Preventing suicide on the railways

[whole diary]

[Tim]

http://news.bbc.co.uk/1/hi/magazine/8456816.stm
A sensitive and interesting report on the issue by the BBC^» (British Broadcasting Corporation - home page).  NR^» (Network Rail - home page) is to be congratulated to their efforts to tackle the issue. 

I was interested to note that the move to selling paracetemols in smaller boxes did lead to fewer suicides.  This was one of the issues raised in a discussion last year http://www.firstgreatwestern.info/coffeeshop/index.php?topic=5479.30

Ollie suggested that "those who want to kill temselves will find a way" which on the face of it is a commonly held and reasonable view, but the evidence seems to suggest otherwise.

[JayMac]

From the BBC^» (British Broadcasting Corporation - home page):

Any suicide is tragic, but the 200 a year that happen on the railways are particularly shocking. The first national strategy in dealing with them hopes to cut the number by a fifth. But can people who want to end their own lives in this way really be helped?

It was morning rush-hour, so the platform was busy and Penny was one of many people waiting for the Edinburgh train.

As the Intercity 125 drew into the station, she jumped in front of it.

"It's strange, but it was as if I went into it," she says, recalling those moments 14 years ago. "It all went black and I remember waking up underneath it.

"It was dark and I thought 'Is this it? Am I dead?' Then I heard a Tannoy and some voices, and I could feel diesel dripping on my face.

"I don't remember anything else, I had passed out and I came round in hospital. But when I did, there was no relief. I thought: 'I can't even do that right.'"

Penny had escaped major injury, apart from five stitches on the back of her head, because she had fallen entirely beneath the train.

Her state of mind that day was divorced from reality, she says. She had a husband she loved, whom she had said goodbye to in the normal way. But work-related stress and the loss of her grandmother had induced her third mental breakdown in 10 years.

"I can see the train coming, clear as day," she says, thinking back to the day she tried to take her life. "But how I got there I don't know. It's almost like I was in a trance.

"I already thought I was dead and I thought I wanted to see my gran. Even talking about it now, I'm thinking it sounds odd."

'No way back'

Unlike other ways that people choose to end their own life, railway suicides endanger and traumatise other people, notably train drivers and railway staff. But to condemn it as "selfish", as some do, annoys Penny, who asked for her real name not to be used.

"They just don't understand. You don't wake up one morning and say: 'Today, I'm going to do that' They are ill. People who choose this method, it's not a cry for help, they've reached the absolute bottom.

"Part of me somewhere thought that it's a sure-fire method. Usually there's no coming back."

For the rail industry, suicides are a commercial headache. Network Rail has to compensate train operating companies for delays and it estimates that suicides cost it ^15m a year in this respect. In partnership with the Samaritans, it has invested ^5m in the country's first national programme in trying to address it.

The money will be spent on a number of measures, including training railway staff in how to spot people on platforms who may be contemplating suicide and how to talk to them.

There will also be guidance to the media about reporting incidents in a way that does not prompt copy-cat attempts. For instance, giving too much information about a victim can lead others to identify with him or her.

"There are about 200 suicides per year on the railways," says Rachel Kirby-Rider of the Samaritans. "But in terms of the cost and emotional impact, it's much higher for suicides on the railways than other forms of suicide, because of the effect on witnesses. All suicides are tragic but some train drivers never go back to work afterwards.

"Many people come across suicides on the railway and get very frustrated because they can't get to their meeting because the train is delayed, but there's a lack of understanding why the person has taken their own life."

More research is needed into why people would choose this method above others, say Ms Kirby-Rider, but the common profile is middle-aged men who are unemployed or struggling financially, she says. And there are more incidents in areas of social deprivation.

She believes that if people thinking about throwing themselves under a train can get to the Samaritans - maybe referred by a vigilant member of rail staff or because a poster on a platform tells them that help is available - then their chances of recovery are greatly increased.

Reducing opportunities for people to take their own life can dissuade them from doing so, she says. Specific measures in prisons and psychiatric services have helped to bring the national suicide rate down, although it increased last year, perhaps due to the economic difficulties.

Limiting the number of aspirins available in a packet to 16, in 1998, led to a fall in fatal overdoses by a fifth in the following year.
 
And according to one study, there was a fall in suicide by car exhaust asphyxiation in all age and gender groups, a trend most marked after 1993, when catalytic converters reduced the toxicity of exhaust fumes. "This shows that measures can be taken," says Ms Kirby-Rider. "What we are planning won't eradicate railway suicides but we are hoping for a 20% reduction in five years."

So why do some people choose to end their life in this way?

Railway suicide is a violent method of choice, especially for younger men, who falsely believe that it is a fast, painless, foolproof way to end one's life, says psychotherapist and counselling psychologist Prof Emmy van Deurzen.

"They often get this wrong idea from media reports or fiction and there is higher incidence of railway suicides after a case has been publicised or fictionalised.

"There is a 10% survival rate of these attempts, which though low, is still considerable, especially since it usually leads to severe and incapacitating injuries."

There is very little research on the motivations and states of mind of those who have not succeeded or those who have contemplated killing themselves in this way, she says.

"The daredevil and violent element of railway suicide may appeal to people who feel desperate about their life, because it conjures up an illusion of control and self assertion.

"Even the idea of having an impact on rail transport and the routines of others may be somewhat appealing and may involve a fantasy of revenge on society.

"Those who have contemplated killing themselves in this way mention awareness of the potential long-term damage to others as a factor in stopping them."

This suggests we need better research, both on people's motivations for choosing this method of suicide and on the reasons for which they ultimately abandon the idea, she says. This would help us providing better support to these people and to prevent more of these catastrophic suicides.
 
Penny's experience shows that people who have hit rock bottom can still fully recover, and she thinks the best way to tackle the problem would be to chip away at the stigma of mental illness, so people would be more likely to seek help.

After being pulled out from under the train, she was diagnosed with bi-polar disorder and spent two months in hospital for her mental illness.

She never returned to her old workplace and the birth of her first child three years later was a major step on the road to recovery. This happy, confident woman bears no resemblance to the figure on the railway platform all those years ago.

"Now I've turned my life around and have two great kids and a happy marriage. I'm horrified now, thinking about it, because I loved my husband and my parents."

[Chris from Nailsea]

I've merged these topics, as they both refer to the same BBC^» (British Broadcasting Corporation - home page) magazine article.  Chris.

[bobm]

According to the BBC^» (British Broadcasting Corporation - home page) the number of suicides is down by over a tenth across the country in the last year.

Not sure there is much evidence of it on FGW^▸ (First Great Western). If anything the national fall must mean there is now an even greater proportion of them on the line from Paddington to Reading.

Rail network suicides 'down 11%'

The number of suicides on Britain's rail network has dropped by 11% in the past year, according to figures from the Rail Safety and Standards Board.

They showed 207 deaths in the year from April 2010, down from 233 in the previous 12 months.

The rail authority said extra training for staff provided by the Samaritans had been a key factor in the reduction.

Last year, Network Rail set a target to reduce the number of suicides by 20% within five years.

"We know that rail staff who have undertaken the Samaritans' training programme have already been able to intervene in potential suicides," said David Higgins, chief executive of Network Rail, who own and operate Britain's rail structure.

"Each suicide is a tragedy for the individuals and families involved, as well as having an inevitable impact on rail staff and passengers."

The ^5m investment in suicide prevention has seen 1,000 staff at 220 locations receive specialist training.

As part of the campaign, Samaritans has interviewed staff members affected by suicides, as well as experts on dealing with trauma.

Rail workers are taught how to identify people potentially at risk, before approaching them and offering emotional support services.

The training also deals with emotional trauma for drivers who have been involved in a death, many of whom suffer from flashbacks and sleeplessness after the incident.

Members of the general public who have witnessed a suicide can also take advantage of help from the Samaritans who offer face-to-face advice and a helpline.

In addition, media companies have been given guidance over how to report suicides in order to prevent copycat deaths.

An awareness campaign has sought to target those typically most prone to suicide attempts.

Nearly 80% of rail suicides involve men, with "working-class men" in their 30s, 40s and 50s statistically most at risk, the Samaritans said.

Prominent advertising and poster campaigns around stations have been aimed at these groups.

"We are pleased to see that, within the first year of delivering the project we already have examples of staff being able to intervene in potentially tragic situations," said Rachel Kirby-Rider, director of fundraising and communications at the Samaritans.

"Whilst the latest railway suicide figures are promising, the next few years could see rising unemployment and an increase in financial worries which may negatively impact on the nation's wellbeing," she said.

"We cannot afford to be complacent and that is why this programme of work shows our commitment to ensuring the figures decline year on year."

[Ollie]

FGW^▸ (First Great Western) and SWT^▸ (South West Trains) have had a fair few just this period alone..

[ChrisB]

So the next set of stats might show a rise, unfortunately.

[JayMac]

From the RSSB^▸ (Rail Safety and Standards Board) (Rail Safety and Standards Board) Community newsletter December 2011.

The rail industry has launched the Joint Suicide Prevention plan (JSSP), drawn up by Network Rail and approved by the National Suicide Prevention Group in September 2011.

It pulls together best practice across the rail network and demonstrates how everyone has a role to play in suicide prevention. It provides a strategic approach for train operators to engage with the partnership and help the overall National Suicide Reduction project achieve its objectives. The document outlines an action plan for how Network Rail, a train operator and Samaritans can work more efficiently to reduce the number of suicides on the Network Rail routes by setting out a minimum number of requirements to which train operators at the highest level will commit.

The plan forms part of the National Suicide Prevention Programme - a five year project, led jointly by Samaritans and Network Rail.

The primary aim of the programme is to reduce suicides on the railways through a range of interventions including communication campaigns, industry staff training, work with the media, community outreach and lobbying for more physical barriers at railway locations. The programme of work is a blend of prevention and post incident initiatives which are taking place across the UK^▸ (United Kingdom) with an overall aim of reducing the number of railway suicides annually by 20% by 2015.

The overall programme has recently scooped a number of awards.
In late September, the joint venture won in the 'Corporate Partnership' category at the Third Sector Excellence Awards. Following this, the Samaritans collaboration with Network Rail was recognised by the transport industry as winners in the 'Best National Partnership' category at the National Transport Awards and then on the 12 October 2011, the partnership received the corporate national partnership of the year award at the Charity Times Awards.

The partnership features a programme of prevention and post-incident activities. This includes:

-Bespoke training of railway industry staff and British Transport Police to identify individuals in distress at railway locations.
-Trauma support training tailored specifically to the needs of those supporting train drivers or others following a suicide, such as Train Driver Managers and ASLEF^» (Associated Society of Locomotive Engineers and Firemen - about) Union Reps.
-Support to rail staff, train crews and members of the public who have witnessed a fatality.
-The development of a local branch call-out service to provide face to face emotional support to people in distress at railway sites.

For more information or if you would like to receive an electronic copy of the template JSSP please contact Ola Rzepczynska, Network Rail Project Officer: o.rzepczynska@samaritans.org

[ChrisB]

Hope the rail industry are putting their hands in their pockets in supporting the Sams work for this.

[JayMac]

I was led to the article on the RSSB^▸ (Rail Safety and Standards Board) website by an item in RAIL issue 686.

Their regular feature, "A day in the life of..." was an interview with an East Midlands Trains driver who had experienced a fatality when someone committed suicide in front of his train.

Following counselling he got involved with the Samaritans and Network Rail's Joint Suicide Prevention Plan.

Sobering reading. 

[BerkshireBugsy]

I was led to the article on the RSSB^▸ (Rail Safety and Standards Board) website by an item in RAIL issue 686.

Their regular feature, "A day in the life of..." was an interview with an East Midlands Trains driver who had experienced a fatality when someone committed suicide in front of his train.

Following counselling he got involved with the Samaritans and Network Rail's Joint Suicide Prevention Plan.

Sobering reading. 

I wish this initiative well and hope that it makes a difference. When I hear of this on the news or experience delays first hand my heart goes out to those affected by such and event.

I can not begin to understand what it must be like for a driver to experience such an incident and commend the East Midlands train driver for taking the initiative he did.

[Chris from Nailsea]

From the Bath Chronicle:

Railway staff in Bath are working with the Samaritans to reduce the number of suicides on the tracks.

Across the country more than 1,000 rail staff have received training on how to identify people who are intending to commit suicide.

The training programme, run by the Samaritans and Network Rail, aims to make staff aware and to reduce railway suicides by 20 per cent over five years.

It also aims to support drivers after a trauma and offer counselling to people intending to commit suicide.

Members of the Bath branch of the charity will be at the station on Wednesday and Saturday for Mental Health Awareness Week.

Network Rail chief executive David Higgins said: "We know that rail staff who have undertaken Samaritans' training programme have already been able to intervene in potential suicides. Each suicide is a tragedy for the individuals and families involved, as well as having an inevitable impact on rail staff and passengers. It is encouraging that the rail industry is pulling together to work with Samaritans who have provided a responsive and professional service to our staff."

The five-year training programme includes helping staff to encourage people away from danger, supporting drivers after a trauma, and looking after witnesses.

[johngreg]

An interesting approach. Funded by Network rail?

[Chris from Nailsea]

Probably - at least partly?  I'm trying to find out more details.

[Ollie]

^5million from NR^» (Network Rail - home page) according to this: http://www.thirdsector.co.uk/news/976000/Samaritans-forges-5m-link-Network-Rail-prevent-railway-suicides/

[Chris from Nailsea]

There you are, then: thanks very much for that confirmation, Ollie!