A comprehensive review of existing work on the impact of socio-environmental determinants of railway suicides
Article Title: The socio-environmental determinants of railway suicide: a systematic review
Authors: Too, L., Milner, A., Bugeja, L., & McClure, R.
Publication date: 2014
Publication: BMC Public Health, 14(1), 20.
This article is interesting because it summarises effectively what is currently known about socio-environmental characteristics of railway suicides that have been analysed in descriptive studies. It emphasises the need to further explore the causal relationship between environmental characteristics and suicides, since results from existing studies are not consistent. This review and the lack of consistency between studies on different railway networks raise the question of potential cultural variations that have yet to be analysed.
Abstract from the authors:
Background: Railway suicide has significant adverse impacts for the victims, their family and friends, witnesses to the incident, general public and train network. There is no previous review on the socio-environmental factors of railway suicide. The research question asked in this review is: ‘What socio-environmental risk and protective predictors are significantly associated with railway suicide?’
Methods: The authors searched Medline, PsycINFO, Web of Science and Scopus for English-language studies that assess the associations between socio-environmental (i.e., geographical, physical, economic, and social) factors and railway suicide from their inception to June 2013. It was reported based on the PRISMA Statement.
Results: Eleven studies met the inclusion criteria. They were categorised into railway environments (availability of railways and trains, accessibility to railways and familiarity with trains), population characteristics, and impact of media reporting. Findings from ecological studies using population level railway suicide data suggested weak and inconsistent evidence for the first two categories. The evidence on the impact of media reporting was moderately strong, with irresponsible media reporting being associated with an increased risk of railway suicide.
Conclusions: There is a need for further research activity to strengthen evidence about socio-environmental risk factors of railway suicide. The focus of such research should be on the factors that determine individuals’ decisions of using the railway as a means of suicide, taking into account a range of geographical, physical, social, and economic factors.
A series of articles on the implementation of blue light to reduce the risk of suicides from railway and metro platforms
Matsubayashi, T., Sawada, Y., & Ueda, M. (2012). Does the installation of blue lights on train platforms prevent suicide? A before-and-after observational study from Japan. Journal of Affective Disorders. doi: 10.1016/j.jad.2012.08.018
Ichikawa, M., Inada, H., & Kumeji, M. (2014). Reconsidering the effects of blue-light installation for prevention of railway suicides. Journal of Affective Disorders, 152–154(0), 183-185. doi: http://dx.doi.org/10.1016/j.jad.2013.09.006
This series of articles is interesting because it shows how a promising and very innovative strategy to reduce railway suicides from platforms did not live up to expectations. It also shows us that innovation is a risky but potentially rewarding affair.
Abstracts from the authors:
Matsubayashi et al., 2012
Background: Railway and metro suicides constitute a major problem in many parts of the world. Japan has experienced an increase in the number of suicides by persons diving in front of an oncoming train in the last several years. Some major railway operators in Japan have begun installing blue light-emitting-diode (LED) lamps on railway platforms and at railway crossings as a method of deterring suicides, which is less costly than installing platform screen doors. However, the effectiveness of the blue lights in this regard has not yet been proven.
Methods: This study evaluates the effect of blue lights on the number of suicides at 71 train stations by using panel data between 2000 and 2010 from a railway company in a metropolitan area of Japan. We use a regression model and compare the number of suicides before and after and with and without the intervention by the blue light. We used the number of suicides at 11 stations with the intervention as the treatment group and at the other 60 stations without the intervention as the control group.
Results: Our regression analysis shows that the introduction of blue lights resulted in a 84% decrease in the number of suicides (CI: 14–97%).
Limitations: The analysis relies on data from a single railroad company and it does not examine the underlying suicide-mitigation mechanism of blue lights.
Conclusions: As blue lights are easier and less expensive to install than platform screen doors, they can be a cost-effective method for suicide prevention.
Ichikawa et al., 2014
Background: A recent preliminary communication suggested that the calming effect of blue lights installed at the ends of railway platforms in Japan reduced suicides by 84%. This estimate is potentially misleading from an epidemiological point of view and is reconsidered in the present study.
Methods: Governmental data listing all railway suicide attempts in Japan from April 2002 to March 2012 were used to investigate the proportion of suicide attempts within station premises, where blue lights are potentially installed, and at night, when they would be lit. For those suicide attempts within station premises, we also estimated the proportion that occurred at the ends of the platforms at night.
Results: Of 5841 total reported suicide attempts, 43% occurred within the station premises, 43% occurred at night (from 18:00 to 05:59), and 14% occurred both within the station premises and at night. Of the 2535 attempts within station premises, 32% occurred at night and 28% at most were at the end of a platform at night.
Limitations: The exact proportion of night time suicide attempts at the ends of railway platforms was not calculable. Nonetheless, the proportion of suicide attempts that is potentially preventable by blue lights should be less than our conservative estimate.
Conclusions: The installation of blue lights on platforms, even were they to have some effect in preventing railway suicides at night, would have a much smaller impact than previously estimated.
A report on the characteristics of railway suicides in the USA
Document title: Berman, A., Sundararaman, R., Price, A., Marshall, K., Martino, M., Doucette, A., . . . Gabree, S. (2013). Defining Characteristics of Intentional Fatalities on Railway Rights-of-Way in the United States, 2007–2010 (pp. 31). Washington, DC 20590: US Department of Transportation.
Authors: Berman, A., Sundararaman, R., Price, A., Marshall, K., Martino, M., Doucette, A., . . . Gabree, S.
Publication date: 2013
This article is interesting because it describes the characteristics of railway suicides in the USA for the first time. It also applies the method of psychological autopsies. Although it is complex, time- and resource-consuming, psychological autopsies are often used in studies of suicides in general. It offers an interesting insight in the psychological, social and environmental processes that may have led to the person taking its own life. However, too little has been found on why a person chooses the train, since there is no possibility to speak directly to the victim.
Abstract from the authors:
This report presents aggregate findings from 55 psychological autopsies of decedents who were identified as an intentional death (i.e., a suicide) on railroad rights-of-way between October 1, 2007, and September 30, 2010. The goal of this study was to assess whether there are unique characteristics of individuals involved in suicides on railroad rights-of-way compared with individuals who complete suicide by other means. The aggregate findings show that this sample of suicides on railroad rights-of-way share much in common with samples of suicides by other means. Only a few notable unique characteristics were found in the former population: the cases are more significantly marked by both severe mental disorder and substance abuse, the individuals tend to live near railroad tracks, and they are possibly less likely to have access to firearms. Additionally, the majority of these completed suicides occurred in urban or suburban areas as opposed to rural areas. The information collected for this effort may provide valuable information for the development of countermeasures or other intervention plans to mitigate this issue on railroad rights-of-way.