Efforts to Prevent Railway Suicides in Denmark

Background: Reviews of camera surveillance systems have demonstrated ambivalent behaviors among people who die by railway suicide. Yet, only few preventive measures have been evaluated. Aims: We aimed to review incidents of suicidal behavior at a Danish railway station, install preventive measures, and monitor subsequent calls to a telephone helpline and reports of suicidal incidences. Method: Suicide incidents at Valby Station during 2012–2018 were reviewed to identify options for preventive measures. Based on these findings, signs encouraging help-seeking and other measures were implemented. Calls to the Danish helpline for suicide prevention and suicidal events at the station were subsequently monitored. Results: The review revealed locations where measures were meaningful and signs, physical barriers, and motion-sensitive lights were installed. Over the following 14 months, no suicide deaths occurred, and the signs were mentioned in 14 calls to the helpline, some of which were made by callers who were evaluated to be at high risk of suicide. Limitations: No direct link between implemented measures and observed outcomes could be established. Conclusion: Installing measures, including signs, at appropriate locations at railway platforms may encourage people in crisis to seek support.

Why Choose the Railway?

Background: The impact of railway suicide in the United Kingdom is extensive, yet reasons for why people choose this method are not clearly understood and research into the examination of suicide notes in this area is limited. Aims: Our study aimed to utilize the unique access to suicide notes written by those who died by suicide on the railway so as to gain a greater understanding of why people chose this method. Method: Descriptive and thematic analysis was conducted on 75 suicide notes for those who had died by suicide on the UK railway between 2010 and 2016. Results: Demographic findings from the sample were largely consistent with railway UK data trends. Five main themes were identified as being significant: “certain and instant,” “impersonal and non-human,” “ability to be planned,” “a good death,” and “bereavement suicide.” Limitations: Findings are based on suicide note authors who died by suicide on the railway in the UK, as such generalizability may be limited. Conclusion: Findings suggest that people select the railway for their suicide for the following motives: perception of being instant and certain and viewed as a good death, ability to be planned, belief it causes less of a burden on loved ones (via the perception of the railway as impersonal), and a prior experience of it being fatal (via bereavement suicide). Key implications in relation to prevention strategies and future research are discussed.

Railway Suicide in The Netherlands Lower Than Expected

Background: Increasing rail transportation requires appropriate railway suicide preventive measures. Aims: The investigation of trends in railway suicide during 2008–2018, a period in which preventive measures were taken by Dutch railway infrastructure manager ProRail. Methods: Generalized linear regression models for railway suicide were developed for the period 1970–2007 with general suicide rate, railway traffic intensity, and a combination of these variables as regressors. Subsequently, the best-fitting model was used to investigate trends in railway suicide after 2007 by comparing in retrospect observed values with the expected outcomes of the regression model. Results: An adequate regression model for railway suicide was obtained using both general suicide rate and railway traffic intensity as regressors. Based on this model, while national suicide mortality and railway traffic increased, a distinct relative decline in railway suicides was found from 2012 onward. Conclusions: This decline of railway suicides in the Netherlands may indicate that preventive measures taken by ProRail were effective and prevented around 85 railway suicides annually, a reduction of 30%.

Characteristics of Train Stations Where Railway Suicides Have Occurred and Locations Within the Stations

Background: To devise effective railway suicide countermeasures, it is necessary to identify stations where suicide is likely to occur. Aim: We explored the characteristics of stations where railway suicides have occurred and locations within the stations. Method: (Study 1) Using suicide data from between April 2014 and September 2019 provided by a major railway company in Japan, station-specific suicide was modeled as an outcome variable in a multivariate Poisson regression model. (Study 2) With railway company staff, we visited stations where suicide frequently occurs and conducted fieldwork. Results: (Study 1) Our estimation using a Poisson regression model revealed that railway suicides were more frequent when stations were serviced by passing trains, had a large number of passengers, and were located near psychiatric hospitals. (Study 2) Of 50 suicides, 48.0% occurred in front of benches or waiting rooms, 26.0% occurred at the front end of the platform, 24.0% occurred at the entrance to the platform, and 22.0% occurred at a blind spot for the train driver. Limitations: All data were provided by one railway company in Japan, limiting the generalizability of the results. Conclusion: Stations where suicide occurs frequently have distinct characteristics. Focusing on suicide hotspots may aid suicide prevention.

Statistical Review of the Suicide Attempts Rates Committed on Polish Railway Tracks between the years 2013-2016

Suicides on railway tracks are one of the most drastic ones. No research concerning this phenomenon has been done to this date in Poland. This article focuses on the connection between suicidal behaviors on Polish railway tracks and sociodemographic traits and presents risk factors. Background: The suicide behavior is largely spread among many European countries. Of these, Poland ranks 22nd in terms of suicide attempts. This study aims to highlight the suicide attempts rates on Polish railways lines and their main risk factors. Limitations: Limited number of available statistical data before 2013. Method: Statistical review of the available Central Police headquarters database and analyses of the influence of the risk factors on people’s awareness during the suicide attempts and their geographical distribution in Poland during the years 2013 - 2016. The prevalence of railway suicides in individual voivodeships (provinces) in Poland have been indicated in a 3D map. Results: There were 834 cases of railway suicide fatalities across the entire country. Of the total suicide statistics by any means, 3.75% are railway related. The average known age of those committing railway suicides were: 37.9 years for men (n = 627) and 34.6 for women (n = 155). In most cases, suicides were committed by bachelors (54.3%). The largest group of people who committed suicide had a primary level of education (42.0%). Among the suicides, a significant group are unemployed (45.2%). Alcohol intoxication have been established as responsible for a person’s lower awareness of his actions in 70.9% of cases. Almost 63.3% of people had a higher propensity for suicidal ideation and behavior, resulting in their being treated for mental health issues. Conclusion: Alcohol intoxication, illegal narcotics and psychotropic medication are responsible for a person’s lower awareness during his ore her actions, in most of the cases of suicide on Polish railway lines.

Prevention of metropolitan and railway suicide

Railway suicides account for less than 10% of all suicides and are considered a major public health issue because of their consequences for the operation of the transportation system and their deteriorating impact on staff and bystanders. Behaviour patterns include jumping, lying, wandering, and deviant behaviour prodromal to the attempt. Case fatality is 90% of all attempts (railway) or circa 60% (metro). Victims are predominately male and young, with a median age stratum in the range of 25–34 years. The weekly distribution shows a peak at the beginning of the week and a low on weekends. Preventive measures include inhibiting access to the track (e.g. barriers at places of advanced risk or surveillance systems), inhibiting media coverage, or education of gatekeepers to increase awareness, and skilfulness in contact with vulnerable subjects. Railway suicide prevention is a realistic option; however, further research is urgently needed.

Alcohol and the Risk of Railway Suicide

Suicide is one of the ten most common causes of death in the world. Of all deaths from suicide, 22% can be attributed to the use of alcohol, which means that every fifth suicide would not occur if alcohol were not consumed by the population. People under the influence of alcohol choose more radical and effective methods of dying by suicide, e.g., throwing themselves under a moving vehicle, such as a train. The presented analysis aimed to determine important risk factors affecting railway suicide in Poland and their relation to the state of alcohol intoxication of the victims, and the relationship between ethyl alcohol consumption and the phenomenon of suicide. Documentation obtained from the Department of Forensic Medicine at the Medical University of Warsaw, in the form of death registers and forensic medical records concerning examination and autopsy, was analyzed. This made it possible to identify suicide victims from among pedestrian victims of railway accidents recorded during the period under study. The research was carried out using unidimensional and multidimensional statistical analyses with IBM SPSS Statistics, version 25. Sober suicide victims were statistically significantly older than victims under the influence of alcohol; alcohol concentration was correlated with the age of the victims—the older the victims were, the higher the alcohol concentration. A significantly higher number of deaths attributed to suicide by sober victims was observed in autumn compared to other seasons. Multidimensional analysis showed a statistically significant effect of age and season on the probability of dying by suicide under the influence of alcohol—this probability decreases with the age of the victims and is also significantly lower in autumn. The observed relationship between age and the presence of alcohol in suicide victims can be the cause of railway suicides. Knowledge of the mechanisms of seasonal variability of suicidal behavior can help to develop effective strategies to prevent railway suicides. It is necessary to improve the system of reporting railway suicides, as only reliable statistics provide the possibility of assessing both the scale of the problem and the effectiveness of actions taken.

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

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.