Railway Suicide In 2017/18: 310 suspected RS + 3,345 suicide - - PowerPoint PPT Presentation

Railway Suicide

• 2-12% suicides worldwide
• Approx. 4-5% of all suicides in

Great Britain

• In 2017/18:
• 310 suspected RS
• + 3,345 suicide attempts and

‘pre-suicidal behaviour’ incidents

Epidemiology and Risk Factors (GB)

• 73% incidents involving males
• “No correlation between RS rate and national suicide rate of

counties and boroughs”

• Approx. half of all incidents at stations (access from platform)
• Peak in April; Mondays (vs. weekend); 3-5pm or 10pm-midnight

Suicide Prevention

• n the Railway:

Anthropology Project The QUEST Study Why do people take their lives

• n the Railways in Great

Britain? Suicide on the Railways in Great Britain: A Multi-Disciplinary Analysis

Suicide Prevention on the Railway: Anthropology Project

• 2016 Robin Pharoah (anthropologist) approached by Network Rail. Asked

whether anthropological / ethnographic research might have something to

• ffer field of suicide prevention on the railway
• Research question: ‘How does the railway ever come to be in a list of
• ptions for taking one’s own life in the first place?’ – so not focussed on

why people take their own life in the first place, or why people take their life on the railway. More interested in culture, specifically the cultural resources people draw on when thinking about / making plans for suicide

• Might be useful for suicide prevention since if we can understand how the

railway might get on to a person’s ‘suicide ideation menu’, then we might be able to identify ways it can be taken off that menu

• Focus on particular locations identified as being suicide ‘hotspots’ by British

Transport Police (3 suspected suicides or injurious attempt incidents within a 12 month period)

• Fieldwork study of local contexts – local communities and local community

cultures (or discourses) that surround it. What wanted to understand was why people, in particular locations, might find they thought about / imagined / visualised taking their life on the railway, and this might be as much to do with the way the railway was seen and understood by non-suicidal people as by those who were suicidal

• Initial research at 4 different stations. 10 days at each site. Tours of area &

interviews with local residents, visits to local stakeholders, station staff interviews, mapping & observation of relevant local spaces, scanning of local news, social media & websites

• Study was complex

• Conclusions
• Which methods those with suicidal thoughts consider is an important question for

the railways, along with the question of how the railway comes to appear in the ideation menu in the first place

• Look at how certain locations can become ‘attractive’ to those with suicidal thoughts
• r intentions
• Popular discourses define the social context in which railway suicides take place, and

that suicidal individuals exist within, and come from within, that social context

• Popular discourses around railway suicide must play a role in determining how the

railway can come to appear in any given individual’s ideation menu

• Discourses about particular locations must play a role in how certain locations

become ‘suicide hotspots’

• Popular discourses around ‘hotspots’ (at least at local level) must also play a role in

pushing the railway (or specific railway locations) on to the ideation menu of suicidal people

• Some discourses might encourage people to consider railways, whilst others might

discourage

• Recommendations
• Influencing wider narratives which encourage / discourage railway as a site of

suicide

• Use of industry ‘messaging’

The QUEST Study:

Why do people take their lives

• n the Railways

in Great Britain?

• 1,804 survey responses
• 353 rail-related suicidal thoughts
• 34 made an attempt at a rail location
• 34 qualitative interviews (face-to-face;

telephone; email)

• Analysis of CCTV footage (16 fatalities)
• 21,810 news reports of suicidal behaviour

(2012-2015)

• 1,292 (5.9%) about suicide on the

railways

• Internet searches
• Suicide-related and rail-specific

keywords/phrases (240 sites)

• 61,000 Tweets
• 121 suicide-related
• Staff survey (N=140)

The QUEST Study Why do people take their lives on the Railways in Great Britain? A research study

Online survey: 1,804 responses, a total of 353 survey responders had considered and 23 had attempted suicide at rail locations (including railways and metro/underground). 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.

https://www.networkrail.co.uk/communities/safety-in-the-community/safety-campaigns/suicide-prevention/

Small Talk Saves Lives

The rail industry is working in partnership with Samaritans and the British Transport Police on the Small Talk Saves Lives bystander campaign, launched in November 2017. The first campaign of its type on the railway, it encourages the general public to support those who may be in emotional crisis around them on the railway network.

Suicide o ide on t the e Railways i in Great Brit itain: in: A Mu Mult lti-Dis iscipl iplina inary Analy lysis is

Dr Ian Marsh, CCCU Dr Lisa Marzano, Ass Prof Social Psychology, Middlesex University Dr David Mosse, Professor Social Anthropology, SOAS

• Multi-disciplinary insights
• ‘Actionable intelligence’
• What associations do people

make with suicide and the railways?

• What ‘myths’ exist?
• How can/should these be

challenged?

• What can the rail industry do?

Sui uicide o

• n

n the he Rail ilways i in Gr Great B Britain in: A Mu Mult lti- Discip iplin linary Analy lysis is

Phase 1: In-depth analyses of existing ethnographic, survey and interview data with individuals who have contemplated or attempted suicide by train, to explore from an anthropological and social psychological perspective the ways in which railway suicide is constructed in these accounts. Phase 2: A series of workshops/consultation events with i) individuals with lived experience – suicidal &/or bereaved by suicide, ii) clinical and academic experts, and iii) rail staff

Phase 1 e 1: In-depth analyses of existing ethnographic, survey and interview data with individuals who have contemplated or attempted suicide by train

Research participants :

Group A: For the purposes of this study, interview participants who had made a suicide attempt by walking, jumping, or lying in front a train. Group B: For the purposes of this study, interview participants who had survived a suicide attempt by another method, having considered and/or rejected a rail. Group C: For the purposes of this study, interview participants who reported thoughts of suicide on the railways but had never made a suicide attempt.

Qualitative Thematic and Discourse Analysis of Railway Suicide Study Data

Perception of the railway environment Process of deciding on method, time and place Consideration for

• thers

Surveillance / being seen / visibility Presence of others as support / deterrent / human contact

Perspecti ctives o

• f

parti tici cipants ts

Understanding that people are seeing the railway environment through very different ‘lenses’ can inform prevention initiatives:

• For those who describe experiencing distress at

a railway site, the environment is often viewed through a ‘mental health’ or ‘help-seeking’ ‘lens’ – that is, opportunities and/or resources to ameliorate distress are looked for (eg Samaritans phone number, staff availability and likely attitude to being approached, the availability of ‘safe’ spaces).

• For those viewing the railway environment

through a ‘suicide’ ‘lens’, then avoiding detection and possible intervention become key elements in the perception and appraisal of the spaces.

Open / plural readings of texts

First-person accounts of the processes and planning involved in a suicide attempt

• n the railway
• In-depth, qualitative interviews with those who have thought about or attempted to

take their own life indicate that people engage in complex and fluid processes when planning and imagining a suicide attempt, ones that frequently involve a dynamic, iterative relationship between the person and their cultural, social and physical environments.

• We argue that existing theories and models of suicide which start from assumptions
• f deficit and pathology underestimate the extent to which suicide, as the end result
• f an often-complex series of actions, requires a person to engage in logistical

processes of planning, decision-making, imagination, and adaptation.

• When people describe in their own words the processes they went through in

planning and undertaking a suicide attempt, and by not interpreting such accounts through a lens of deficit and pathology, we can arrive at different understandings of suicide.

Narrating / curating a suicide attempt

‘But with like, I guess, creating a suicide, you’re creating a narrative that’s special and meaningful to you, and… and it was the thought of, I guess, doing something right for once. And like making it a spectacle and making it, I guess,

• theatrical. I even had like… I’d created a playlist. To kind of accompany it. So

it had like lots of… lots of… mostly classical music. Like kind of Beethoven and

• Puccini. Theatrical stuff. And then when I was considering the railway, when I

wasn’t actually able to go through with it in the end, again it was a kind of last resort, I guess… … One of the other things that stops me is the kind of the driver… And what he might see. And what the most… that’s what I hate the most… … And I don’t want to do it at home, because I don’t want to be found by my

• partner. So I think to… from my experience, you have to be pretty desperate

to go out like that. Because it’s very… it is quite gruesome… And I don’t want to do that to anyone.’

Phase 2 e 2: A series of workshops/consultation events with i) individuals with lived experience – suicidal &/or bereaved by suicide, ii) clinical and academic experts, and iii) rail staff

• 17th July, 2019: Lived

Experiences Advisory Group (LEAG) workshop

• 22nd October 2019:

workshop for academics and experts

• 10th December, 2019: 2nd

Lived Experiences Advisory Group (LEAG) workshop

• 10th March 2020: Rail staff

workshop

Lived Experiences Advisory Group (LEAG)

This group is made up of individuals bereaved by suicide or with lived experience of suicidality. Workshop 17th July, 2019:

• How a death by suicide on the railway is communicated, with a

particular focus on the impact of using certain words and phrases.

• This was considered from the perspective of both the general public but

also potentially vulnerable individuals at stations and on trains

• How distraction may help those experiencing suicidal thoughts at

stations

• Ways to change the face of stations from impersonal to friendlier spaces

(for example by displaying artwork), and how this might help to create suicide-safer environments

• How to provide and seek help at a station, with discussions on what

form support could take and where individuals might go to seek help

• The discussions benefited from the different perspectives of those

present – those who have experience of what it is like to feel suicidal

• n the railways and those who have been bereaved by suicide
• These ‘experts by experience’ can potentially give the industry

valuable insight into how suicide prevention measures and initiatives might impact different groups of people

• At the workshop it was acknowledged by all how complicated many
• f these issues are, and how hard in can be to find a consensus

position

22nd October, workshop for academics and experts.

Programme

10.00 am Arrival and Coffee 10.15 am Lisa Marzano, Ian Marsh, David Mosse: Welcome and Introductions Understanding Context 10.25 am Lisa Marzano Suicide-related communications: Project rationale and overview 10.45 am Robin Pharoah and Alex Dark Suicide on the railways: An ethnographic approach 11.15 am Roger Mackett Travel and Mental Health 11.45 am Discussion Understanding Audiences and Localities 1.00 pm Amy Chandler Suicide cultures 1.30 pm Ian Marsh and Rachel Winter Online discussions of train suicides 2.00 pmDiscussion Dissuasion by Design 2.45pm Ralf Alwani Creating a barrier through civic ownership and the arts: A case study of the Foyle Reeds in Derry/Londonderry 3.15pm Discussion 3.45pm Concluding comments and close

16 people attended from different academic disciplines, including anthropology, sociology, psychiatry, psychology, design and technology, architecture and a transport planner / engineer, as well as representatives from Samaritans and Rethink Mental Illness charities.

• the nature and possible functions of common myths and

(mis)understandings around railway suicide, including in relation to its causes, lethality and impact

• the ways in which these may be perpetuated and/or challenged

via formal and informal messaging around rail suicide/suicide attempts (both at railway locations and in online spaces).

• the possible implications, and risks, of different communications

strategies and other forms of intervention

• how learning from prevention projects that have utilised

environmental design and technology (e.g. Foyle Bridge in Northern Ireland) can potentially inform prevention on the railways

• the potential challenges for suicide prevention on the railway

Messaging

Shaping cultural scripts and local stories to influence individual actions in relation to railway suicide (e.g. messages talk of injuries rather than fatalities, soap opera storyline) Changing the discourse around suicide on the railways

NEWS & MEDIA ONLINE COMMS SIGNAGE

ANNOUNCEMENTS

‘SOCIAL LISTENING’ MEDIA CAMPAIGNS PUBLIC DISCOURSE IMAGERY ‘NUDGING’

“When all you can think about is death and dying, you don't particularly notice signs or posters so I don't believe they would particularly help. I like the idea they have at, I think it's called, Beachy Head? Where they have suicide patrols for hot spot areas, clever idea, but yes a lot of money!! I think that would be great, if I'd have gone through with my plan, and someone had stopped to talk to me, I think that would have helped”

• Limited (evidence of) effectiveness or cost-effectiveness
• Potential to cause harm ?
• Content ?
• Imagery ?
• Frequency ?
• Reach?
• Audience/s ?

Messaging

• Online discussions of railway suicide methods / online ethnography
• NR/Train companies;
• Twitter
• Station announcements
• Station atmosphere

Online discussions of railway suicide methods

Online discussions may give an insight into how railway suicide is discussed and understood as a method by those who have seemingly given this a lot of thought, and who describe high levels of intent (and also some have experience of attempt). Also insight into how people individually engage with those ideas

• Online, people well-informed about railway suicide methods

generally advise against it

• Forum members discuss in detail negative or aversive

aspects of method;

• traumatic effect on others (esp driver)
• family identifying body
• possibility of surviving with injuries
• possibility of intervention
• fear-inducing method so difficult to overcome survival instinct

• Online, people well-informed about railway suicide methods

generally advise against it

• Does it follow, therefore, that people who do go to railway to end life

have less detailed knowledge of reality of method? Does it indicate less planning or more?

• Are people more likely to choose method if they don’t find aversive

elements convincing or relevant, or think aversive elements can be

• vercome? i.e.;
• Method not always lethal – you plan carefully to ensure lethality
• Possibility of surviving with injuries - as above
• Possibility of intervention – careful planning incl scouting of location and

taking advice from others on forum about time of day, what to wear, how to act

• Trauma to others – cognitively minimise possible impact on others (by

rationalising that they will get support, get over it, not be too affected)

• Need to be brave / overcome survival instinct - practice overcoming through

exposure, use alcohol &/or drugs

• Would wider availability of knowledge of reality of method act as a

deterrent?

• Online, people well-informed about railway suicide methods generally advise against it
• Does it follow, therefore, that people who do go to railway to end life have less detailed

knowledge of reality of method? Does it indicate less planning or more?

• Are people more likely to choose method if they don’t find aversive elements convincing or

relevant, or think aversive elements can be overcome? i.e.;

• Method not always lethal – you plan carefully to ensure lethality
• Possibility of surviving with injuries - as above
• Possibility of intervention – careful planning incl scouting of location and taking advice from
• thers on forum about time of day, what to wear, how to act
• Trauma to others – cognitively minimise possible impact on others (by rationalising that they

will get support, get over it, not be too affected)

• Need to be brave / overcome survival instinct - practice overcoming through exposure, use

alcohol &/or drugs

• Would wider availability of knowledge of reality of method act as a deterrent?

lostallhope.com/suicide ‘Years later I put together this site. In doing so I researched suicide forums, books, blogs, newsgroups and websites. I am no longer surprised I failed. Because the more I read, the more I see how many ways there are to screw up killing yourself… The people who discuss suicide the most, think about it for the longest time, attempt suicide the most, yet fail suicide most often, are those looking for peaceful and painless methods to go. This site was designed to help people thinking of killing themselves. That help might consist of informing of the dangers of particular methods. And there are, many dangers, in many methods. They aren’t on this site to dishearten you, or

• verwhelm you with information, it is just the facts. A successful, painless suicide takes a

lot of research and preparation. And, if you read as much information as I have, you will realise it does take effort.’

• N

I think it (and internet as a whole) might change the way people suicide. Less stupid ideas, like wrist cutting, more people exploring new peaceful alternatives like SN. Soon the "surface people" will notice.

Key elements of RS prevention

• Procedures at ‘escalated locations’ and involving local communities
• Reducing access to lethal means

RS Prevention (Cont.)

• Comprehensive media strategy and increased understanding of media

influences

• Station and social media announcements

Station atmosphere

Conclusions

Decision-making around methods and locations is an important aspect of the suicidal process

• Important to also understand why and how specific methods/locations disregarded

Implications for prevention

• Challenge unhelpful beliefs and cognitions in therapy/via public health messaging/media

portrayal (?)

Methodological limitations and other challenges

• Unintended consequences?
• Ethics of translation and dissemination

Need more evidence of effectiveness and cost-effectiveness

• Local and global context