Railway suicide in England and Wales 2000–2013:a time-trends analysis

Abstract Background In 2010, the “Tackling Suicide on the Railways” programme was launched as a joint initiative among Network Rail, the Samaritans and other key organisations such as the British Transport Police and train operators to achieve a 20 % reduction in railway suicides from 2010 to 2015 in Great Britain. We report the most recent age and sex specific trends in railway suicide in England and Wales from 2000 to 2013 and examine whether the initiative’s target reduction in railway suicides is likely to be achieved. Methods Population data and suicide mortality data (all methods combined and railway) for England and Wales were obtained from the Office for National Statistics (ONS) and used to calculate age and gender specific rates for deaths registered from 2000 to 2013. Data on railway suicides were also obtained from the Rail Safety and Standards Board (RSSB) and compared with ONS data. We used joinpoint regression to identify changes in suicide trends across the study period. Results The railway was used in 4.1 % of all suicides in England and Wales (RSSB data were similar to ONS data for most years). Suicides in all persons from all causes decreased from 2000 to 2007, with small increases from 2008 until 2013; this rise was entirely due to an increase in male suicides. Railway suicide rates increased over the entire study period; the proportion of railway suicides in all persons increased from 3.5 to 4.9 % during the study period. This trend was also mainly driven by increases in male suicides as female railway suicide rates remained steady over time. The highest age specific railway suicide rates were observed in middle aged men and women. Although there was no conclusive evidence of an increase in ONS railway suicides, RSSB data showed a statistically significant increase in railway suicides in males from 2009 onwards. Conclusion The continued rise in male railway suicide in England and Wales is concerning, particularly due to the high economic costs and psychological trauma associated with these deaths. The initiative’s target of a 20 % reduction in railway suicide is unlikely to be achieved

Regional variation in suicide rates in Sri Lanka between 1955 and 2011:a spatial and temporal analysis

Abstract Background Between 1955 and 2011 there were marked fluctuations in suicide rates in Sri Lanka; incidence increased six-fold between 1955 and the 1980s, and halved in the early 21st century. Changes in access to highly toxic pesticides are thought to have influenced this pattern. This study investigates variation in suicide rates across Sri Lanka’s 25 districts between 1955 and 2011. We hypothesised that changes in the incidence of suicide would be most marked in rural areas due to the variation in availability of highly toxic pesticides in these locations during this time period. Methods We mapped district-level suicide rates in 1955, 1972, 1980 and 2011. These periods preceded, included and postdated the rapid rise in Sri Lanka’s suicide rates. We investigated the associations between district-level variations in suicide rates and census-derived measures of rurality (population density), unemployment, migration and ethnicity using Spearman’s rank correlation and negative binomial models. Results The rise and fall in suicide rates was concentrated in more rural areas. In 1980, when suicide rates were at their highest, population density was inversely associated with area variation in suicide rates (r = −0.65; p < 0.001), i.e. incidence was highest in rural areas. In contrast the association was weakest in 1950, prior to the rise in pesticide suicides (r = −0.10; p = 0.697). There was no strong evidence that levels of migration or ethnicity were associated with area variations in suicide rates. The relative rates of suicide in the most rural compared to the most urban districts before (1955), during (1980) and after (2011) the rise in highly toxic pesticide availability were 1.1 (95% CI 0.5 to 2.4), 3.7 (2.0 to 6.9) and 2.1 (1.6 to 2.7) respectively. Conclusions The findings provide some support for the hypothesis that changes in access to pesticides contributed to the marked fluctuations in Sri Lanka’s suicide rate, but the impact of other factors cannot be ruled out

Data from ACE & Self harm Sri Lanka (10-2020)

Data collected as part of the hospital case control study investigating the association between adverse childhood experiences and self-poisoning in Sri Lanka https://bmjopen.bmj.com/content/9/8/e02776

Data from ACE & Self harm Sri Lanka (10-2020)

Data collected as part of the hospital case control study investigating the association between adverse childhood experiences and self-poisoning in Sri Lanka https://bmjopen.bmj.com/content/9/8/e02776

Sri Lanka suicide counts and rates

The data deposit contains the suicide data between 1880 and 2015 which has been used in previous publications