Effectiveness of surveillance technology for the prevention of suicides in public spaces: a systematic review

Article

Joyner, L., Cliffe, B., Mackenzie, J.M., Hawton, K., Craig, P. and Marzano, L. 2026. Effectiveness of surveillance technology for the prevention of suicides in public spaces: a systematic review. BMJ Public Health. 4 (3). https://doi.org/10.1136/bmjph-2025-004286
TypeArticle
TitleEffectiveness of surveillance technology for the prevention of suicides in public spaces: a systematic review
AuthorsJoyner, L., Cliffe, B., Mackenzie, J.M., Hawton, K., Craig, P. and Marzano, L.
Abstract

Objective
The use of surveillance technologies (e.g., security cameras, motion sensors, video analytics) has been recommended for supporting suicide prevention efforts in public spaces. We sought to identify and synthesise the current evidence on the impact of surveillance technologies deployed in such environments on suicide and related outcomes.

Design
Systematic review without meta-analysis.

Data sources
We conducted systematic searches between 1990 up to August 2025 on the following databases: PsycINFO, MEDLINE, CINAHL, Computer Source, Ovid, SPP, Web of Science, PTSDpubs, CENTRAL, ACM DL, and IEEE Explore. Our searches also extended to grey literature from relevant websites.

Eligibility criteria
Studies were included if they assessed the deployment of surveillance technology at a public location on suicide-related outcomes (including suicides, suicide attempts, rescue interventions, and trespass events).

Data extraction and synthesis
Two reviewers independently screened studies and extracted data. Study results were synthesised using narrative and tables, and the quality of studies was assessed using the Mixed Methods Appraisal Tool.

Results
The searches identified 3,039 items, with 15 studies meeting the eligibility criteria. Just one study provided clear evidence of a reduction in suicides (IRR = 0.37, 95% C.I. = 0.26, 0.54) following the installation of a “smart” surveillance system on a bridge, but its use of tension-wire sensors also restricted ease of physical access. The presence of closed-circuit television cameras was associated with a 7% reduction in rates of suicide at local rail stations in one study (IRR = 0.93, 95% CI = 0.88, 0.98), but the presence of cameras was not a significant factor in two metro station studies. Additionally, two studies observed an increase in interventions (e.g., rescue responses) following the installation of smart surveillance technologies on bridges (140% and 520% increases, respectively), but saw no change in suicide rates. Three studies indicated that smart surveillance technologies with audible deterrents may reduce trespass to dangerous sites, but their relevance to suicide prevention is unclear.

Conclusions
The current evidence base to support the use of surveillance technologies for preventing suicides is limited. There is a clear need for further evaluations of surveillance-based interventions, including their implementation, associated measures and impacts to inform development of effective suicide prevention initiatives.

KeywordsSuicide; Suicide Prevention; Surveillance Technology; CCTV; Systematic Review
Sustainable Development Goals3 Good health and well-being
Middlesex University ThemeHealth & Wellbeing
Research GroupCentre for Abuse, Trauma and Suicide Studies (CATS)
PublisherBMJ Publishing Group
JournalBMJ Public Health
ISSN
Electronic2753-4294
Publication dates
Online01 Jul 2026
PrintJul 2021
Publication process dates
Accepted26 May 2026
Deposited01 Jun 2026
Output statusPublished
Publisher's version
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File Access Level
Open
Copyright Statement

© Author(s) (or their employer(s)) 2026. Re- use permitted under CC BY. Published by BMJ Group.

Digital Object Identifier (DOI)https://doi.org/10.1136/bmjph-2025-004286
LanguageEnglish
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Powell, C., Marzano, L. and Ciclitira, K. 2017. Mother-infant separations in prison. A systematic attachment-focused policy review. The Journal of Forensic Psychiatry & Psychology. 28 (2), pp. 274-289. https://doi.org/10.1080/14789949.2016.1204465
Promoting responsible portrayal of suicide: lessons from the UK and the Republic of Ireland
Fraser, L., Marzano, L. and Hawton, K. 2017. Promoting responsible portrayal of suicide: lessons from the UK and the Republic of Ireland. in: Niederkrotenthaler, T. and Stack, S. (ed.) Media and Suicide: International Perspectives on Research, Theory, and Policy Routledge. pp. 227-240
Making a difference with ‘smartphone psychology’: can mobile digital technologies help create new insights into self-harming behaviours?
Marzano, L., Al-Ayoubi, L., Bardill, A., Herd, K., Vale, D., Grey, N. and Moran, P. 2017. Making a difference with ‘smartphone psychology’: can mobile digital technologies help create new insights into self-harming behaviours? in: Niven, K., Lewis, S. and Kagan, C. (ed.) Making a Difference with Psychology United Kingdom Richard Benjamin Trust. pp. 139-147
Non-suicidal self-harm amongst incarcerated men: a qualitative study
Marzano, L., Ciclitira, K. and Adler, J. 2016. Non-suicidal self-harm amongst incarcerated men: a qualitative study. Journal of Criminal Psychology. 6 (4), pp. 157-172. https://doi.org/10.1108/JCP-04-2016-0017
Prevention of suicidal behaviour in prisons: An overview of initiatives based on a systematic review of research on near-lethal suicide attempts
Marzano, L., Hawton, K., Rivlin, A., Smith, E., Piper, M. and Fazel, S. 2016. Prevention of suicidal behaviour in prisons: An overview of initiatives based on a systematic review of research on near-lethal suicide attempts. Crisis: The Journal of Crisis Intervention and Suicide Prevention. 37 (5), pp. 323-334. https://doi.org/10.1027/0227-5910/a000394
Police and suicide prevention: Evaluation of a training programme
Marzano, L., Smith, M., Long, M., Kisby, C. and Hawton, K. 2016. Police and suicide prevention: Evaluation of a training programme. Crisis: The Journal of Crisis Intervention and Suicide Prevention. 37 (3), pp. 194-204. https://doi.org/10.1027/0227-5910/a000381
Evaluation of long-term counselling at a community health service for women who are on a low income
Payne, N., Ciclitira, K., Starr, F., Marzano, L. and Brunswick, N. 2015. Evaluation of long-term counselling at a community health service for women who are on a low income. Counselling and Psychotherapy Research. 15 (2), pp. 79-87. https://doi.org/10.1080/14733145.2013.877513
The application of mHealth to mental health: opportunities and challenges
Marzano, L., Bardill, A., Fields, B., Herd, K., Veale, D., Grey, N. and Moran, P. 2015. The application of mHealth to mental health: opportunities and challenges. The Lancet Psychiatry. 2 (10), pp. 942-948. https://doi.org/10.1016/S2215-0366(15)00268-0
Hard-to-get-at data from difficult-to-access users
Fields, B., Bardill, A., Marzano, L. and Herd, K. 2015. Hard-to-get-at data from difficult-to-access users. Abascal, J., Barbosa, S., Fetter, M., Gross, T., Palanque, P. and Winckler, M. (ed.) 15th IFIP TC 13 International Conference on Human-Computer Interaction. Bamberg, Germany 14 - 18 Sep 2015 Springer. pp. 409-416 https://doi.org/10.1007/978-3-319-22723-8_32
Responding to repetitive, non-suicidal self-harm in an English male prison: staff experiences, reactions, and concerns
Marzano, L., Adler, J. and Ciclitira, K. 2015. Responding to repetitive, non-suicidal self-harm in an English male prison: staff experiences, reactions, and concerns. Legal and Criminological Psychology. 20 (2), pp. 241-254. https://doi.org/10.1111/lcrp.12025
Psychosocial characteristics and social networks of suicidal prisoners: towards a model of suicidal behaviour in detention
Rivlin, A., Hawton, K., Marzano, L. and Fazel, S. 2013. Psychosocial characteristics and social networks of suicidal prisoners: towards a model of suicidal behaviour in detention. PLoS ONE. 8 (7), pp. 1-11. https://doi.org/10.1371/journal.pone.0068944
A typology of male prisoners making near-lethal suicide attempts
Rivlin, A., Ferris, R., Marzano, L., Fazel, S. and Hawton, K. 2013. A typology of male prisoners making near-lethal suicide attempts. Crisis: The Journal of Crisis Intervention and Suicide Prevention. 34 (5), pp. 335-347. https://doi.org/10.1027/0227-5910/a000205
The suicidal process in male prisoners making near-lethal suicide attempts
Rivlin, A., Fazel, S., Marzano, L. and Hawton, K. 2013. The suicidal process in male prisoners making near-lethal suicide attempts. Psychology, Crime and Law. 19 (4), pp. 305-327. https://doi.org/10.1080/1068316X.2011.631540
Comfort and challenge: A thematic analysis of female clinicians’ experiences of supervision
Starr, F., Ciclitira, K., Marzano, L., Brunswick, N. and Costa, A. 2013. Comfort and challenge: A thematic analysis of female clinicians’ experiences of supervision. Psychology and Psychotherapy: Theory, Research and Practice. 86 (3), pp. 334-351. https://doi.org/10.1111/j.2044-8341.2012.02063.x
Impact on prisoners of participating in research interviews related to near-lethal suicide attempts
Rivlin, A., Marzano, L., Hawton, K. and Fazel, S. 2012. Impact on prisoners of participating in research interviews related to near-lethal suicide attempts. Journal of Affective Disorders. 136 (1-2), pp. 54-62. https://doi.org/10.1016/j.jad.2011.09.009
Studying survivors of near-lethal suicide attempts as a proxy for completed suicide in prisons
Rivlin, A., Fazel, S., Marzano, L. and Hawton, K. 2012. Studying survivors of near-lethal suicide attempts as a proxy for completed suicide in prisons. Forensic Science International. 220 (1), pp. 19-26. https://doi.org/10.1016/j.forsciint.2012.01.022
Women counsellors' experiences of personal therapy: A thematic analysis
Ciclitira, K., Starr, F., Marzano, L., Brunswick, N. and Costa, A. 2012. Women counsellors' experiences of personal therapy: A thematic analysis. Counselling and Psychotherapy Research. 12 (2), pp. 136-145. https://doi.org/10.1080/14733145.2011.645050
The impact of prison staff responses on self-harming behaviours: prisoners’ perspectives
Marzano, L., Ciclitira, K. and Adler, J. 2012. The impact of prison staff responses on self-harming behaviours: prisoners’ perspectives. British Journal of Clinical Psychology. 51 (1), pp. 4-18. https://doi.org/10.1111/j.2044-8260.2010.02007.x
Psychosocial influences on prisoner suicide: a case-control study of near-lethal self-harm in women prisoners
Marzano, L., Hawton, K., Rivlin, A. and Fazel, S. 2011. Psychosocial influences on prisoner suicide: a case-control study of near-lethal self-harm in women prisoners. Social Science & Medicine. 72 (6), pp. 874-883. https://doi.org/10.1016/j.socscimed.2010.12.028
Near-lethal self-harm in women prisoners: contributing factors and psychological processes
Marzano, L., Fazel, S., Rivlin, A. and Hawton, K. 2011. Near-lethal self-harm in women prisoners: contributing factors and psychological processes. The Journal of Forensic Psychiatry & Psychology. 22 (6), pp. 863-884. https://doi.org/10.1080/14789949.2011.617465
Self-harm in a men's prison: staff's and prisoners' perspectives.
Marzano, L. 2007. Self-harm in a men's prison: staff's and prisoners' perspectives. PhD thesis Middlesex University
Visuo-spatial ability and dyslexia: is there a male global advantage?
Brunswick, N., Martin, G. and Marzano, L. 2008. Visuo-spatial ability and dyslexia: is there a male global advantage? British Dyslexia Association International Conference, 2008 [Dyslexia: making links]. Harrogate, York 27 - 29 Mar 2008
Visuo-spatial ability, handedness and developmental dyslexia: just how sinister was Andy Warhol?
Brunswick, N., Martin, G. and Marzano, L. 2007. Visuo-spatial ability, handedness and developmental dyslexia: just how sinister was Andy Warhol? 25th European Workshop on Cognitive Neuropsychology. Bressanone, Italy 21 - 26 Jan 2007
To be or not to be … a psychologist: critical and feminist dilemmas.
Ciclitira, K., Capdevila, R., Marzano, L. and Adams, E. 2008. To be or not to be … a psychologist: critical and feminist dilemmas. 2008 BPS Annual Conference.. Dublin 04 Feb 2008
Counsellors’ experiences of working as volunteers at a women’s service.
Costa, A., Ciclitira, K. and Marzano, L. 2008. Counsellors’ experiences of working as volunteers at a women’s service. 2008 Psychology of Women Section 21st Anniversary Conference on 'Rights and Changes'.. Cumberland Lodge, The Great Park, Windsor.
The impact of personal psychotherapy and supervision on volunteer counsellors.
Ciclitira, K., Marzano, L., Starr, F., Brunswick, N., Costa, A. and Berger, S. 2009. The impact of personal psychotherapy and supervision on volunteer counsellors. 2009 BPS Annual Conference. Brighton, UK 01 - 03 Apr 2009
Afghan nationals in the UK: professional capacity and views on return
Sales, R., Blitz, B. and Marzano, L. 2002. Afghan nationals in the UK: professional capacity and views on return. Research commissioned by Refugee Action and the International Organization for Migration, London..
Self-harm in prisons: dominant models and (mis)understandings
Marzano, L. 2010. Self-harm in prisons: dominant models and (mis)understandings. in: Adler, J. and Gray, J. (ed.) Forensic psychology: concepts, debates and practice Willan. pp. 486-507
Psychiatric disorders in male prisoners who made near-lethal suicide attempts: case-control study
Rivlin, A., Hawton, K., Marzano, L. and Fazel, S. 2010. Psychiatric disorders in male prisoners who made near-lethal suicide attempts: case-control study. The British Journal of Psychiatry. 197 (4), pp. 313-319. https://doi.org/10.1192/bjp.bp.110.077883
Psychiatric disorders in women prisoners who have engaged in near-lethal self-harm: case–control study
Marzano, L., Fazel, S., Rivlin, A. and Hawton, K. 2010. Psychiatric disorders in women prisoners who have engaged in near-lethal self-harm: case–control study. The British Journal of Psychiatry. 197 (3), pp. 219-226. https://doi.org/10.1192/bjp.bp.109.075424
Visuospatial superiority in developmental dyslexia: myth or reality?
Brunswick, N., Martin, G. and Marzano, L. 2010. Visuospatial superiority in developmental dyslexia: myth or reality? Learning and Individual Differences. 20 (5), pp. 421-426. https://doi.org/10.1016/j.lindif.2010.04.007
Theoretical and ethical issues in conducting research at a women’s centre.
Ciclitira, K. and Marzano, L. 2004. Theoretical and ethical issues in conducting research at a women’s centre. Proceedings of the British Psychological Society. 12 (2).
Being a man: justice and care.
Capdevila, R., Ciclitira, K., Lazard, L. and Marzano, L. 2006. Being a man: justice and care. Psychology of Women Section Annual Conference 2005.. University of Huddersfield. The British Psychological Society.
Interviewing survivors of near-lethal self-harm: a novel approach for investigating suicide amongst prisoners
Marzano, L., Rivlin, A., Fazel, S. and Hawton, K. 2009. Interviewing survivors of near-lethal self-harm: a novel approach for investigating suicide amongst prisoners. Journal of Forensic and Legal Medicine. 16 (3), pp. 152-155. https://doi.org/10.1016/j.jflm.2008.08.011
Justice and care: theorising the 'new man' and the 'caring father.'
Marzano, L., Capdevila, R., Ciclitira, K. and Lazard, L. 2009. Justice and care: theorising the 'new man' and the 'caring father.'. Psychology of Women Secton Review. 11 (2), pp. 11-20.
Being young feminists: discussions and (dis)contents
Adams, E., Del Busso, L., Foster, N., Majumdar, A., Marzano, L. and Papadima, M. 2007. Being young feminists: discussions and (dis)contents. Feminism and Psychology. 17 (3), pp. 291-294. https://doi.org/10.1177/0959353507079081
I. Is my work 'feminist' enough? Tensions and dilemmas in researching male prisoners who self-harm
Marzano, L. 2007. I. Is my work 'feminist' enough? Tensions and dilemmas in researching male prisoners who self-harm. Feminism and Psychology. 17 (3), pp. 295-301. https://doi.org/10.1177/0959353507079082
Supporting staff working with prisoners who self-harm: a survey of support services for staff dealing with self-harm in prisons in England and Wales
Marzano, L. and Adler, J. 2007. Supporting staff working with prisoners who self-harm: a survey of support services for staff dealing with self-harm in prisons in England and Wales. International Journal of Prisoner Health. 3 (4), pp. 268-282. https://doi.org/10.1080/17449200701682501
Non voluntary return? The politics of refugee return to Afghanistan
Sales, R., Blitz, B. and Marzano, L. 2005. Non voluntary return? The politics of refugee return to Afghanistan. Political Studies. 53 (1), pp. 182-200. https://doi.org/10.1111/j.1467-9248.2005.00523.x
Theoretical and ethical issues in conducting research at a women’s health centre.
Ciclitira, K., Marzano, L., Brunswick, N., Starr, F. and Berger, S. 2004. Theoretical and ethical issues in conducting research at a women’s health centre. Psychology of Women Section Review. 6 (1), pp. 60-69.