provide information and technical assistance to statewide and regional partners regarding best practices on suicide prevention policies and programs and conduct and convene experts and stakeholders to encourage collaboration and coordination of resources for suicide prevention. Provides that if OSP is established, DPH may focus resources on groups with the highest risk, including the youth and Native Americans.
   5. SB 656 (Hueso), Chapter 651, Statutes of 2019, requires the CalTrans director to select members for an advisory committee to provide input into the selection of a physical suicide deterrent system for the San Diego-Coronado Bridge.
   6. AB 114 (Committee on Budget), Chapter 38, Statutes of 2017, appropriated $100,000 from the Mental Health Services Fund for the BHSOAC to develop a statewide suicide prevention plan.
3. AMENDMENTS. The committee may wish to amend this bill to strike the language requiring the identification of bridges and roadways with a relatively high risk of suicide, and to extend the due date for the report by OSP by one year to December 31, 2027, and extend the repeal date to January 1, 2029.

REGISTERED SUPPORT / OPPOSITION:

Support

Didi Hirsch Mental Health Services (Sponsor)
California Alliance of Child and Family Services
California Association of Social Rehabilitation Agencies
California Hospital Association
California State Association of Psychiatrists (CSAP)
Children Now
NAMI California
Sycamores

Opposition

None on file.

Analysis Prepared by: Logan Hess / HEALTH / (916) 319-2097