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Counselling and psychotherapy

Small talk saves lives

Ella Rhodes meets a psychologist behind a major Samaritans campaign.

10 January 2018

The Samaritans’ new campaign, Small Talk Saves Lives, aims to give ordinary people the confidence to approach and chat to anyone they may think is contemplating suicide at train stations. We spoke to Dr Lisa Marzano, lead psychologist behind the campaign, who works with the Samaritans Media Advisory Team, and previously British Transport Police, on training staff in helping suicidal people.

A 2016 systematic review of rail suicides by Brian Mishara and Cécile Bardon, commissioned by Samaritans, revealed there was little information about why people choose to die by suicide on the railways and, importantly, what might reverse this decision. Marzano (Middlesex University London), along with colleagues from her own university and the University of Westminster, were selected by Samaritans and Network Rail to develop five studies to explore this question. These included an online survey, face-to-face interviews, the assessment of CCTV footage of railway suicides, an analysis of news reports and an exploration of what information is available to those searching online about suicide on the railways.

‘The interviews and survey revealed that one of the main reasons people considered the railways was this perception, or misperception, that it would be guaranteed to be lethal. But people also talked about the railways as being places that were easily accessible, quite impersonal and remote, and where they felt unlikely to be interrupted. We also analysed CCTV footage to see if there were any patterns of behaviour prior to a suicide on the railways and we saw that people weren’t interacting with others much and in all but one case they’d all been at a train station, sometimes switching platforms or station hopping, for quite some time. It showed there were lots of opportunities for intervention.’

Around one in six staff on the railways are now trained in helping those who may be suicidal, but the chances of a suicidal person meeting one of those staff members is less likely than their coming into contact with a fellow commuter. ‘I always contextualise this work in the wider suicide literature. For example there was a Public Health England guidance document published in 2015 on preventing suicides in public locations. Based on a review of the literature, the authors couldn’t identify any reasons against interventions that address public fears, increase whole-community awareness and preparedness to intervene, in tackling suicides in public places. The people who spoke to us about their suicide attempts said ensuring they wouldn’t be interrupted was one of the factors for carrying out an attempt, so we reversed that to suggest that if someone did intervene that might help.’

Marzano said the research and resulting campaign were relevant beyond suicides on the UK rail network: ‘I hope it helps us to open up more conversations about suicide and more opportunities around it. I hope we begin to recognise that suicidal thoughts are very common but there’s recovery from them, and there are things we can all do to help’.

Marzano is working with Network Rail and Samaritans on further themes that emerged from her research; one of which concerns the perceived lethality of rail suicides. She said while many believe such methods are sure to cause death, rates of death on the London Underground are closer to 55 per cent, with a higher average rate (around 80 per cent) on UK main railways. ‘This perception was one of the key factors that we found to be driving people to this kind of death. The numbers of people who are seriously injured in an attempted suicide by rail are high. In our surveys when people commented on why they decided against the rails they made comments about the effects on others and the train driver, but it was rare for them to say they were worried about surviving with serious injuries. We’re now considering how to deliver that message in a safe and effective way.’

The Small Talk Saves Lives campaign reached more than 10 million people in its first 15 days and was endorsed by Stephen Fry, Lord Alan Sugar, suicide researcher Professor Rory O’Connor and many others. 

- To find out more about the campaign see www.samaritans.org and to contact Samaritans for support call 116 123 (UK and Ireland). Find many more resources in our archive.