Health, Social Care and Sport Committee’s inquiry into Suicide Prevention

Written evidence submitted on behalf of Network Rail and the rail industry

1.    Introduction

1.1 Network Rail runs, maintains and develops Britain's railway infrastructure. We also manage 18 stations and there are 22,000 miles of track with 32,000 bridges and tunnels. We have circa 4.5 million people who travel on the rail network each day.

1.2             There are 28 different Train Operating Companies (TOC’s) who run trains on the railway system of Great Britain, 23 of them are passenger and 5 are freight. 

1.3 The award winning and publicly acknowledged work of Network Rail and the rail industry has made us world leaders in the area of suicide prevention on railway networks.  We contribute significant amounts of time to support Government initiatives work with other industries and sectors to more broadly spread the suicide prevention message and lecture around the world to other railway administrations in an effort to not only reduce the number of suicides on the railway, but  in the community at large.

1.4 We feel this inquiry provides us with the opportunity to highlight the award winning and ground breaking work we do in relation to Suicide Prevention.

2.    Key facts and figures

2.180% of people who die by suicide on the rail network are men

 

2.2Men are three and a half times more likely to take their own lives than women

 

2.3Those from the most deprived areas are ten times more likely to take their own lives than those from the most affluent areas.  Men from deprived social groups are at the highest risk of all

 

2.4In 2016-17 85 people or one in four who attempted to take their live survived. Most were left with life changing injuries.

      3.   Impact of suicide

3.1 Each suicide on the network causes on average 2,200 minutes of delay and costs £230,000. The annual cost of suicide to the rail industry in 2016-17 was circa £54 million.

3.2 The trauma experienced by staff involved in or witness a suicide may mean that they never return to work.  On average most who are involved in such events take 29 days off work.  For every suicide that occurs on the railway around 10 staff/support colleagues will get directly involved.

3.3 On average there are 262 suicides on the network per year. In 2015/16 there were 253, a 12% reduction in suicides on 2014/15 (287 incidents) and in 2016/17 a further 6% reduction in suicides on 2015/16 (237 incidents)

3.4 Each suicide is a tragic event for the individual, their friends and family, but also for a wider group of people; notably our staff, the emergency services and passengers.

3.5 The Rail Industry’s objectives relative to suicide prevention are:

                      I.        To reduce the risk of suicide on the railway

                    II.        Reduce trauma to staff

                   III.        Improve the passenger journey experience.

3.6 The safety impact of these incidents can be wider than just the immediate incident location. Our customers may be detained on trains until the network can be returned to full operation. 

3.7 One of our challenges is the operational/safety difficulties encountered when people come onto the running lines to hold vigils or place memorials. This may take the form of ‘symbols of mourning’ left near to where an individual took their life. We look to remove memorials as quickly and as sympathetically as possible. Whilst they may appear not to be causing harm they are in fact:

                      I.        Acting as a constant reminder to rail staff of where a tragic event took place

                    II.        Potentially presenting a safety risk to the operational railway as mourners for example congregate around them on the infrastructure.

                   III.        Identifying a particular location as one from which a suicide can be completed. This may in turn encourage others to do likewise

4.   Network Rail and the industry role in suicide prevention

4.1 Suicide is a complex societal issue and whilst the rail industry has a responsibility to prevent deaths on the railway, there is only so much it can do in relation to a problem it has no direct control over.  If the number of suicides is to be significantly reduced on the network, then support must come from those external to it such as local authorities and the health sector.  They must play their part in reducing the risk of suicide just as the rail industry does. 

4.2 The rail industry has made significant progress in suicide prevention over the last seven years, but the problem is a truly ‘wicked’ one which is beyond the industry’s gift to solve.  Whilst we recognise, acknowledge and discharge our responsibilities in this area; we make the following ‘calls to action’ to drive down the suicide rate not only on the railway but in society as a whole:

                      I.        Mental and physical health should be treated equally, and vulnerable people should be encouraged to seek help;

                    II.        There should be compulsory suicide prevention training for all those in the health sector;

                   III.        All local authorities/health boards should engage with the British Transport Police and Network Rail when creating Suicide Prevention Action Plans to ensure that they have the fullest picture of local trends;

                  IV.        More should be done in schools, colleges and universities  to make our young people aware of mental health issues to allow them to look after themselves and others at any point through life’s journey;

                    V.        We should not have to rely on our police force supporting vulnerable people until appropriate medical facilities become available for them.  A situation brought about by the lack of adequate health care provision for those most at risk in our society;

                  VI.        The standard of proof required in Coroner’s Inquests should be changed.  Despite suicide being decriminalized in 1961, Coroners are still required to use the criminal standard of proof (beyond reasonable doubt) before making suicide findings.  All other available findings (except unlawful killing) require the civil standard to be met (on the balance of probabilities).  This extremely high standard of proof may mask the true extent of suicide and hinder research into it.

                 VII.        Consideration on the impact to the Railway when Care Homes and Mental Health Hospitals are built or relocated near the railway. 

                VIII.        The need for real time data capture to identify where focus work needs to be completed and to assist local authorities with their decision making and completion of suicide audits.

                  IX.        The need to share information between health services, local authorities and the rail industry on individuals who have disclosed that they are considering taking their life on the network.

                    X.        The sharing of information held by public bodies with the British Transport Police should be a positive requirement, rather than the current cautious approach based around data protection requirements.

5.   Suicide Prevention Strategy

Our strategy consists of measures that seek to prevent the incidents occurring whilst ensuring we respond to each event in a dignified, respectful and supportive way.

Prevention measures

5.1 Physical and technological measures

For the rail industry’s part, a significant and increasing amount of intervention measures are being installed or implemented across the network.  These are measures related to engineering or technology such as fencing, landscaping, detection systems and lighting devices. They seek to influence the behaviour of a suicidal individual prior to them accessing the infrastructure or once they are on it, providing some form of warning to rail staff or other industry partners which can then be acted upon.

The prevention methods that the industry deploys across the network can be classified into ‘hard’ and ‘soft’ measures. Hard measures are defined as those that present a physical barrier or require some form of mechanical process to introduce them, whilst soft measures are those which rely on people or some form of social interaction to deliver them.

 

5.2 ‘Hard’ prevention measures

These are deployed on the network and may also be referred to as ‘engineering’ or ‘target hardening’ solutions.

                      I.        Restricting access to the running lines - It is important to make access to the running lines as difficult as possible to reduce accessibility to the lethal means.

                    II.        Securing Platform Ends - Platform end barriers and trespass guards, provide an effective counter measure to prevent individuals easily accessing the running lines from platforms.

                   III.        Lineside Fencing - Locations on high speed lines that are particularly prone to suicide events are best fenced using industry standard palisade fencing. 

                  IV.        Mid Platform Fencing - Such fencing is deployed to divide platforms where one is served by stopping services and an adjacent one is served by high speed non-stopping services. The introduction of the fence restricts the ability of individuals gaining access to the high speed line just by walking across the platform. Note: The installation of mid platform fencing requires a high level of stakeholder consultation, reference to a number of standards and may not be viable for all appropriate locations due to issues such as pedestrian flows.

                   V.        Restricting access to unused platforms - Unused platforms with adjacent running lines open to traffic should not be accessible to the public. They offer an unrestricted point of entry to the network.

                  VI.        Securing small and unique access points - Surveys of high risk sites may identify unique vulnerable points of access to the network. These will require bespoke mitigation measures to ensure their security.

                 VII.        Securing large and unique access points - Surveys of locations at risk of suicide may identify unique vulnerable points of access to the network. These will require bespoke mitigation measures to be employed and in some cases the requirements of third parties to be taken into account when doing so.

               VIII.        CCTV Cameras - There are a considerable number of CCTV cameras on the network and these can be employed to monitor key locations. A camera is trained to capture images of an area that is otherwise invisible to station staff and where it is known those contemplating taking their lives emerge from. Linking cameras with the means of communicating with or making announcements to individuals who may be loitering in strategic locations, provides a means of immediate access to them where staff or security personnel may not be on hand to approach them.

                  IX.        Platform hatching/yellow box markings - yellow cross hatching on platforms is a psychological measure. Many grow up knowing that a yellow box painted on the road indicates the need to keep the carriageway clear. Their use on platforms is to promote this thinking. Vulnerable people subsequently have to deal with the dilemma of stepping into this area to gain access to the running line, whilst at the same time potentially exposing themselves to increased surveillance from rail staff and passengers amongst others.

5.3 ‘Soft’ prevention measures

These are employed across the industry and rely on people or some form of social interaction to deliver them and involve the following activities:

5.4 Third party cooperation

Where there are known high risk locations and our mitigation measures are not reducing the number of suicides at them, we find ourselves working increasingly with or seeking the cooperation of others to reach out and identify those in the wider community that are at risk of suicide by:

i.      Organisational and procedural measures - These are strategic, collaborative, enforcement and process related measures which seek to define the suicide problem in particular areas and develop strategies with third parties to help address them. The benefit of these measures is that they have the potential to influence the attitude and/or activities of a vulnerable individual who may be considering taking their life prior to them accessing the railway or even thinking about it as a means of lethality. Collaborating with third parties is critical to the success of these measures not only to prevent suicides on the railway but in the wider community as a whole.

ii.    Public awareness and educational measures - Such measures seek to improve the knowledge or skills of various groups of people who have the potential to influence those at risk of suicide. They comprise of communications campaigns, signage, education, media guidelines and work with third parties.

5.5 Training

As an industry, we recognise the importance of suicide prevention training and Samaritans our partners, deliver a Managing Suicidal Contacts Course to all rail industry staff and to date we have trained over 15,000 people. A positive output of this training is the number of lifesaving interventions made and last year we saw over 1500 completed. This year there have already been 1048. The aim of the training is to:

                      I.        Increase the number of people who use the network to identify, approach and support a potentially suicidal person

                    II.        Provide basic guidance on talking to a vulnerable person; how and where to seek support and safely resolve the situation

                   III.        Increase awareness of trauma, how it can affect people and the warning signs

                  IV.        Provide basic guidance on talking to someone who may be suffering from trauma and how and where to seek further support

We have created a highly acclaimed suicide prevention video package known as the Learning Tool which has been designed to allow everyone in the industry to play their part in our suicide prevention programme. It provides insight into how to prevent a suicide through to understanding the trauma such events can have and how to manage it.

The tool has been developed at the request of the industry to make the details and materials of the programme more accessible to its entire workforce through video content that can form part of a briefing, training or personal awareness package.

5.6 Intervening in suicide attempts

Intervening in suicides is one of the most effective methods the industry has of preventing them. Interventions rely on rail staff and others being on hand to personally interrupt an individual in the act of taking their own life - this usually means by approaching them, providing ‘emotional’ support, taking them to a place of safety and handing them on to the emergency services for treatment or further support.

We are aware that interventions are successful and as an industry have recently launched our Small Talk Saves Lives Campaign. The objective is to further increase the number of successful suicide interventions on the rail network by targeting potential bystanders amongst the general public and encouraging action for people to intervene safely through highlighting that a simple question can be all takes and emphasises that suicides can be prevented.

5.7 Trauma support

Ensuring our people are appropriately cared for following a traumatic event forms a key part of our programme. A trauma support code of practice has been developed which provides guidance to help support colleagues involved in, or who witness a potentially traumatic incident. The implementation of this code of practice contributes to the mitigation of the risk of poor health and well-being. It helps employees to:

                      I.        identify work colleagues potentially at risk immediately after a traumatic event and in the weeks following;

                    II.        confirm that work colleagues are offered effective support from the point of incident onwards;

                   III.        assess and refer colleagues to appropriate clinical support services if required;

                  IV.        specific collateral has been developed to supplement the code of practice which is distributed to all at risk staff.

Bespoke trauma support training delivered by Samaritans is offered to key groups that may be at risk of experiencing traumatic events.

5.8 Partnership Approach

i.      As an industry we have made contributions to many Government documentation

ii.    We have been in partnership with Samaritans since 2010; we renewed our contractual arrangements with them for another five years in 2015. We work closely and part-fund a dedicated BTP Mental Health and Suicide Prevention Unit. 

iii.   We have developed an escalation process which targets specific additional activity at locations where three suicides or injurious attempts have occurred in a rolling 12 month period, to mitigate against the risk of further incidents.  This involves forging links with Local Authorities and relevant stakeholders. This process has enabled us to prompt some Local Authorities to develop Suicide Prevention Plans and establish steering groups.

5.9 Innovative measures

As an industry we continually strive to find new ways of learning to improve our knowledge and understanding of this complex area and how to manage it. Some examples include:

i.      Middlesex University was commissioned to carry out research that would increase the industry’s understanding of why people take their lives on the railways and what factors might influence their decision.

ii.    Rail505 a pilot project that has tested the concept of using passengers to report people who they suspect may be at risk of taking their own lives. The success of the system has prompted the industry to consider rolling it out more widely across the network.

iii.    Commissioning an Anthropologist to support the industry to identify why clusters of people take their lives at specific locations particularly where existing mitigation measures should, it is believed, act as a significant deterrent.

6 Conclusions

Since 2010, the rail industry has invested millions of pounds in preventing suicides on Great Britain’s railways and in the communities it is very much a part of.

Roughly 4.5% of those that take their lives each year do so on the railway.  This percentage we acknowledge as being far too high and as an industry look to those with responsibility to address the causes of suicide in society, to do so more robustly and effectively. 

However, we recognise the part we have to play in reducing not only suicides on the railway, but in the communities we are part of as a whole and the stigma that surrounds them.  To conclude, as well as discharging our legal responsibilities in this area as an industry of ‘Duty Holders’ (be it of franchises or railway operations); we seek to work with any organisation and share our knowledge and materials with those that can help achieve that end for the greater good of society.