Characteristics and circumstances of rail suicides in England 2019-2021: A cluster analysis and autopsy study.

BACKGROUND: Around 4 % of all suicide deaths in Great Britain occur on the railways. This exploratory study was designed to increase understanding of the individuals that take their lives in this way, and the circumstances of their death. METHOD: Data were obtained from fatality investigation files compiled by the British Transport Police (BTP) relating to suspected suicides on the mainline railway in England from April 2019 to March 2021. Cluster analysis was carried out to identify grouped associations of characteristics and circumstances relating to rail suicide. RESULTS: A total of 436 files were analysed, representing 93 % of all suspected railway suicides during this period. Cluster analysis identified four groups of almost equal size, distinguished principally by age, living arrangements, employment status and location of death. The study is novel in the way it integrates individual characteristics and circumstances of death. The identified clusters may provide a multidimensional way of conceptualising suicide risk that could inform more targeted interventions at rail locations. LIMITATIONS: A high proportion of missing data means that the findings need to be interpreted with caution. It also restricted the multivariate analysis to those categories of information for which sufficient information was available. CONCLUSION: The characteristics and circumstances of suicide deaths on the railways are complex and multifaceted. The typology identified in this study may help to target preventative strategies prior to the incident as well as at different location types.

Patterns and motivations for method choices in suicidal thoughts and behaviour: qualitative content analysis of a large online survey.

BACKGROUND: Choice of suicide method can strongly influence the outcome of suicidal behaviour, and is an important aspect of the process and planning involved in a suicide attempt. Yet, the reasons why individuals consider, choose or discard particular methods are not well understood. AIMS: This is the first study to explore method choices among people with a history of suicidal behaviour and individuals who have experienced, but not enacted, suicidal thoughts. METHOD: Via an online survey, we gathered open-ended data about choice of methods in relation to suicidal thoughts and behaviours, including reasons for and against specific means of harm. RESULTS: A total of 712 respondents had attempted suicide, and a further 686 experienced suicidal thoughts (but not acted on them). Self-poisoning was the most commonly contemplated and used method of suicide, but most respondents had considered multiple methods. Method choices when contemplating suicide included a broader range of means than those used in actual attempts, and more unusual methods, particularly if perceived to be lethal, 'easy', quick, accessible and/or painless. Methods used in suicide attempts were, above all, described as having been accessible at the time, and were more commonly said to have been chosen impulsively. Key deterrents against the use of specific methods were the presence of and impact on other people, especially loved ones, and fears of injury and survival. CONCLUSIONS: Exploration of method choices can offer novel insights into the transition from suicidal ideation to behaviour. Results underscore the need for preventative measures to restrict access to means and delay impulsive behaviour.

Factors deterring and prompting the decision to attempt suicide on the railway networks: findings from 353 online surveys and 34 semi-structured interviews.

BACKGROUND: There is a suicide on the British railways every 36 hours. However, the reasons why people choose to die by train are not well understood.AimsTo explore factors influencing and discouraging the decision to attempt suicide on the railway networks. METHOD: We conducted an online survey and qualitative interviews with individuals who had contemplated or attempted suicide by train. RESULTS: A total of 353 survey responders had considered and 23 had attempted suicide at rail locations (including railways and metro/underground); a third of these cases were impulsive. The most frequently reported motivations for contemplating or attempting suicide were perceptions of quick and certain lethality (54 and 37%, respectively) and easy access to rail settings (33 and 38%, respectively). The main factor discouraging people from rail suicide was its wider impact, especially on train drivers (19%). In qualitative interviews (N = 34) the desire to avoid intervention from others was also a common motivating factor for attempting suicide on the railway networks. CONCLUSIONS: People attempt suicide by train because railway settings are easy to access and because of an inaccurate perception of certain and quick lethality. Tackling exaggerated perceptions of lethality may help reduce suicides by train.Declaration of interestNone.

Behaviours preceding suicides at railway and underground locations: a multimethodological qualitative approach.

OBJECTIVES: Suicides by train have devastating consequences for families, the rail industry, staff dealing with the aftermath of such incidents and potential witnesses. To reduce suicides and suicide attempts by rail, it is important to learn how safe interventions can be made. However, very little is known about how to identify someone who may be about to make a suicide attempt at a railway location (including underground/subways). The current research employed a novel way of understanding what behaviours might immediately precede a suicide or suicide attempt at these locations. DESIGN AND METHODS: A qualitative thematic approach was used for three parallel studies. Data were gathered from several sources, including interviews with individuals who survived a rail suicide attempt (n=9), CCTV footage of individuals who died by rail suicide (n=16) and qualitative survey data providing views from rail staff (n=79). RESULTS: Our research suggests that there are several behaviours that people may carry out before a suicide or suicide attempt at a rail location, including station hopping and platform switching, limiting contact with others, positioning themselves at the end of the track where the train/tube approaches, allowing trains to pass by and carrying out repetitive behaviours. CONCLUSIONS: There are several behaviours that may be identifiable in the moments leading up to a suicide or suicide attempt on the railways which may present opportunities for intervention. These findings have implications for several stakeholders, including rail providers, transport police and other organisations focused on suicide prevention.

SensePath: Understanding the Sensemaking Process Through Analytic Provenance.

Sensemaking is described as the process of comprehension, finding meaning and gaining insight from information, producing new knowledge and informing further action. Understanding the sensemaking process allows building effective visual analytics tools to make sense of large and complex datasets. Currently, it is often a manual and time-consuming undertaking to comprehend this: researchers collect observation data, transcribe screen capture videos and think-aloud recordings, identify recurring patterns, and eventually abstract the sensemaking process into a general model. In this paper, we propose a general approach to facilitate such a qualitative analysis process, and introduce a prototype, SensePath, to demonstrate the application of this approach with a focus on browser-based online sensemaking. The approach is based on a study of a number of qualitative research sessions including observations of users performing sensemaking tasks and post hoc analyses to uncover their sensemaking processes. Based on the study results and a follow-up participatory design session with HCI researchers, we decided to focus on the transcription and coding stages of thematic analysis. SensePath automatically captures user's sensemaking actions, i.e., analytic provenance, and provides multi-linked views to support their further analysis. A number of other requirements elicited from the design session are also implemented in SensePath, such as easy integration with existing qualitative analysis workflow and non-intrusive for participants. The tool was used by an experienced HCI researcher to analyze two sensemaking sessions. The researcher found the tool intuitive and considerably reduced analysis time, allowing better understanding of the sensemaking process.

The application of mHealth to mental health: opportunities and challenges.

Advances in smartphones and wearable biosensors enable real-time psychological, behavioural, and physiological data to be gathered in increasingly precise and unobtrusive ways. Thus, moment-to-moment information about an individual's moods, cognitions, and activities can be collected, in addition to automated data about their whereabouts, behaviour, and physiological states. In this report, we discuss the potential of these new mobile digital technologies to transform mental health research and clinical practice. By drawing on results from the INSIGHT research project, we show how traditional boundaries between research and clinical practice are becoming increasingly blurred and how, in turn, this is leading to exciting new developments in the assessment and management of common mental disorders. Furthermore, we discuss the potential risks and key challenges associated with applying mobile technology to mental health.