This study aims to simultaneously examine individual- and community-level factors associated with railway suicide.
We performed a case–control study in Victoria, Australia between 2001 and 2012. Data on cases of railway suicide were obtained from the National Coronial Information System (a database of coronial investigations). Controls were living individuals randomly selected from the Household, Income and Labour Dynamics in Australia study, matching to cases on age groups, sex and year of exposures. A conditional logistic regression model was used to assess the individual-level and community-level influences on individual odds of railway suicide, controlling for socioeconomic status.
Individual-level diagnosed mental illness increased railway suicide odds by six times [95 % confidence interval (CI) 4.5, 9.2]. Community-level factors such as living in an area with a presence of railway tracks [odds ratio (OR) 1.8, 95 % CI 1.2, 2.8], within a city (OR 3.2, 95 % CI 1.9, 5.4), and with a higher overall suicide rate (OR 1.02, 95 % CI 1.01, 1.04) were independently associated with greater individual odds of railway suicide compared to living in an area without a presence of railway tracks, outside a city, and with a relatively lower overall suicide rate.
The effects of mental illness and high incidence of overall suicides are prominent, but not specific on railway suicide. The effects of presence of railway tracks and city residence suggest the importance of accessibility to the railways for individual risk of railway suicide. Prevention efforts should focus on vulnerable people live in areas with easy access to the railways.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Krysinska K, De Leo D (2008) Suicide on railway networks: epidemiology, risk factors and prevention. Aust N Z J Psychiatry 42:763–771. doi:10.1080/00048670802277255
van Houwelingen CAJ, Kerkhof AJFM (2008) Mental healthcare status and psychiatric diagnoses of train suicides. J Affect Disord 107:281–284. doi:10.1016/j.jad.2007.08.024
Van Houwelingen CAJ, Kerkhof AJFM, Beersma DGM (2010) Train suicides in The Netherlands. J Affect Disord 127:281–286. doi:10.1016/j.jad.2010.06.005
Debbaut K, Krysinska K, Andriessen K (2014) Characteristics of suicide hotspots on the Belgian railway network. Int J Inj Contr Saf Promot 21:274–277. doi:10.1080/17457300.2013.825630
Andriessen K, Krysinska K (2012) Railway suicide in Belgium 1998–2009: incidence and prevention. Crisis 33:39–45. doi:10.1027/0227-5910/a000105
Too LS, Milner A, Bugeja L, McClure R (2014) The socio-environmental determinants of railway suicide: a systematic review. BMC Public Health 14:1–10. doi:10.1186/1471-2458-14-20
Uittenbogaard A, Ceccato V (2015) Temporal and spatial patterns of suicides in Stockholm’s subway stations. Accid Anal Prev 81:96–106. doi:10.1016/j.aap.2015.03.043
Ladwig KH, Kunrath S, Lukaschek K, Baumert J (2012) The railway suicide death of a famous German football player: impact on the subsequent frequency of railway suicide acts in Germany. J Affect Disord 136:194–198. doi:10.1016/j.jad.2011.09.044
Hegerl U, Koburger N, Rummel-Kluge C, Gravert C, Walden M, Mergl R (2013) One followed by many? Long-term effects of a celebrity suicide on the number of suicidal acts on the German railway net. J Affect Disord 146:39–44. doi:10.1016/j.jad.2012.08.032
Too LS, Spittal MJ, Bugeja L, Milner A, Stevenson M, McClure R (2015) An investigation of neighborhood-level social, economic and physical factors for railway suicide in Victoria, Australia. J Affect Disord 183:142–148. doi:10.1016/j.jad.2015.05.006
Wilkins R (2012) Families, incomes and jobs, volume 8: a statistical report on waves 1–10 of the household, income and labour dynamics in Australia survey. Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Melbourne
Rothman KJ, Greenland S, Lash TL (2008) Modern epidemiology, 3rd edn. Wolters Kluwer Health, Philadelphia
Wachoider S, Silverman DT, McLaughlin JK, Mandel JS (1992) Selection of controls in case–control studies. Am J Epidemiol 135:1042–1050
Cavanagh JTO, Carson AJ, Sharpe M, Lawrie SM (2003) Psychological autopsy studies of suicide: a systematic review. Psychol Med 33:395–405
Rumpf H-J, Meyer C, Hapkeb U, Johnb U (2001) Screening for mental health: validity of the MHI-5 using DSM-IV Axis I psychiatric disorders as gold standard. Psychiatry Res 105:243–253
Rose S, van der Laan MJ (2009) Why match? Investigating matched case–control study designs with causal effect estimation. Int J Biostat 5:1. doi:10.2202/1557-4679.1127
Robertson C, Boyle P, Hsieh CC, Macfarlane GJ, Maisonneuve P (1994) Some statistical considerations in the analysis of case–control studies when the exposure variables are continuous measurements. Epidemiology 5:164–170
Steer Davies Gleave (2011) The value of station investment: research on regenerative impacts. Network Rail, London
Diez-Roux AV (2000) Multilevel analysis in public health research. Annu Rev Public Health 21:171–192
Australian Bureau of Statistics (2007) Information paper: external causes of death, data quality, 2005. Cat. no. 3317.0.55.001. Australian Bureau of Statistics, Canberra
Watson N, Wooden M (2006) Modelling longitudinal survey response: the experience of the HILDA survey, HILDA Project Discussion Paper Series No. 2/06. Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne
Mishara BL (1999) Suicide in the Montreal subway system: characteristics of the victims, antecedents, and implications for prevention. Can J Psychiatr 44:690–696
World Health Organization (2014) Preventing suicide: a global imperative. World Health Organization, Geneva
Yip PSF, Caine E, Yousuf S, Chang S-S, Wu KC-C, Chen Y-Y (2012) Means restriction for suicide prevention. Lancet 379:2393–2399. doi:10.1016/S0140-6736(12)60521-236
Thomas K, Chang SS, Gunnell D (2011) Suicide epidemics: the impact of newly emerging methods on overall suicide rates—a time trends study. BMC Public Health 11:314. doi:10.1186/1471-2458-11-314
Berman AL, Sundararaman R, Price A, Au JS (2014) Suicide on railroad rights-of-way: a psychological autopsy study. Suicide Life Threat Behav 44:710–722. doi:10.1111/sltb.12107
Miller M, Warren M, Hemenway D, Azrael D (2015) Firearms and suicide in US cities. Inj Prev 21:e116–e119. doi:10.1136/injuryprev-2013-040969
Pirkis J, Too LS, Spittal MJ, Krysinska K, Robinson J, Cheung YTD (2015) Interventions to reduce suicides at suicide hotspots: a systematic review and meta-analysis. Lancet Psychiatry. doi:10.1016/S2215-0366(15)00266-7
Ueda M, Sawada Y, Matsubayashi T (2015) The effectiveness of installing physical barriers for preventing railway suicides and accidents: evidence from Japan. J Affect Disord 178:1–4. doi:10.1016/j.jad.2015.02.017
Law CK, Yip PSF, Chan WSC, Fu KW, Wong PWC, Law YW (2009) Evaluating the effectiveness of barrier installation for preventing railway suicides in Hong Kong. J Affect Disord 114:254–262. doi:10.1016/j.jad.2008.07.021
Rådbo H, Andersson R (2012) Patterns of suicide and other trespassing fatalities on state-owned railways in greater Stockholm; implications for prevention. Int J Environ Res Public Health 9:772–780. doi:10.3390/ijerph9030772
Cheng Q, Li H, Silenzio V, Caine ED (2014) Suicide contagion: a systematic review of definitions and research utility. PLoS One 9:e108724. doi:10.1371/journal.pone.0108724
Haw C, Hawton K, Niedzwiedz C, Platt S (2013) Suicide clusters: a review of risk factors and mechanisms. Suicide Life Threat Behav 43:97–108. doi:10.1111/j.1943-278X.2012.00130.x
Pirkola S, Sund R, Sailas E, Wahlbeck K (2009) Community mental-health services and suicide rate in Finland: a nationwide small-area analysis. Lancet 373:147–153. doi:10.1016/S0140-6736(08)61848-6
Kapur N (2009) Health services and suicide prevention. J Ment Health 18:1–5. doi:10.1080/09638230802370704
The authors acknowledge the Department of Justice and Regulation for granting access to the National Coronial Information System, the Coroners Court of Victoria for providing us railway suicide data for cross-referencing, and Ms Nadia Polikarpowski (NCIS Coder at the Coroners Court of Victoria) for her assistance in data collection. We also thank the Victorian railway regulators and operators (from the Department of Transport, Planning and Local Infrastructure, Public Transport Victoria, Victrack, Metro trains, V/Line, Australian Rail Track Corporation and Transport Safety Victoria), HILDA, the Australian Bureau of Statistic, Victorian Commission for Gambling and Liquor Regulation and the Victoria Police for providing data. This study used unit record data from the HILDA Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the author and should not be attributed to either FaHCSIA or the Melbourne Institute.
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the Health Sciences Human Ethics Committee (the University of Melbourne) and the Justice Human Research Ethics Committee (State Government Victoria) and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Too, L.S., Spittal, M.J., Bugeja, L. et al. Individual and community factors for railway suicide: a matched case–control study in Victoria, Australia. Soc Psychiatry Psychiatr Epidemiol 51, 849–856 (2016). https://doi.org/10.1007/s00127-016-1212-9
- Mental health