Predictors of Suicide and Suicide Attempt in Subway Stations: A Population-based Ecological Study

Abstract

Suicidal behavior on the subway often involves young people and has a considerable impact on public life, but little is known about factors associated with suicides and suicide attempts in specific subway stations. Between 1979 and 2009, 185 suicides and 107 suicide attempts occurred on the subway in Vienna, Austria. Station-specific suicide and suicide attempt rates (defined as the frequency of suicidal incidents per time period) were modeled as the outcome variables in bivariate and multivariate Poisson regression models. Structural station characteristics (presence of a surveillance unit, train types used, and construction on street level versus other construction), contextual station characteristics (neighborhood to historical sites, size of the catchment area, and in operation during time period of extensive media reporting on subway suicides), and passenger-based characteristics (number of passengers getting on the trains per day, use as meeting point by drug users, and socioeconomic status of the population in the catchment area) were used as the explanatory variables. In the multivariate analyses, subway suicides increased when stations were served by the faster train type. Subway suicide attempts increased with the daily number of passengers getting on the trains and with the stations' use as meeting points by drug users. The findings indicate that there are some differences between subway suicides and suicide attempts. Completed suicides seem to vary most with train type used. Suicide attempts seem to depend mostly on passenger-based characteristics, specifically on the station's crowdedness and on its use as meeting point by drug users. Suicide-preventive interventions should concentrate on crowded stations and on stations frequented by risk groups.

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

“…In the multivariate model, station density was the factor with the strongest effect. This supports the finding in Vienna, where positive association between the number of station and railway suicide was reported (Niederkrotenthaler et al, 2012). The current findings also strengthen the evidence for the relationships of an elevated rate of railway suicide with higher train frequency and higher passenger volume (Too et al, 2014).…”

“…The current findings also strengthen the evidence for the relationships of an elevated rate of railway suicide with higher train frequency and higher passenger volume (Too et al, 2014). However, contrary to the previous results (Niederkrotenthaler et al, 2012), our adjusted model showed that an increased number of video surveillance systems at stations and carparks was associated with a reduced risk of railway suicide.…”

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

“…Video surveillance and CCTV systems to facilitate the intervention of security staff at stations may increase the difficulties for suicide attempters to complete the act (Lindberg, 2012;Ratnayake et al, 2007). This is supported by Niederkrotenthaler et al (2012) who have shown that the presence of a surveillance unit at stations is associated with a decrease of suicidal behaviours (see Table 5 for details). In addition, the mere presence of human personnel at stations is believed to be a deterrent in itself: station staffing and the presence of human personnel at stations may discourage suicide (Clarke and Poyner, 1994), but also trespass (RSSB, 2005).…”

“…Organisations or industries can identify the risk of suicide associated with particular groups or individuals: patients in services that are located near railways (Bhui et al, 2013), patients with affective and psychotic disorders (van Houwelingen and Kerkhof, 2008), drug users in subway stations (Niederkrotenthaler et al, 2012), or the causes of suicide in different age groups (Routley et al, 2004). Other risk assessment recommendations include the identification and monitoring of regional and local suicide hotspots (Brown et al, 2012;Debbaut et al, 2013;Erazo et al, 2004a) and station audits (RSSB, 2013).…”

“…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.…”