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Suicide deaths on railways: the nurse-led interventions that could save lives

Community engagement is key, says mental health nurse in groundbreaking Network Rail role

Community engagement is key, says mental health nurse who has taken groundbreaking role at Network Rail

While fewer than 5% of suicides in Britain happen on railways, witnessing such a shocking event can leave lasting trauma, says Network Rail.

But there can be many opportunities for people to intervene and help to dissuade someone from ending their life, says Rachel Luby, who in October was appointed as the organisations first ever mental health nurse, a role created with the aim of reducing incidents.

What happens before an individual reaches the station

Engaging the community in suicide prevention work is key. Our approach is to look at all of the touch points before someone arrives at a station,

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Community engagement is key, says mental health nurse who has taken groundbreaking role at Network Rail

Picture: iStock

While fewer than 5% of suicides in Britain happen on railways, witnessing such a shocking event can leave lasting trauma, says Network Rail.

But there can be many opportunities for people to intervene and help to dissuade someone from ending their life, says Rachel Luby, who in October was appointed as the organisation’s first ever mental health nurse, a role created with the aim of reducing incidents.

What happens before an individual reaches the station

Engaging the community in suicide prevention work is key. ‘Our approach is to look at all of the touch points before someone arrives at a station,’ says Ms Luby.

This could include a taxi rank, pubs, supermarkets and coffee bars. ‘It’s about equipping those staff, so if they see someone they are concerned about, they feel able to ask if they are okay and signpost them to where they can get help,’ she says.

According to Network Rail, in 2019-20 there were 283 suicides or suspected suicides on the overground rail network –an increase of 12 on the previous year. During the same time period, rail employees, the police and passengers successfully intervened in more than 1,881 suicide attempts on the network.

‘This role is also very much about working with people. There is no greater reward than knowing someone could have ended their life but has chosen not to do it’

Rachel Luby, Network Rail’s first mental health nurse

Although she has only been in post a few weeks, Ms Luby has already followed the path someone might take towards a station before attempting suicide, experiencing what they may see and who they will potentially come into contact with.

‘They may arrive by bus, but what if the driver felt able to say to that person, you look distressed, can I help you?’ says Ms Luby. She plans to roll out training on how to have these kinds of conversations to as many different groups of people as possible.

The campaign messages that could make a difference

Individuals seeing posters of voluntary organisations, such as the Samaritans, with depictions of people who look like them, is also important.

‘We need to target the message,’ she says, emphasising the need for campaigns that also appeal to younger people. ‘They need to look at something they can identify with, otherwise they assume that organisation isn’t for them.’

Challenging common fears of saying the wrong thing and exacerbating a situation is crucial, she believes.

‘The message I want to give is that the person has already made their decision,’ says Ms Luby, who won the mental health nursing category at the 2019 RCNi Nurse Awards. ‘We aren’t pushing them towards it. All we can do is help them change their minds.’

Research from those who have survived suicide attempts shows they value interventions, she says. ‘It can come in very different forms. Sometimes people respond better to someone who isn’t a professional, rather than someone in a paid role. It’s the human factor, a stranger who cares can offer hope.’

Understanding the long-term, wider impact of suicide

Rachel Luby: ‘A stranger who cares can offer hope’

There is also a myth that suicide on railways is quick, says Ms Luby. ‘It’s not always fatal and often people are left with life-changing injuries,’ she says.

Alongside the family of the person who has died by suicide, witnesses and the train driver can also suffer long-term effects. ‘We want to get involved quite quickly in bereavement support for everyone affected,’ says Ms Luby.

‘It impacts a lot of people who will need support afterwards. At the time, they may not be ready to process their trauma, so we need to make sure it’s there when they’re ready.’

After graduating in 2016 from London South Bank University, Ms Luby started her career with North East London Foundation Trust before moving to East London Foundation Trust (ELFT), where she worked in a forensic unit.

Her new post as a roving mental health nurse is part of a joint initiative between Network Rail and ELFT. ‘I really wanted it because I know I can improve outcomes,’ says Ms Luby.

‘This role is also very much about working with people, giving them time. There is no greater reward than knowing someone could have ended their life but has chosen not to do it.’

Creating a service model that can be replicated

Although the post is initially a 12-month pilot, the idea is that more nurses will be recruited in a year’s time. ‘I hope this is just the start,’ says Ms Luby. ‘I want to develop a whole service that will include peer support workers and mentors.’

She will also be analysing data and trends, identifying where resources are lacking and looking at particular ‘hot spot’ stations where practical steps to mitigate risks could be taken. This includes putting gates in place and making railway staff more visible.

Another goal is to develop a model that could be replicated in other areas of the UK. ‘There’s great potential to create a whole service that can be emulated elsewhere,’ says Ms Luby.

‘I really want this to empower the wider community, so they feel this is their responsibility. I think a lot of people want to be a good neighbour, so this is about giving them opportunities to help someone in crisis.

‘It sends a message that no one is alone and there are people who care.’

Do you need help?

  • Call the Samaritans for free, 24 hours a day, 365 days a year on 116 123 or visit the website
  • The RCN offers a free, confidential counselling service to members. Call 0345 772 6100 or find out more on the website
  • The Laura Hyde Foundation is a charity that provides mental health support for all healthcare and emergency services staff, including self-help resources and a clinically supervised support line
  • The NHS Support Line, on 0300 131 7000, is available between 7am and 11pm daily, with a text service available 24/7 – text Frontline to 85258

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