New article: Factors deterring and prompting the decision to attempt suicide on the railway networks

Full article: 

ABSTRACT:

Background
There is a suicide on the British railways every 36 hours. However, the reasons why people choose to die by train are not well understood.

Aims
To explore factors influencing and discouraging the decision to attempt suicide on the railway networks.

Method
We conducted an online survey and qualitative interviews with individuals who had contemplated or attempted suicide by train.

Results
A total of 353 survey responders had considered and 23 had attempted suicide at rail locations (including railways and metro/underground); a third of these cases were impulsive. The most frequently reported motivations for contemplating or attempting suicide were perceptions of quick and certain lethality (54 and 37%, respectively) and easy access to rail settings (33 and 38%, respectively). The main factor discouraging people from rail suicide was its wider impact, especially on train drivers (19%). In qualitative interviews (N = 34) the desire to avoid intervention from others was also a common motivating factor for attempting suicide on the railway networks.

Conclusions
People attempt suicide by train because railway settings are easy to access and because of an inaccurate perception of certain and quick lethality. Tackling exaggerated perceptions of lethality may help reduce suicides by train.

REFERENCE: Lisa Marzano, Jay-Marie Mackenzie, Ian Kruger, Jo Borrill, Bob Fields (2019). Factors deterring and prompting the decision to attempt suicide on the railway networks: findings from 353 online surveys and 34 semi-structured interviews. British Journal of Psychiatry, E-pub ahead of print,

The RESTRAIL Toolbox: a problem-solving guide for implementation of measures to prevent railway suicides and trespassing accidents

The RESTRAIL Toolbox is a problem-solving guide for implementation of measures to prevent railway suicides and trespassing accidents and to mitigate the post incident consequences. It is the main output of the RESTRAIL research project and it aims to be a helpful, intuitive and user-friendly tool. It summarises practical information collected and produced during the project (synthesis, guidelines, best practice, lessons learned and empirical evidence for effectiveness). The content also makes links with scientific publications which support the recommended measures, providing a wide list of references (peer-reviewed articles, research reports, reviews, etc.).

The Toolbox is designed to help railway undertakings (RUs), infrastructure managers (IMs), station managers and other concerned decision makers in three ways:

1. lead them through the process of selecting from the range of preventative and mitigation measures,
2. provide more detailed guidance on the implementation of those measures and
3. provide a framework for collecting and structuring information in order to feed an accessible and documented database on measures for implementation and efficiency across the rail community and beyond.

To access the complete RESTRAIL toolbox, visit: http://www.restrail.eu/toolbox/

Railway suicide in England and Wales 2000–2013: a time-trends analysis

To read the full article:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791921/

ABSTRACT:

Background

In 2010, the “Tackling Suicide on the Railways” programme was launched as a joint initiative among Network Rail, the Samaritans and other key organisations such as the British Transport Police and train operators to achieve a 20 % reduction in railway suicides from 2010 to 2015 in Great Britain. We report the most recent age and sex specific trends in railway suicide in England and Wales from 2000 to 2013 and examine whether the initiative’s target reduction in railway suicides is likely to be achieved.

Methods

Population data and suicide mortality data (all methods combined and railway) for England and Wales were obtained from the Office for National Statistics (ONS) and used to calculate age and gender specific rates for deaths registered from 2000 to 2013. Data on railway suicides were also obtained from the Rail Safety and Standards Board (RSSB) and compared with ONS data. We used joinpoint regression to identify changes in suicide trends across the study period.

Results

The railway was used in 4.1 % of all suicides in England and Wales (RSSB data were similar to ONS data for most years). Suicides in all persons from all causes decreased from 2000 to 2007, with small increases from 2008 until 2013; this rise was entirely due to an increase in male suicides. Railway suicide rates increased over the entire study period; the proportion of railway suicides in all persons increased from 3.5 to 4.9 % during the study period. This trend was also mainly driven by increases in male suicides as female railway suicide rates remained steady over time. The highest age specific railway suicide rates were observed in middle aged men and women. Although there was no conclusive evidence of an increase in ONS railway suicides, RSSB data showed a statistically significant increase in railway suicides in males from 2009 onwards.

Conclusion

The continued rise in male railway suicide in England and Wales is concerning, particularly due to the high economic costs and psychological trauma associated with these deaths. The initiative’s target of a 20 % reduction in railway suicide is unlikely to be achieved.

Keywords: Suicide, Railways, England and Wales, Epidemiology, Train

REFERENCE: Taylor, A.K., Knipe, D.W., Thomas, K.H. (2016). Railway suicide in England and Wales 2000–2013: a time-trends analysis. BMC Public Health, vol. 16, p. 270.

Predictors of using trains as a suicide method: Findings from Victoria, Australia

To read the full article: https://www.ncbi.nlm.nih.gov/pubmed/28395228

Abstract

This study aimed to investigate the factors associated with the choice of trains over other means of suicide. We performed a case-control study using data on all suicides in Victoria, Australia between 2009 and 2012. Cases were those who died by rail suicide and controls were those who died by suicide by any other means. A logistic regression model was used to estimate the association between the choice of trains and a range of individual-level and neighbourhood-level factors. Individuals who were never married had double odds of using trains compared to individuals who were married. Those from areas with a higher proportion of people who travel to work by train also had greater odds of dying by railway suicide compared to those from areas with a relatively lower proportion of people who travel to work by train. Prevention efforts should consider limiting access to the railways and other evidence-based suicide prevention activities.

Reference

Too, L.S., Bugeja, L., Milner, A., McClure, R., Spittal, M.J. (2017). Predictors of using trains as a suicide method: Findings from Victoria, Australia. Psychiatry Res. 2017 Jul;253:233-239. doi: 10.1016/j.psychres.2017.03.057. Epub 2017 Apr 4.

New article: Developing a framework of behaviours before suicides at railway locations

Reference: Brendan Ryan (2018). Developing a framework of behaviours before suicides at railway locations. Ergonomics, 61(5), 605-626.

Abstract

Better knowledge of behaviours of people at railway property could help with identifying those at risk of suicide. Literature has been reviewed from a range of disciplines on what is known about studying behaviour in this type of public location. Secondary analysis has been carried out on descriptions of behaviour from structured exercises with experts and other pre-existing sources. A framework has been produced with five main classes (display of emotion, appearance, posture/movements, activities and interactions) and associated sub-classes. Commentary has been provided on factors that influence identification of suspicious behaviours, how to distinguish these from normal behaviours and the circumstances that inhibit timely reactions to the behaviour amidst the complexity of the operational railway. Opportunities to develop and use the framework are discussed, including using this to prompt collection of additional behavioural data from wider resources, enhancing staff training and developing requirements for effective use of surveillance technologies.

Practitioner Summary: Many railway suicides could be prevented with better understanding of behaviours before events. Pre-existing data sources have been analysed, producing a framework highlighting five aspects of behaviour. This can prompt the collection of better evidence on pre-suicidal behaviours, with future applications in developing surveillance technologies, training staff and public awareness.

Keywords: Suicidal behaviour, railway, reporting, observation, surveillance technologies

Access full article: https://www.tandfonline.com/doi/full/10.1080/00140139.2017.1401124?scroll=top&needAccess=true

Behaviours preceding suicides at railway and underground locations: a multimethodological qualitative approach

To access full article: https://bmjopen.bmj.com/content/bmjopen/8/4/e021076.full.pdf

ABSTRACT

Objectives

Suicides by train have devastating consequences for families, the rail industry, staff dealing with the aftermath of such incidents and potential witnesses. To reduce suicides and suicide attempts by rail, it is important to learn how safe interventions can be made. However, very little is known about how to identify someone who may be about to make a suicide attempt at a railway location (including underground/subways). The current research employed a novel way of understanding what behaviours might immediately precede a suicide or suicide attempt at these locations.

Design and methods

A qualitative thematic approach was used for three parallel studies. Data were gathered from several sources, including interviews with individuals who survived a rail suicide attempt (n=9), CCTV footage of individuals who died by rail suicide (n=16) and qualitative survey data providing views from rail staff (n=79).

Results

Our research suggests that there are several behaviours that people may carry out before a suicide or suicide attempt at a rail location, including station hopping and platform switching, limiting contact with others, positioning themselves at the end of the track where the train/tube approaches, allowing trains to pass by and carrying out repetitive behaviours.

Conclusions

There are several behaviours that may be identifiable in the moments leading up to a suicide or suicide attempt on the railways which may present opportunities for intervention. These findings have implications for several stakeholders, including rail providers, transport police and other organisations focused on suicide prevention.

Reference: Mackenzie J, Borrill J, Hawkins E, et al. (2018). Behaviours preceding suicides at railway and underground locations: a multimethodological qualitative approach. BMJ Open, 8: e021076. doi: 10.1136/bmjopen-2017-021076

Suicide patterns on the London Underground railway system, 2000-2010

To access full article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623887/

ABSTRACT: 

Aims and Method Suicidal acts on underground railway networks are an area of public health concern. Our aim was to review recent epidemiological patterns of suicidal acts on the London Underground to inform future preventive interventions. Data from 2000 to 2010 were obtained from the British Transport Police via a Freedom of Information request.

Results The mean annual rate of suicidal acts from 2000 to 2010 was 5.8 per 100 million passenger journey stages. Of those who died by suicide, 77.3% were of White Northern European ethnicity. A fifth had a history of mental illness.

Clinical implications The widening gap between the number of recorded suicide attempts and completed suicides is encouraging. Further research is required regarding the role of drug and alcohol use, psychiatric history and area of residence. Installation of platform screen doors should be considered in future railway network expansion.

Reference: Martin, S., & Rawala, M. (2017). Suicide patterns on the London Underground railway system, 2000-2010. BJPsych bulletin, 41(5), 275-280.

Lessons learned from the collaborative European project RESTRAIL: REduction of suicides and trespasses on RAILway property

To read full article: https://link.springer.com/article/10.1007/s12544-016-0203-y

Abstract:
Background
RESTRAIL was a three year EU FP7 research project which aimed to help reduce the occurrence of suicides and trespasses on railway property and the costly service disruption caused by these events. The project was coordinated by the International Union of Railways (UIC) and provided the rail industry and researchers worldwide with an analysis of the most cost-effective prevention and mitigation measures. The goal of this paper is to inform the railway and scientific community about the successful completion of the project and to present an overview of the main results and key innovations.

Method
The project covered five relevant issues which significantly contributed to improve the prevention of railway suicide and trespass, and to mitigate their consequences: (1) collection and analysis of data related to railway suicides and trespassing accidents and information about preventative strategies; (2) assessment of preventive measures to reduce railway suicide and trespass; (3) assessment of measures to mitigate the consequences; (4) pilot tests to evaluate some promising measures on the field; and (5) practical recommendations and guidelines.

Results
The main project outcomes included: an integrated data analysis on railway suicide and trespass, a list of 25 recommended measures, 11 field tests which provided new pieces of evidence for the effectiveness of different measures, and a free online toolbox for decision-makers.

Discussion
These achievements are discussed in relation to the ongoing need of practical and exploitable results from EU-funded research projects, since the scientific and applied outcomes of RESTRAIL are an example of good practice for the benefit of the entire railway community and society.

Keywords
Safety Security Rail suicide Trespass Incident prevention Consequence mitigation

Reference: Havârneanu, G.M., Bonneau, MH. & Colliard, J. (2016) Lessons learned from the collaborative European project RESTRAIL: REduction of suicides and trespasses on RAILway property. Eur. Transp. Res. Rev. 8: 16. https://link.springer.com/article/10.1007/s12544-016-0203-y

The effectiveness of platform screen doors for the prevention of subway suicides in South Korea

Full article: https://www.sciencedirect.com/science/article/pii/S0165032715310971?via%3Dihub

Abstract

BACKGROUND:
Subway suicide can significantly impact the general public. Platform Screen Doors (PSDs) are considered to be an effective strategy to prevent suicides at subway stations, but the evidence on their effectiveness is limited.

METHODS:
We assessed the effectiveness of installing half- and full-height platform screen doors in reducing subway suicides using Poisson regression analysis. Ten-year monthly panel data for 121 subway stations between 2003 and 2012 in the Seoul metropolitan area were used for the analysis.

RESULTS:
We found that installing PSDs decreases fatal suicide cases by 89% (95% CI: 57-97%). We also found that the installation of full-height PSDs resulted in the elimination of subway suicides by completely blocking access to the track area; however, half-height PSDs, which do not extend to the ceiling of the platform, were not as effective as full-height ones.

LIMITATION:
Our findings were based on the data from a single subway operator for a limited period of time. Accordingly, we did not consider the possibility that some passengers choose to die at a station run by other operators. Our study did not examine the potential substitution effects of other suicide methods.

CONCLUSION:
Installing physical barriers at subway stations can be an effective strategy to reduce the number of subway suicides; however, half-height PSDs are not as effective as full-height ones, even when they are as high as the height of an adult. Thus, these barriers should be made high enough so that nobody can climb over them.

KEYWORDS:

Metro suicide; Platform screen door; South Korea; Subway; Suicide; Suicide prevention

Reference: Chung, YW, Kang, SJ, Matsubayashi, T, Sawada, Y, Ueda, M. (2016). "The effectiveness of platform screen doors for the prevention of subway suicides in South Korea". J Affect Disord. 194:80-3. doi: 10.1016/j.jad.2016.01.026

New article: Suicide on the Railways in Belgium: A Typology of Locations and Potential for Prevention

Abstract:

Suicide on railway networks comprises a serious public health problem. However, the geographical distribution and the environmental risk factors remain unclear. This study analyzed the geographic distribution of railway suicides in Belgium from 2008–2013 at the level of a railway section (average length of 3.5 km). Principal component analysis (PCA) identified three groups of correlations that helped explain the variance of railway suicide. The three groups are related to characteristics of urban spaces, psychiatric facilities, and railway traffic density. Based on the PCA results, the study found four types of railway sections. The density of railway suicide was average and low in the urban and rural/industrial sections, respectively. However, it was high in the suburban sections and the sections close to psychiatric facilities. As the geographical proximity of a psychiatric facility comprises a specific risk factor for suicide on railways, preventative measures should target these sections and establish collaborations with psychiatric facilities. The typology of locations found in this study constitutes crucial information for national and local suicide prevention on the Belgian railway network.

Reference: Strale, M., Krysinska, K., Van Overmeiren, G. &l Andriessen, K. (2018). Suicide on the Railways in Belgium: A Typology of Locations and Potential for Prevention. Int. J. Environ. Res. Public Health, 15(10), 2074.

To see full article: https://doi.org/10.3390/ijerph15102074