Declining railway suicide during multisectoral interventions: Lessons from Australia

OBJECTIVE: Since 2017, several key multisectoral interventions have been progressively implemented to reduce railway suicide in Australia. This study aims to identify change points in railway suicide and evaluate the overall effect of these interventions in Australia and across states. METHODS: We identified railway suicides that occurred in Australia between 2001 and 2023, using data from the National Coronial Information System. We performed joinpoint regression analysis to identify change points and negative binomial regression analysis to assess whether railway suicide decreased during the implementation of interventions. RESULTS: Between 2001 and 2023, railway suicide in Australia declined by 54%. Greater declines were observed in Victoria (-62%) and New South Wales (-67%). Nationally, one change point was identified: the annual percent change was -8.8% between 2017 and 2023. In Victoria, railway suicide rates decreased annually by 13.6% between 2018 and 2023. In Western Australia, railway suicide rates increased annually by 10.3% between 2002 and 2010 and decreased annually by 5.4% between 2010 and 2023. During the intervention period, Australian railway suicide rate was 31% lower than the pre-intervention period (IRR 0.69, 95% CI 0.58-0.81). It was 30% lower in Victoria (IRR 0.70, 95% CI 0.57-0.85) and 49% lower in New South Wales (IRR 0.51, 95% CI 0.37-0.71). This effect was not observed for other states. CONCLUSION: Australian railway suicides have declined substantially. The greatest reductions were observed in Victoria and New South Wales, particularly during the intervention period. These findings suggest that multisectoral interventions should be continued to further reduce railway suicides.