Interventions to reduce suicides at suicide hotspots: a systematic review

Abstract

Background‘Suicide hotspots’ include tall structures (for example, bridges and cliffs), railway tracks, and isolated locations (for example, rural car parks) which offer direct means for suicide or seclusion that prevents intervention.MethodsWe searched Medline for studies that could inform the following question: ‘What interventions are available to reduce suicides at hotspots, and are they effective?’ResultsThere are four main approaches: (a) restricting access to means (through installation of physical barriers); (b) encouraging help-seeking (by placement of signs and telephones); (c) increasing the likelihood of intervention by a third party (through surveillance and staff training); and (d) encouraging responsible media reporting of suicide (through guidelines for journalists). There is relatively strong evidence that reducing access to means can avert suicides at hotspots without substitution effects. The evidence is weaker for the other approaches, although they show promise.ConclusionsMore well-designed intervention studies are needed to strengthen this evidence base.

An investigation of neighborhood-level social, economic and physical factors for railway suicide in Victoria, Australia

“…Relevant interventions for which there is some evidence of effectiveness include increasing surveillance or installing fencing along railway tracks within highrisk neighborhoods (Cox et al, 2013). We would encourage healthcare professionals, police officers and other gatekeepers who work in these areas to be aware of a heightened risk for railway suicide in vulnerable people they are dealing with.…”

A systematic review of the literature on safety measures to prevent railway suicides and trespassing accidents

“…Beskow et al, 1994;Cox et al, 2013;Daigle, 2005;Etzersdorfer and Sonneck, 1998;Hepp et al, 2012;Holdaway et al, 2012;Leenaars, 2005;Mishara, 2007;Niederkrotenthaler et al, 2009Niederkrotenthaler et al, , 2012Sarchiapone et al, 2011;Sonneck et al, 1994;Sisask and Värnik, 2012;Stack, 2005;Too et al, 2014;Yip et al, 2012). The main goal of this measure is to provide mass media with guidelines and tips on how to adequately report suicides in order to avoid a copycat effect.…”

Work-related posttraumatic stress disorder (PTSD) and other emotional diseases as consequence of traumatic events in public transportation: a systematic review

“…This fact is particularly remarkable since in the context of the prevention of accidents and railway suicides, science and industry cooperate very closely (Cox et al 2013;Matsubayashi et al 2013). At best, it is mentioned that drivers might be affected by the events, but with very rare exceptions (e.g., Mishara 2007; Krysinska and de Leo 2008), this issue is hardly treated more thoroughly.…”