When the Road Becomes Refuge or Risk: Road Safety as a Structural Strategy for Suicide Prevention

Introduction: Road safety, historically focused on reducing unintentional collisions, has gradually incorporating suicide into its preventive scope. Highways, railways, bridges, and viaducts constitute high-risk environments due to the combination of immediate access to lethal means, high fatality rates, and the rapid materialization of impulsive attempts. This study critically analyzes scientific evidence regarding the role of structural, technological, and institutional road safety interventions in suicide prevention.

Methods: A scoping review was conducted according to the PRISMA-ScR framework on studies published between 2000 and 2025. Databases consulted included PubMed, Scopus, Web of Science, PsycINFO, ScienceDirect, and Google Scholar. The study considered empirical research, systematic reviews, technical reports, and institutional documents. Keywords included road safety, suicide prevention, railway suicide, means restriction, transport networks, and public infrastructure. The search identified 1,247 records. After removing duplicates and screening titles and abstracts, 86 studies were assessed in full text and 42 were included in the final synthesis.

Results: Among the 42 included studies, 26 evaluated physical barriers. Most studies reported reductions ranging from 50% to 90% in suicides at intervention sites. Evidence converges on the decisive role of environmental interventions in reducing suicides related to the road environment. Physical barriers (fencing, safety nets, overpass screens, platform screen doors) show significant reductions, exceeding 50% on railways, highways, and elevated structures. Technological systems—such as intelligent CCTV, thermal sensors, and road intrusion alarms—enhance the early detection of suicidal behavior, especially in railways where reaction time is critical. Spatial reorganization—including alternative routes, the elimination of makeshift access points, functional landscaping, and strategic lighting—reduces impulsive approaches to critical points. There is no consistent evidence of geographic displacement following structural interventions.

Conclusion: The review demonstrates that road safety should be incorporated as a distinct domain within national suicide prevention strategies, expanding the traditional focus on mental health services alone.