3.3Consultation with psychiatric hospitals


What does this measure refer to and what is its objective?

This measure refers to the collaboration with mental health authorities, institutions or clinics for reasons of coordination of efforts, timely access to relevant information or special needs of mentally or physically ill patients. This measure is aimed in particular to address the suicide hotspots near psychiatric hospitals.


Best practice and lessons learned

  • Redefine some roles among your staff and allocate time for inter-agency meetings and work activities.
  • Make political lobby. Political acceptance (and guidelines) of suicide being a growing public problem and not a railway problem will help focus agencies, organisations and operators making joint efforts to challenge the problem.
  • Propose / organize national inter-agency meetings.
  • Use a letter of recommendation from a well-known psychiatric institute or doctor.
  • Try to publish a general story; why you contact these institutions; is there technical literature to get their attention.
  • Try to educate non rail professionals on the implications of rail suicides - to get across the importance of prevention from a rail point of view.

Warning points

Expected difficulties and issues you should pay attention to

  • This might depend on the degree of openness and willingness to change in different cultures, or different legal constraints in different countries (e.g. relating to how information is shared; whether power is important to some organisations or agencies; whether there are specific legal requirements that could limit collaboration).
  • There may be the potential for better collaboration as the organisations and agencies become familiar with models of joint working. However, any initial benefits from better joint working might lapse if individuals who have been important in promoting the collaborative working move to different jobs, or if initial funding sources cannot be maintained (e.g. financial cutbacks).
  • Costs are largely time related, potentially including need for some release from other work activities. Might also include costs of travel for meetings.


Other points that you should not forget

  • The measure is likely to need support and contributions from senior members of relevant organisations.

Study results

Data or other evidence supporting the measure's effectiveness

  • Several international studies have shown that a considerable proportion of hotspots are in the vicinity of psychiatric centres (Emmerson & Cantor, 1993; Erazo et al., 2004a; Kerkhof, 2003; O’Donnell & Farmer, 1994).
  • There is a need for better collaborations between emergency services and psychiatric institutions (Mishara, 2007).
  • Increased collaboration with psychiatric services, as well as community services and the local suicide prevention centre is suggested as a way of increasing the effectiveness of security forces in prevention activities (Mishara, 1999).

last update: 2014-08-05