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README.md
austria-suicide-media.pdf
england-historic-suicides.pdf
hong-kong-barriers.pdf
japan-blue-light.pdf
suicide-factors-frequency.pdf
suicide-risk-factors-prevention.pdf
underground-suicides.pdf
who-evidence-based-suicide-prevention.pdf

README.md

Suicide Prevention

This directory contains a number of papers that study the issue of railway suicide. At a high level:

  • There are several factors that predict suicide incidence.

  • There are several factors that have been demonstrated to reduce suicide incidence.

Together these suggest that Caltrain may be able to take steps to reduce the incidence of suicide.

What factors predict suicide?

  • Psychopathy/psychiatric hospitalization. An above average number of victims have a documented psychiatric history.

    One paper suggests train track areas near psychiatric facilities are higher risk areas for suicide. We could map suicides against psych facilities on the Peninsula corridor, and invest in fencing in those areas.

  • Easy access to train tracks: In many cases railway suicide attempts are impulsive and not very well thought out. "24% of the people who made near-lethal suicide attempts took less than 5 min between the decision to kill themselves and the actual attempt, and 70% less than 1 h," according to Miller and Hemenway (2008).

  • Frequency of train service: The more trains that run the more suicides there are. This is a risk factor for electrification, which plans to increase rail frequency.

  • Knowing someone who has committed suicide: there is a contagion effect where one suicide may lead to others; either sensational coverage of a suicide or a community member committing suicide may prompt copy cats.

What are the costs of suicide?

  • Loss of life: Branches of government like the US DOT assign a statistical value between $5 million and $10 million to a single life when evaluating safety improvements. This suggests an investment of $3-4 million in railway safety is a net positive if it saves a single life.

  • Loss of railway service: Train strikes frequently result in death, and trains cannot begin moving again until a coroner can come on site to evaluate the cause of death. This can result in delays of several hours. This results in lost revenue — commuters may choose not to ride the train if the arrival time is unpredictable — and lost productivity from missed meetings, work time and so forth.

  • Employee trauma: The psychological effects of striking people on the railway have not been as well studied, but some drivers experience severe reactions to striking people. This increases the cost of hiring and trauma management.

What measures can prevent suicide?

Highly effective:

  • Platform Screen Doors: Subways in Singapore and Hong Kong saw a significant reduction in suicides - 59% - after installing screen doors at some stations. Suicides did not increase at other stations without screen doors, either, which fits with a characterization that suicide is an impulsive behavior, and deterring people with a suicidal impulse is enough to lower total rates of suicide.

    Tasha Bartholomew suggested that about half of suicides occur in station areas and half do not. The requirement to have freight traffic on the corridor and potential FRA regulations around such may also make platform screen doors a non starter.

  • Media Training: Between 1984 and 1987 there was dramatic coverage of subway suicides in Austria. In 1987 a group developed media guidelines for suicide coverage and the suicide rate promptly dropped by 80%. Suicide rates by other means also declined suggesting no substitution.

    Media coverage is more likely to lead to suicides when:

    • Lurid details about the method are provided

    • The more it's reported as being inconceivable ("he had everything he could have wanted")

    • If it's reported as having a romantic motive

    • If it's on the front page, the word suicide is in the headline, a photo is provided

    These steps can reduce suicide incidence:

    • Telling the audience where to find help, providing background information about suicidal behavior, and what to do with people with suicidal thoughts.

    There are only a few reporters and outlets that cover Caltrain regularly so working with them may pay dividends if we are not already doing it.

Somewhat Effective:

  • Reducing access to the railway more broadly: This can come in many forms besides platform doors - grade separations, more fencing, ticketed station areas, identifying hot spots like mental hospitals and increasing fencing there.

    Several places on the Peninsula are considering grade separation projects - Palo Alto, Burlingame, others - and reducing pedestrian track access should be a key consideration above and beyond grade separating cars and trains.

  • "Suicide pits" (deep channels between rails): Some stations in the London Underground have a pit three feet deep between the rails at stations. This allows people who have second thoughts to duck below the train, and reduce the potential for the train to drag people along with it, and thus the risk further injury. Strikes at stations with pits are less likely to lead to fatalities than stations without them.

    This may be worthwhile to install at new stations such as the Hillsdale station (if it is not already being considered).

Needs More Study:

  • Train design: Fatal pedestrian/car accidents have been on the rise due to Americans buying larger cars with a higher front profile. Similarly, the design of the train engine may make strikes more or less deadly depending on the design. A lower point of impact and a skirt which makes it impossible for a body to go underneath the train may reduce the likelihood of a fatal injury.

    An airbag that was deployed concurrently with the emergency brake could also reduce the impact of a collision. There is not enough research into the effect of these changes, though they may be cheap to implement relative to grade separations or screen doors.

Ineffective:

  • Blue lights: A study in Japan got attention for saying that blue LED lights at station platforms led to a lower number of suicide attempts. A later study found that the effect of blue lights was not measurable.