Chow Selina, Men Vera Yu, Zaheer Rabia, Schaffer Ayal, Triggs Christine, Spittal Matthew J, Elliott Maureen, Schaffer Dalia, Vije Mathavan, Jayakumar Navitha, Sinyor Mark
Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada.
Department of Psychiatry, University of Toronto, Toronto, Canada.
Lancet Reg Health Am. 2024 May 8;34:100754. doi: 10.1016/j.lana.2024.100754. eCollection 2024 Jun.
The Toronto Transit Commission (TTC) operates the public transit system in Toronto, Canada. From 1954 to 1980, there were 430 suicide deaths/attempts on the TTC subway system. In 2011, TTC implemented Crisis Link, a suicide helpline to connect subway passengers with counsellors. Upstream factors such as media reporting about suicide incidents may also influence suicidal behaviour. Our objectives were to investigate how Crisis Link and media reports about TTC suicide incidents influenced suicide rates.
Suicide data were obtained from the TTC and Coroner, with Crisis Link data provided by Distress Centres of Greater Toronto (1998-2021). Media articles were identified through a database search of Toronto media publications. Interrupted time-series analysis investigated the association between Crisis Link calls, media articles, and quarterly suicide rates on the subway system.
There were 302 suicides on TTC's subway system from 1998 to 2021. The introduction of Crisis Link was associated with a large but non-significant decrease in TTC-related suicide rate in the same quarter (IRR = 0.64, 95% CI = 0.36-1.12). Each subsequent post-Crisis-Link quarter experienced an average 2% increase in suicide rate (IRR = 1.02, 95% CI = 1.004-1.04). Furthermore, for each TTC-related media article in the previous quarter, the suicide rate on the TTC increased by 2% (IRR = 1.02, 95% CI = 1.004-1.04).
The Crisis Link helpline was associated with a large but non-significant short-term decrease in suicide rates. However, this outcome was not sustained; this may, in part, be attributable to media reporting which was associated with increased suicides. This should inform suicide prevention policies in Canada and worldwide.
No funding.
多伦多交通委员会（TTC）运营着加拿大多伦多的公共交通系统。1954年至1980年期间，TTC地铁系统发生了430起自杀死亡/未遂事件。2011年，TTC实施了危机热线（Crisis Link），这是一条自杀求助热线，用于将地铁乘客与咨询师联系起来。诸如媒体对自杀事件的报道等上游因素也可能影响自杀行为。我们的目标是调查危机热线和媒体对TTC自杀事件的报道如何影响自杀率。
自杀数据来自TTC和验尸官，危机热线数据由大多伦多地区危机中心提供（1998 - 2021年）。通过对多伦多媒体出版物的数据库搜索来识别媒体文章。中断时间序列分析研究了危机热线呼叫、媒体文章与地铁系统季度自杀率之间的关联。
1998年至2021年期间，TTC地铁系统发生了302起自杀事件。危机热线的引入与同一季度TTC相关自杀率的大幅但不显著下降相关（发病率比[IRR]=0.64，95%置信区间[CI]=0.36 - 1.12）。危机热线引入后的每个后续季度，自杀率平均上升2%（IRR = 1.02，95% CI = 1.004 - 1.04）。此外，上一季度每有一篇与TTC相关的媒体文章，TTC的自杀率就上升2%（IRR = 1.02，95% CI = 1.004 - 1.04）。
危机热线求助热线与自杀率的大幅但不显著的短期下降相关。然而，这一结果并未持续；这可能部分归因于与自杀率上升相关的媒体报道。这应为加拿大及全球的自杀预防政策提供参考。
无资金支持。
