This study is divided into 4 work packages, completed December 2004 Ð July 2005,which are: literature review, review of suicide management & trauma mitigation used in the rail industry worldwide, review of suicide management & trauma mitigation schemes outside the rail industry, critical appraisal management & trauma mitigation schemes & recommendations for practice. This report (package 4) blends the findings from packages 1,2, & 3 with more material gathered from UK & non-UK rail staff & managers & presents recommendations & a framework for considering response to a railway suicide. (LC)