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Suicidal Behaviour on Subway Systems: A Review of the Epidemiology

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An Erratum to this article was published on 02 October 2007

Abstract

Suicide on subway systems is a public health challenge that has been reported in urban centers worldwide. Our objective was to analyze studies of suicide on subway systems, develop a profile of characteristics that are suggestive of association with suicides or attempts, and show how this profile can inform prevention. A literature review involving epidemiology studies and studies relating to subway suicide was conducted. Twenty-eight studies were included in this review. Across studies, characteristics were not often assessed for risk factor status, although several characteristics were remarkably similar. Those attempting suicide on the subway appear to be affected by serious mental illness and have contact with mental health services before the suicidal behavior. Several characteristics may be shared among this population, emphasizing the potential for prevention in clinical and public health domains. Well-designed studies that utilize robust data collection and statistical methods are needed to establish the risk status associated with these characteristics.

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References

  1. Light Rail Transit Association. A World of trams and urban transit. Available at: http://www.lrta.org/world/worldind.html. Accessed April 3, 2007.

  2. Gershon RRM, Qureshi KA, Barrera MA, Erwin MJ, Goldsmith F. Health and safety hazards associated with subways: a review. J Urban Health. 2005;82:10–20.

    CAS  PubMed  Google Scholar 

  3. Ladwig K, Baumert JJ. Patterns of suicidal behaviour in a metro subway system: a study of 360 cases injured by the Munich subway, 1980–1999. Eur J Public Health. 2004;14:291–295.

    Article  PubMed  Google Scholar 

  4. O’Donnell I, Farmer RD. Suicidal acts on metro systems: an international perspective. Acta Psychiat Scand. 1992;86:60–63.

    Article  PubMed  Google Scholar 

  5. Suicide on railways. Soc Sci Med. 1994;38(3).

  6. Abbott R, Young S, Grant G, Goward P, Seager P, Pugh J. Railway suicide: an investigation of individual and organisational consequences. A Report of the SOVRN (Suicides and Open Verdicts on the Railway Network) Project. Doncaster: Doncaster and South Humber Healthcare NHS Trust; 2003.

    Google Scholar 

  7. Symonds RL. Psychiatric and preventative aspects of rail fatalities. Soc Sci Med. 1994;38:431–435.

    Article  CAS  PubMed  Google Scholar 

  8. Urbanrail.net. About UrbanRail.Net. Available at: http://www.urbanrail.net/about.htm. Accessed April 3, 2007.

  9. Maclean AA, O’Neill AM, Pachter HL, Miglietta MA. Devastating consequences of subway accidents: traumatic amputations. Am Surg. 2006;72:74–76.

    PubMed  Google Scholar 

  10. Guth AA, O’Neill A, Pachter HL, Diflo T. Public health lessons learned from analysis of New York City subway injuries. Am J Public Health. 2006;96:631–633.

    Article  PubMed  Google Scholar 

  11. Etzersdorfer E, Sonneck G. Preventing suicide by influencing mass-media reporting. The Viennese experience 1980–1996. Arch Suicide Res. 1998;4:67–74.

    Google Scholar 

  12. Lester D. Subway suicide rates and national suicide rates. Percept Motor Skill. 1995;80:954.

    CAS  Google Scholar 

  13. O’Donnell I, Farmer RD. The limitations of official suicide statistics. Brit J Psychiat. 1995;166:458–461.

    Article  PubMed  Google Scholar 

  14. Clarke RV, Poyner B. Preventing suicide on the London Underground. Soc Sci Med. 1994;38:443–446.

    Article  CAS  PubMed  Google Scholar 

  15. O’Donnell I, Farmer R, Tranah T. Editorial/introduction. Soc Sci Med. 1994;38:399–400.

    Article  Google Scholar 

  16. O’Donnell I, Farmer R, Catalan J. Suicide notes. Brit J Psychiat. 1993;163:45–48.

    Article  PubMed  Google Scholar 

  17. Etzersdorfer E, Sonneck G, Nagel-Kuess S. Newspaper reports and suicide. N Engl J Med. 1992;327:502–503.

    Article  CAS  PubMed  Google Scholar 

  18. O’Donnell I, Catalan J, Farmer RD. Suicidal behaviour and HIV disease: a case report. Couns Psychol Quart. 1992;5:411–415.

    Article  Google Scholar 

  19. Berman AL. Suicide and mass urban transit. Suicide Life Threat Behav. 1991;21:204–211.

    CAS  PubMed  Google Scholar 

  20. Littman SK. Suicide epidemics and newspaper reporting. Suicide Life Threat Behav. 1985;15:43–50.

    Google Scholar 

  21. Chowdhury AN, Dutta S, Chowdhury S. Eco-psychiatry: suicidal behaviour at Calcutta metro rail: A prospective study. Int Med J. 2000;7:27–32.

    Google Scholar 

  22. Coats TJ, Walter DP. Effect of station design on death in the London underground: observational study. BMJ. 1999;319:957.

    CAS  PubMed  Google Scholar 

  23. Farmer R, O’Donnell I, Tranah T. Suicide on the London Underground System. Int J Epidemiol. 1991;20:707–711.

    Article  CAS  PubMed  Google Scholar 

  24. Gaylord MS, Lester D. Suicide in the Hong Kong subway. Soc Sci Med. 1994;38:427–430.

    Article  CAS  PubMed  Google Scholar 

  25. Johnston DW, Waddell JP. Death and injury patterns, Toronto Subway System 1954–1980. J Trauma. 1984;24:619–622.

    Article  CAS  PubMed  Google Scholar 

  26. Mishara BL. Suicide in the Montreal subway system: characteristics of the victims, antecedents, and implications for prevention. Can J Psychiat. 1999;44:690–696.

    CAS  Google Scholar 

  27. O’Donnell I, Farmer RD. The epidemiology of suicide on the London Underground. Soc Sci Med. 1994;38:409–418.

    Article  PubMed  Google Scholar 

  28. Sonneck G, Etzersdorfer E, Nagel-Kuess S. Imitative suicide on the Viennese subway. Soc Sci Med. 1994;38:453–457.

    Article  CAS  PubMed  Google Scholar 

  29. Cocks RA. Study of 100 patients injured by London underground trains 1981-6. BMJ. 1987;295:1527–1529.

    Article  CAS  PubMed  Google Scholar 

  30. Kraemer HC, Kazdin AE, Offord DR, Kessler RC, Jensen PS, Kupfer DJ. Coming to terms with the terms of risk. Arch Gen Psychiat. 1997;54:337–343.

    CAS  PubMed  Google Scholar 

  31. Guggenheim FG, Weisman AD. Suicide in the subway: psychodynamic aspects. Suicide Life Threat Behav. 1974;4:43–53.

    CAS  Google Scholar 

  32. Rabban J, Adler J, Rosen C, Blair J, Sheridan R. Electrical injury from subway third rails: serious injury associated with intermediate voltage contact. Burns. 1997;23:515–518.

    Article  CAS  PubMed  Google Scholar 

  33. O’Donnell I, Farmer R, Catalan J. Explaining suicide: the views of survivors of serious suicide attempts. Brit J Psychiat. 1996;168:780–786.

    Article  PubMed  Google Scholar 

  34. World Health Organization. Suicide Rates (per 100,000), by country, year, and sex: most recent year available. As of June 2004. Available at: http://www.who.int/mental_health/prevention/suicide/en/Figures_web0604_table.pdf. Accessed April 3, 2007.

  35. O’Donnell I, Arthur AJ, Farmer RD. A follow-up study of attempted railway suicides. Soc Sci Med. 1994;38:437–442.

    Article  PubMed  Google Scholar 

  36. Guggenheim FG, Weisman AD. Suicide in the subway: publicly witnessed attempts of 50 cases. J Nerv Ment Dis. 1972;155:404–409.

    Article  CAS  Google Scholar 

  37. Denning DG, Conwell Y, King D, Cox C. Method choice, intent, and gender in completed suicide. Suicide Life Threat Behav. 2000;30:282–288.

    CAS  PubMed  Google Scholar 

  38. Cina SJ, Koelpin JL, Nichols CA, Conradi SE. A Decade of train-pedestrian fatalities: the Charleston experience. J Forensic Sci. 1994;39:668–673.

    CAS  PubMed  Google Scholar 

  39. Strauch H, Wirth I, Geserick G. Fatal accidents due to train surfing in Berlin. Forensic Sci Int. 1998;94:119–127.

    Article  CAS  PubMed  Google Scholar 

  40. Toronto Transit Commission. 2005 Operating Statistics. Available at: http://www.toronto.ca/ttc/pdf/operatingstatistics2005.pdf. Accessed April 3, 2007.

  41. Hawton K, Williams K. Influences of the media on suicide. BMJ. 2002;325:1374–1375.

    Article  PubMed  Google Scholar 

  42. Unknown. Platform Screen Doors. Available at: http://mic-ro.com/metro/platform-screen-doors.html. Accessed April 3, 2007.

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Acknowledgements

This project was carried out as part of a contractual agreement between the Toronto Transit Commission and St. Michael’s Hospital, Toronto, Canada. Rahel Eynan was employed under this contractual agreement to complete this research and an evaluation of a suicide prevention initiative. The review was adapted from Ruwan Ratnayake’s report that was written while he was a graduate student at the Johns Hopkins Bloomberg School of Public Health.

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Authors and Affiliations

  1. Suicide Studies Unit, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Ruwan Ratnayake & Rahel Eynan

  2. Arthur Sommer Rotenberg Suicide Studies, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Paul S. Links

  3. Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Rahel Eynan

Authors
  1. Ruwan Ratnayake
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  2. Paul S. Links
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  3. Rahel Eynan
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Corresponding author

Correspondence to Ruwan Ratnayake.

Additional information

Ratnayake and Eynan are with the Suicide Studies Unit, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Links is with the Arthur Sommer Rotenberg Suicide Studies, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Eynan is with the Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

An erratum to this article can be found at http://dx.doi.org/10.1007/s11524-007-9227-x

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Ratnayake, R., Links, P.S. & Eynan, R. Suicidal Behaviour on Subway Systems: A Review of the Epidemiology. J Urban Health 84, 766–781 (2007). https://doi.org/10.1007/s11524-007-9211-5

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  • DOI: https://doi.org/10.1007/s11524-007-9211-5

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