Written evidence submitted by Samaritans (RLS0015)

Summary of key points

1. Over 6,000 lives are lost to suicide in the UK every year with around 250-300 of these occurring on the rail network.

2. Men aged 30-55 from lower-income backgrounds are the highest risk demographic group for deaths by suicide on the rail network.

3. Samaritans partnership with Network Rail, as part of a wider rail industry programme, has involved training over 13,000 staff in how to recognise potentially suicidal individuals and then intervene appropriately.

4. Over 1,100 potentially life-saving interventions were carried out by rail industry staff in 2015/16.

5. Further action and long-term sustainable funding is required to ensure that the progress achieved through this partnership work is maintained and stakeholders across the whole rail network are fully engaged and committed to prioritising suicide prevention.

6. We fully support the rail industry’s new 9-point suicide prevention plan which includes commitments on staff training and post incident support.

7. The Department for Transport should ensure that minimum requirements that Train Operating Companies need to attain on suicide prevention form part of the baseline franchise agreement at franchise re-letting in future.

About Samaritans

8. Samaritans is the UK’s largest suicide prevention charity, taking 5.4 million calls for help a year – that’s someone contacting us every six seconds. We have 201 branches, with over 20,000 trained volunteers. We also work in a wide range of community settings, including prisons, schools, workplaces, railways, hospitals and offer training and support where it’s most needed.

9. Samaritans’ vision is that fewer people die by suicide. We work to achieve this by making it our mission to alleviate emotional distress and reduce the incidence of suicidal feelings and behaviour. We do this by:

• Being available 24 hours a day to provide confidential, non-judgemental emotional support for people who are struggling to cope, including those who have had thoughts of suicide

• Reaching out to high risk groups and communities to reduce the risk of suicide

• Working in partnership with other organisations, agencies and experts

• Influencing public policy and raising awareness of the challenges of reducing suicide

Suicide on the rail network

10. Suicide is a major public health problem. More than three times as many people die each year by suicide than as a result of road traffic accidents[1] with over 6,000 lives lost in the UK each year[2], around 250-300 of which occur on the rail network.

11. The effects of deaths by suicide are felt in the wider community, by family, friends, colleagues and witnesses, often shattering lives. Railway suicides in particular have an enormous impact, on rail employees and witnesses as well as on their friends and family, and those of the deceased. Being involved in a railway fatality is probably one of the most distressing and traumatic events that a train driver will ever experience during their career.

12. Men are three and a half times more likely to die by suicide than women and those from the most deprived areas are ten times more likely to take their own lives than those from the most affluent areas. This pattern also applied to suicides on the rail network where 80% of people who take their own lives are men, with those in mid-life and from C2DE social groups at the highest risk of all.

13. In addition to the devastating human cost of suicide on the rail network there are also significant financial and operational implications. In 2014/15, suicides cost the rail industry £67 million in total, of which 86% was paid in compensation by Network Rail to train operators. Each suicide costs an estimated £230,000 mainly because of the need for replacement train crews and sick pay for train drivers. Added to this is the economic cost to society as a whole of each suicide which has been estimated at an average of £1.67m[3]. On the railways, each incident resulted in an average delay of 2,200 minutes – a total of 609,000 minutes delay attributable to suicide incidents in 2014/15.

14. In recent years, Samaritans has been working in partnership with Network Rail as part of a wider rail industry programme to try to prevent deaths by suicide on the rail network through a range of actions. The partnership model was developed on three pillars outlining a holistic, strategic and evidence-based approach:

A. EDUCATION and TRAINING

• Training personnel and industry partners, promoting occupational health support and helping front-line staff identify suicidal behaviour and intervene in a timely, effective manner
• Coordinating national industry and local health and social care groups

B. PREVENTION

• Providing suicide prevention guidance to the industry and their networks
• Identifying priority areas and developing local action plans in coordination with other local efforts
• Developing campaign materials to promote the Samaritans service to the general public

C. “POSTVENTION” (action after a suicide)

• Supporting staff and customers in the aftermath of suicide
• Providing trauma support training and guidance to the industry
• Ensuring responsible reporting of suicides

15. The partnership between Samaritans and Network Rail has been in place for over seven years and has now evolved into an industry wide programme. The Suicide Prevention Duty Holder Group (SPDHG) and National Suicide Prevention Working Group (NSPWG) oversee and coordinate this unique, multi-agency programme for the rail industry.  It is recognised however that they alone cannot meet the challenge suicides present on the railway, so a cross industry group known as the Rail Industry Suicide Stakeholder Group (RISSG) works alongside them to achieve that.

16. The groups comprise of Samaritans, Network Rail, British Transport Police (BTP), Train Operating Company representatives and the wider railway industry, such as ATOC (Association of Train Operating Companies), RSSB (Rail Safety & Standards Board), London Underground, ORR (Office of Rail and Road) and rail Trade Unions. In addition, dedicated teams have been set up within Network Rail, Samaritans and BTP for the programme. A ‘joined up’ response to rail suicide is one of the core underlying principles that make this initiative so valuable.

17. While the SPDHG and RISSG set the industry’s strategic direction, it is the members of the National Suicide Prevention Working Group (NSPWG) that deliver the outputs which bring the strategy to life. 

Training for staff on the rail network

18. The Samaritans partnership with Network Rail, as part of a wider industry programme, has now delivered training to over 13,000 staff on the rail network covering areas such as ‘Managing Suicidal Contacts’ (MSC) and ‘Trauma Support’. The MSC training programme aims to help staff prepare and recognise when and how they can intervene if someone looks like they may be experiencing suicidal thoughts. An evaluation of the course found that it was successful in affecting:

• Staff ability to identify potentially suicidal individuals, equipping them with the confidence and skills to see when someone may be in need
• The quality of interventions, so that when staff feel the need to take action they can do so knowing their training will help them decide what to do
• Positive actions following an incident, including coordinating responses with other teams and ensuring everyone is kept safe
• Attitudes towards suicide, particularly positivity that suicidal thoughts can be overcome and that intervention and prevention work
• The likelihood of staff making an intervention in the future by building confidence and skills that they can make a difference to someone’s life.

19. We are aware of at least 400 cases where staff trained in the MSC programme have carried out an intervention involving a vulnerable person on the rail network.

20. According to the RSSB’s Annual Safety Performance Report there were a total of 1,137 “interventions on the mainline railway that had been made in situations judged as having the potential to result in suicide” in 2015/16, an increase from 847 the previous year[4]. Over the same period there was a 13% reduction in suspected suicides on the rail network from 289 in 2014/15 to 252 in 2015/16.

21. Much of the feedback from people who have received training and gone on to use the skills gained in real life situations has highlighted the value of human contact in such circumstances and the importance of having trained staff available at all times across the rail network.

22. In addition, the wider social impact of trained rail staff who go on to use their listening skills, both in their work environment and in their social networks, is to help raise awareness of suicide among the general population, break down taboos and encourage help-seeking behaviour.

Expansion of training elsewhere

23. Suicide awareness and skills training could also be beneficial in other parts of the transport sector where much could be learnt from the principles of the training programme which has given rail station staff across the country the skills and confidence to approach a person in desperate need and prevent them from ending their lives.

24. Between April 2013 and December 2014, over 1,500 incidents brought to the attention of the Highways Agency Traffic Officer Service, were recorded as suicide, attempted suicide or “threatened” suicide. In 2014, 856 suicides or attempted suicides resulted in road closures on England’s main routes. We must do all we can to improve responses by training and preparing those who attend incidents.

25. This is also an important issue beyond the transport sector. Many of the people who have been helped through the Samaritans/rail industry partnership have reached crisis point, where an attempt to take their own life is often imminent. But in order to reduce the number of people who attempt suicide on the rail network, those at risk need to be identified much earlier and provided with the appropriate care and support.

26. There can often be an assumption that preventing suicide is mainly the responsibility of mental health services. These services are of course vital, but we also know that only 28% of people who died by suicide in England between 2003 and 2013 were in contact with mental health services in the 12 months prior to their deaths[5]. This means that there is also a huge role for our other public services, and indeed the wider community, in identifying and helping people who may be at risk of suicide before they reach a point of crisis.

Other interventions

27. Communications Campaigns - Another important element of the partnership programme has been a series of communications campaigns involving materials displayed prominently within railway stations which aim to raise awareness and increase understanding of Samaritans so that people see contacting the service as a positive, empowering first step in seeking help and taking control of their lives.

28. There have now been three high profile campaigns across England, Scotland and Wales through the partnership programme. The first two campaigns; Men on the Ropes (featuring a male boxer), and We’re in your Corner (featuring a male soldier, workman and trainer) were targeted primarily at the demographic group at the highest risk of suicide on the railways - men in their 30s, 40s and 50s from lower-income backgrounds. The We’re in your Corner campaign was launched in 2012 alongside Samaritans’ report into male suicide: Men and suicide: Why it’s a social issue. This has recently been replaced by the new We Listen campaign which retains a focus on middle-aged men but also features men and women of different ages and ethnicities allowing for a broader appeal. The marketing materials for the campaigns were developed following research and testing with the target groups and posters from these campaigns have become a common sight at stations across the rail network.

29. Community Outreach locations (COL) work - Samaritans, Network Rail and BTP have been working together to develop a plan for tackling suicide on the railway at priority locations by looking beyond the railway and tackling the causes of suicidal behaviour in communities around priority rail locations. The key aspects of this plan are to identify groups within the communities around these COLs that are vulnerable or at risk of suicide on the railway, and to attempt to reduce the suicide risk of those groups in these areas.

30. Suicide is a social issue and must be tackled in collaborative way. Our partnership engages local authorities and other organisations at a local level to tackle issues which are created in communities and presenting as suicidal issues on the railway. The objective is to undertake a deeper level of community activity, with the main focus being multi-agency outreach work and formation multi-agency group activities. 

31. Media guidelines – Certain types of media reporting on suicide can increase the risk of ‘copycat’ suicides among vulnerable individuals within the audience and also risk inadvertently promoting high-frequency locations for suicide, including certain rail stations. Samaritans has been working with the media for over two decades to improve the portrayal of suicide and reduce the risk of imitative suicidal behaviour. Our Media Guidelines for Reporting Suicide[6] are widely recognised and used across the media industry as a whole.

32. “Postvention” – This is the term used to refer to support services provided after an incidence of suicide. Occasionally rail staff involved in traumatic incidents, including those involving a death by suicide, feel extremely guilty as though they were responsible for the event, or could have done more to prevent it. Although these feelings are almost always misplaced, they can prolong the trauma if not managed effectively. They may also experience anger, flashbacks and post-traumatic stress.

33. Samaritans deliver a one-day Trauma Support Training course to managers, to improve support available to those working in high risk roles e.g. drivers and Network Rail operations staff. The aim of the course is to highlight the trauma that may be caused by fatalities on the railway and techniques to assist recovery. The course has been tailored to the needs of those supporting staff following a traumatic incident. Train drivers, ASLEF and driver Managers have helped developed the course.

34. Samaritans is also able to provide a physical presence at stations after an incident. We have a rapid response service which means we can mobilise volunteers to go to stations to hand out cards and provide emotional support to anyone that might need it.

35. Station design - Samaritans and rail industry colleagues input into the planning and design of new stations and infrastructure to ensure suicide prevention initiatives are considered. The teams pilot and evaluate new technology such as blue lights to see whether they have a calming effect on passengers, mid-platform fencing, smart cameras for monitoring, platform hatching and Samaritans contact details on help points. This is a developing area of research and it is only through this programme that such cutting-edge techniques are being considered.

Future development of suicide prevention on the rail network

36. The progress that has been made on tackling suicide on the rail network is recent years had been very encouraging and the support and active engagement of the rail industry has been invaluable in delivering these initiatives. In order to build on this progress for the future it is vitally important to maintain the momentum and ensure the long-term buy-in to suicide prevention work from all industry stakeholders.

37. We welcome the development of the rail industry's new 9-point suicide prevention plan and fully support its implementation. The custodians of the plan are the Suicide Prevention Duty Holder Group (SPDHG) who have collaborated with us on the content. The key elements of Samaritans’ suicide prevention programme activity have been included in the 9-Point Plan including the facilitation of training, provision of post incident support, development of staff support materials and help-seeking behavioural change campaigns.

38. Through the 9-Point Plan, all industry stakeholders can understand what it is they need to deliver and how they need to interact with others for their contribution to be effective. The plan captures the nine deliverables that in their view the industry need to collectively and consistently deliver to prevent suicides on the network and minimise their impact on staff and passengers. The plan will be launched at the Industry Health and Safety Strategy Meeting in November 2016.

39. We support the DfT’s approval to contractualise the BTP Suicide Prevention Strategy and SPDHG 9-Point Plan as the minimum standard that Train Operating Companies must attain in suicide prevention and making this requirement part of the baseline franchise agreement at franchise re-letting.

40. Long term sustainable funding is a crucial element of keeping this work going across the rail network and we back the SPDHG's recommendation to set up a ring fenced national fund administered through the existing governance arrangements to support suicide prevention initiatives in the future.

41. Samaritans previously had a partnership with London Underground Limited (LUL) which ran from September 2013 to December 2014 and involved three main strands of work: staff training, outreach and communications through help seeking campaigns. TfL’s 2013/14 annual report highlighted LUL’s partnership agreement with Samaritans as one of the ‘successfully implemented initiatives’ in the context of tube reliability improvements over their 2013/14 financial year, relating to the ‘Mayor’s reliability commitment’. Despite this endorsement, our partnership work with LUL ceased in December 2014.

42. There are a number of LUL stations which are also mainline stations and there are also a significant number of interchange stations between over ground and underground service. Securing LUL’s commitment to suicide prevention going forward would be beneficial not just to users and staff of the Underground network but also to the wider rail network. 

October 2016