Abstract
BackgroundRailway 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 and railway suicide. The research question asked in this review was: ‘What socio-environmental risk and protective predictors are significantly associated with railway suicide?’MethodsThe review searched Medline, PsycINFO, Web of Science and Scopus for English-language studies that assessed 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.ResultsEleven 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.ConclusionsThere is a need for further research activity to strengthen evidence about socio-environmental risk factors for railway suicide. The focus of this research should be on the factors that determine individuals’ decisions of using the railway as a method of suicide, with the consideration of a range of geographical, physical, social, and economic factors.
Highlights
Railway suicide has significant adverse impacts for the victims, their family and friends, witnesses to the incident, general public and train network
In terms of socio-environmental factors, we examined geographical, physical, economic and social characteristics for railway suicide such as: railway- and train-related factors, population characteristics, and presence of media reporting on railway suicide
Among the 65 articles that were excluded, four articles described railway suicide preventive measures, one article measured the reliability of railway suicide rates, 27 articles described only the individual and temporal factors related to railway suicide, and 33 articles described the socio-environments that were relevant to railway suicide using case report and case series methods
Summary
Railway suicide has significant adverse impacts for the victims, their family and friends, witnesses to the incident, general public and train network. Railway suicide is reported to trigger imitative behaviour (i.e., at-risk individuals may use the Suggested prevention strategies for railway suicide have emphasised the need to decrease the perceived attractiveness (e.g. increase public knowledge on survival rate) and availability of trains as a suicide means (e.g. reduce train frequency) [9]. These strategies have suggested reducing accessibility to train lines (e.g. install physical barriers) and the potential of collision (e.g. decrease train speed), mitigating the consequences of collision (e.g. modify the front design of the train), and increasing medical survival and recovery (e.g. offer rehabilitation for survivors) [9]. A ten year follow-up study of 94 railway suicide attempters found that only 7% of these persons went on died by suicide and 3% repeated the same method three and half years after their initial attempts [19]
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