Rail suicide: A systematic review using systems thinking

This systematic review evaluated rail suicide research against the systems thinking techniques AcciMap & PreventiMap.

Some extracts:

· “In Australia, 67 suicides by train occurred across 2019–20, representing 80 % of all fatalities occurring on the railways”

· “Rail suicide is distinct in that in addition to the person who dies by suicide [and the familiy/friends affected], the event directly involves another person, the train driver”

· “Poor mental health outcomes for drivers are further exacerbated by the fact that, at least in Australia, the use of formal trauma counselling services for train drivers is reportedly rare … and needs around driver psychological support are not always met”

· “52 contributory and demographic/risk factors were identified within 48 of the 65 included articles”

· Many of the demographic factors sat outside of the usual AcciMap structure

· “existing studies have focused on the lower levels of the AcciMap (relating to the environment and the individuals directly involved in events)”

· “no factors were identified at the highest two levels that encompass decisions and actions by governments and regulatory bodies or industry associations. Along with the relatively few relationships between factors identified; these findings suggest that a systems thinking perspective has not yet been applied to understand rail suicide”

· “Further, with the exception of media guidelines, most interventions have been targeted at the lower levels of the system, focused on the design of infrastructure. While the design of the physical environment plays an important role in shaping behaviour in the moment, the fact that higher level interventions were missing suggests that a wider systems approach has yet to gain traction in rail suicide prevention”

· “Rail suicide in a complex issue with significant costs to society and to the rail industry. Therefore, systems thinking approaches are required to better understand and intervene”

· “However, the findings of this review demonstrate that existing approaches have been reductionist, and as a whole the literature has not yet conceptualised the multiple contributory factors influencing rail suicide, nor evaluated a range of systemic interventions”

· “The findings highlight the need for structured systems approaches to gain a more holistic understanding of the problem”

Ref: Read, G. J. M., Elstak, I., Naweed, A., Cox, J. A., Too, L. S., Hermens, D. F., … & Salmon, P. M. (2025). Rail suicide: A systematic review using systems thinking. Safety Science, 187, 106856.