A rapid review of interventions to reduce suicide ideation, attempts, and deaths at public locations

Background and Context

Between April 2022 and March 2023, 356 Welsh residents died by suspected suicide. Some of the suicide deaths happened in public places, such as in woods or at railway stations, bridges or cliffs. Suicide deaths are tragic events. Those that happen in public places can have an impact not only on the deceased person and their family and friends but also on bystanders, members of the public who find the body, or the wider community. 

Public locations where many suicides happen are sometimes referred to as “locations of concern” or “frequently-used locations”.

Aims

The aim of the review was to find up-to-date information about the effectiveness of different interventions that can prevent people from considering, attempting, or dying by suicide in public locations. 

The review did not include physical restrictions alone, such as barriers, fencing, or netting, because there is a wealth of evidence around this already.

Methods

A review of literature published since 2014 was carried out. All types of studies, carried out in any country, were included in the review. 

A search of UK government, charity, and other relevant organisations’ websites was also carried out to look for reports or other relevant information.  

Results

The review identified 24 studies. 

The review found that surveillance technologies, which can provide an opportunity for third-party intervention, showed the most promise. However, there was a low level of confidence in the evidence about their effectiveness because of disagreements between the studies and because of how the studies were conducted. 

Seven studies examined the effectiveness of promoting “suicide helplines” to encourage people to seek help. The results were inconclusive and more research is needed to understand if this type of intervention is effective. 

The review also found a range of other interventions, such as staff training about suicide, sending specialist staff to locations of concern, campaigns that encouraging bystanders to help a person who looks in distress, a crisis café, blue lights at railway stations, memorials, spinning rollers at the top of fences that prevent gripping, and others.  The effectiveness of these interventions could not be determined with certainty but some of them appeared promising, so more research is needed.

Policy and Practice Implications

The main finding of the review is that more robust evaluations are needed before any of the interventions can be recommended for implementation.

High-quality research is needed in the future to identify which interventions work for who and in which locations of concern. 

Better support is needed in gathering and sharing evidence on the effectiveness of interventions in locations of concerns, taking into consideration the sensitivity around the topic.

The full report can be accessed via the following link: https://www.medrxiv.org/content/10.1101/2025.04.09.25325515v1

Lay Summary Author: Nathan Davies (Evidence Centre Public Partnership Group Member)