Predictors of using trains as a suicide method: Findings from Victoria, Australia
Introduction
In Australia, hanging, poisoning by carbon monoxide, and poisoning by other substances are the most frequently used methods of suicide (Australian Bureau of Statistics, 2014). However, there is variation in the choice of suicide method used across Australia's eight states and territories. For instance, Victoria has the largest proportion of suicides by jumping in front of a train, in the Northern Territory hanging is more common, and in Western Australia poisoning by carbon monoxide is particular prevalent. The current study focused on suicide by train in Victoria, which accounted for approximately 7% of all suicides in the state (Australian Bureau of Statistics, 2014). This proportion was relatively moderate compared to the global proportion of suicide by train which range from 1% to 12% of all suicides (Krysinska and De Leo, 2008, Taylor et al., 2016).
Suicides by train are highly distressing for train drivers and witnesses (Bardon and Mishara, 2015). They can also cause economic losses through the disruption of train services, driver absenteeism, and counseling required for affected individuals (Lukaschek et al., 2011, Mehnert et al., 2012, Silla et al., 2012). Although suicides by train are a prominent problem within the railway sector, there is limited understanding of the factors associated with an individual's decision to use a train as a method of suicide (as opposed to other methods). One study interviewed railway suicide survivors and found that nearly half chose trains because they knew of someone else who used this method (O'Donnell et al., 1996). The same study found that some survivors also perceived this method as quick, highly lethal, easily accessible and/or widely available. Another study interviewed nine railway suicide survivors and found that the view that jumping in front of a train has a high chance of dying and easy access to trains were their main reasons for choosing trains (Chowdhury et al., 2000). This second point is consistent with a large body of work showing that suicide by particular means is closely linked with the availability of that means (Ajdacic-Gross et al., 2008, Thomas et al., 2011, Yip et al., 2012).
Previous studies comparing suicides by train with suicides by other means have shown, in general, that suicides by train do not differ from suicides by other means in terms of gender, mental health, adverse life events, and socioeconomic status (Emmerson and Cantor, 1993, Silla and Luoma, 2012). However, in one study, nearly 40% of those who died by rail suicide were found to have some kind of connection with rail (e.g. living close to a railway line, past experience trespassing on rail tracks); whereas, only 7% suicides by other means had that same relationship (Abbot et al., 2003). There is also evidence that people who died by rail suicide were younger than those who used other suicide means (Emmerson and Cantor, 1993, Silla and Luoma, 2012). Mental health inpatients were more likely to use trains while outpatients were more likely to poison themselves to end their own lives (Huisman et al., 2010). Existing literature on suicides by train showed that the majority of the victims were male, young, never married or single, unemployed or not in the labour force, and have been diagnosed with a mental illness and admitted for mental health care (Mishara, 2007, Ratnayake et al., 2007, Krysinska and De Leo, 2008, van Houwelingen and Kerkhof, 2008).
Beyond this much remains largely unknown about why some people choose trains over other methods of suicide. Based on the findings from previous research, we hypothesized that people who died of suicide by train would be different from those who died of suicide by other means on several factors. Those who died of suicide by train would be younger, never married or single, unemployed or not in the labour force, and have a history of mental illness and mental health hospitalisation. We also hypothesized that these people would have easier access to trains. It is less clear what the association would be for other factors.
Section snippets
Study setting and design
Victoria is the second largest state in Australia. It has a population of approximately 5.7 million people. Most Victorians live in Melbourne, the state's capital with a population of 4.1 million. Melbourne is serviced by a metropolitan railway network consisting of 16 railway lines with 230 railway stations. Seventy percent of people from Melbourne who travel to work by public transport use train services (Bureau of Infrastructure Transport and Regional Economic, 2012). The railway tracks are
Demographic characteristics
During the study period, we identified 105 suicides by train (5%) and 1856 suicides by other methods (95%). Among suicides by train, 66% were by males and 34% by females, with a mean age of 37 years [standard deviation (SD) = 16 years]. Of those suicides by other methods, 77% were males and the mean age was 46 years (SD =18 years).
Factors associated with choice of method
In univariate analyses, the individual-level variables that were associated with the likelihood of choosing trains over other methods were age, sex and marital status
Main findings
We found that being never married was a key predictor of choosing trains over other suicide methods, while living in an area with high proportion of people who use train for commuting to work was an important neighbourhood factor associated with the choice of trains. Contrary to our hypothesis, age, sex, employment status, mental health-related variables, history of previous attempt, alcohol consumption, social and environmental variables, and other train-related variables (e.g. easy access to
Authors’ contributions
All authors participated in the design of the study. LST collected data with support from LB. LST performed the statistical analyses with input from MJS, AM and RM. LST prepared the first draft of the paper. All authors revised the draft and contributed to the final version of manuscript.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of interest
None.
Ethical approval
This study received full ethical approval from the Health Sciences Human Ethics Committee (the University of Melbourne) and the Justice Human Research Ethics Committee (State Government Victoria).
Acknowledgements
The authors would like to thank the Department of Justice and Regulation for granting access to the National Coronial Information System, the Coroners Court of Victoria for cross-referencing railway suicide data, 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 & Local Infrastructure, Public Transport Victoria, Victrack, Metro
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