Rail suicide: a systematic review using systems thinking

Rail suicide is a complex problem with significant adverse social and economic impacts. Systems thinking approaches are commonly used to understand emergent outcomes in complex systems. Systems thinking takes the system as the unit of analysis; often using a hierarchical representation to show how decisions and actions made across levels of a system (e.g., by governments, regulators, industry associations, companies, and individuals) can interact to create adverse outcomes. However, the extent to which rail suicide research has explored the problem from a systems thinking approach is unclear. A systematic review was conducted to identify: (1) the theories and methods that have been used to investigate rail suicide in the peer reviewed literature; (2) the contributory and demographic/risk factors for rail suicide identified across system levels; and (3) the preventative measures to address rail suicide that have been evaluated in published studies. The review followed the PRISMA guidelines and the systems thinking techniques AcciMap and PreventiMap were used to map factors and interventions across system levels. Gaps identified included a lack of consideration of contributory factors at higher system levels, that few preventative measures have been subject to evaluation, and that there has been little consideration of relationships between preventative measures. The review highlights the need for structured systems approaches to gain a more holistic understanding of rail suicide and to design more effective preventative measures.