Challenges in prevention
There are several ways to address railway suicide prevention:
Reduce the risk for injury once the impact has taken place
Limit access decrease possible trespassing on tracks
Monitor trespassing activities to identify at risk trespassers and intercept them or signal the train to brake or slow down
Discourage people from using the railway as a means of suicide
Dissuade potential attempters from proceeding with an attempt using publicity for helplines and providing telephones nearby for them to call for help
Identify and better treat at risk persons in the community to reduce the risk of suicide attempts
All these methods can have varied effects depending on the context. For example limiting access to tracks has proved very effective in high density areas and at hot spots where multiple suicides have occurred. However, it may not be feasible in low density railway networks.
Costs involved in railway prevention strategies are an important issue. Although it is impossible to put a price on a human life, the high costs of some prevention strategies make them difficult to justify and implement on a large scale.
Railway suicides do not have similar patterns in all countries. Therefore a prevention strategy that is effective to prevention platform and railway station suicide will not be useful in a country where most suicides take place away from stations on open tracks, such is the case in most of Canada. An in-depth analysis of the local patterns of railway suicides is needed before any strategy can be devised to fit the local context.
Hotspots are a common phenomenon that renders the implementation of a railway suicide prevention strategy easier because there are a large number of suicides in a small area. Thus, local actions at and near hotspots may save lives with relatively limited investments. However in some places there are no hotspots and even when there are hotspots, they only account for a limited number of suicides. Therefore, prevention measures that focus on hotspots, although they may be effective in saving lives, only address part of the problem.
Evaluation of Effectiveness
For many railways, suicide remains a rare phenomenon with a small number of suicides per mile or kilometre of track therefore evaluating the effectiveness of a suicide prevention strategy may be difficult. Natural variations in small frequency behaviours may make it difficult to isolate the effect of the prevention strategy and provide statistically significant proof of the effectiveness of prevention strategies, unless the research continues for many years.
All these issues reduce the number of potential effective strategies to implement in a specific area that has been or can easily be validated by research. They increase the difficulty for those who want to implement and evaluate the effectiveness of railway suicide prevention. It also may be hazardous to implement strategies developed elsewhere without extensive previous analysis. Finally it often makes the evaluation of railway suicide prevention projects costly in resources and time.
However, these challenges should not stop railway stakeholder from developing and implementing ways to reduce the risks for railway suicide. Strategies can combine several activities to fit local characteristics. For example, a strategy may combine using barriers to prevent access to the tracks in a sensitive urban area with an intensive intervention, such as cameras and surveillance, with posters and dedicated telephone lines to a crisis centre, in the vicinity of a hot spot, as well as providing education to mental health professionals in less urbanised areas where few suicides occur. Local partners may also be involved to develop multi-faceted strategies including community awareness, gatekeeper training and support to reduce the number of walking paths close to tracks.