Suicide in the Montreal subway system: characteristics of the victims, antecedents, and implications for prevention.

Abstract

To understand the characteristics of persons who commit suicide in the Montreal subway system (the Montreal Metro), their personal and psychiatric histories, and the nature of the event in order to develop better prevention strategies. Systematic analysis of coroner's office investigations of the 129 suicides in the Montreal Metro from 1986 to 1996. Of the 129 people who committed suicide, 81% had expressed a prior suicidal intention, 66% had previously attempted suicide, and 9% had attempted suicide in the metro. One hundred and five of the victims had serious mental health problems, most frequently depression; 73% had had inpatient psychiatric treatment, and at the time of death, 27% resided in a mental health treatment institution. Recent adverse life events included failed relationships, work problems, and family difficulties. Suicide victims intentionally go to the metro to kill themselves, often tell others beforehand, and are generally in treatment for serious psychiatric problems. Possible prevention strategies include modification of the environment and procedures in the metro, changing public conceptions of metro suicides, and modifying practice in psychiatric facilities.