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Suicide Prevention & Response: New Tools Help Employers Take Action
Suicide is a topic that must be brought out of the darkness in order to save lives. There are many organizations working to dispel myths and bring hope and light to the subject so that those in crisis feel comfortable seeking help to recover and reengage fully in life.
While the burden of suicide is carried by the working-age population, age 24-64, most workplaces are relatively unprepared to help employees who are struggling with suicidal thoughts or to assist colleagues following the death of a co-worker by suicide (CDC, 2010). Thankfully, employers can play a powerful role in preventing suicide and responding appropriately when tragedies occur.
Suicide is more common than you might think: A report published in the American Journal of Public Health in the fall of 2012 found that more Americans die by suicide than in car crashes, by homicide, or in other injury-related deaths (Rockett, 2012). For every suicide death, an estimated minimum of six people are affected, resulting in approximately six million American “survivors of suicide” in the last 25 years (Crisis Care Network, 2013). As employers, your workforce can be impacted directly through the suicide of employees or more indirectly through employees who lose family members or friends, or through the loss of clients or vendors to suicide.
Employees are affected when family members, clients, vendors, and others who surround the work team attempt suicide or die by suicide. Because of the stigma associated with suicide, many people are unsure how to respond to a co-worker who had a death in the family due to suicide. Apart from the immense human cost, suicide deaths often lead to a decrease in productivity and workplace morale when left unaddressed or handled poorly by workplace leaders. Moreover, suicidal behavior and untreated mental illness can often lead to escalating healthcare costs. When a suicide death of an employee does affect the workplace, the surviving co-workers are often left feeling a mixture of grief, trauma, and guilt that can linger for a long time.
Suicide prevention is the ultimate goal of all the tools we share at the Partnership for Workplace Mental Health. We hope that the use of these tools and resources will better equip you to help prevent suicides and to better care for those dealing with suicide loss.
New Tools to Help Employers Respond
Many organizations are coming together to work collaboratively to maximize their collective impact and respond to the reality of suicide. Coordinated suicide prevention in the United States began in the late 1950s. Over the following 50 years, many more organizations were developed to respond to the loss of life through suicide. A revised National Strategy for Suicide Prevention, which was released by the U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, and National Action Alliance for Suicide Prevention (2012), is representative of the new research and resources available to prevent suicide. The Partnership for Workplace Mental Health is pleased to serve on the Workplace Task Force of the NationalAction Alliance for Suicide Prevention (Action Alliance). The Action Alliance is the public-private partnership that is advancing the national strategy, and the Workplace Task Force is pleased to share resources that have been created to specifically address the impact of suicide and suicide attempts in the workplace.
Informational Sheets on the Role of Managers and Co-Workers in Preventing Suicide
In March, the Suicide Prevention Resource Center (SPRC), the nation’s only federally supported resource center devoted to advancing the national strategy, posted two new information sheets online for the workplace: The Role of Managers in Preventing Suicide in the Workplace and The Role of Co-Workers in Preventing Suicide in the Workplace. These sheets provide basic information to help managers and employees (co-workers) recognize and respond to people who may be suicidal or at high risk. They also contain a list of relevant resource materials and organizations. These sheets are part of SPRC’s series of customized information sheets for professionals who work in settings that bring them in contact with individuals at potential risk of suicide.
Having tools that are tailored to both of these perspectives is important, as an individual who is experiencing a crisis may not reach out to his or her manager or supervisor. It is helpful to have tools for co-workers who may have more interactions with the individual or more opportunity to notice behavior changes in their colleagues. Informed managers allow teams to work together to support those in crisis and to find resources.
Manager’s Guide to Suicide Postvention in the Workplace
In May, the Action Alliance’s Workplace Task Force released the Manager’s Guide to Suicide Postvention in the Workplace: 10 Action Steps for Dealing with the Aftermath of Suicide. The primary developers of this resource were the American Association of Suicidology and the Action Alliance in partnership with Crisis Care Network and the Carson J Spencer Foundation.
Postvention, a new term for many, is psychological first aid, crisis intervention, and other support offered after a suicide to affected individuals or the workplace as a whole. Postventions seek to alleviate the potential effects of a suicide death. The Manager's Guide to Suicide Postvention in the Workplace describes the postvention approach in more detail and provides a checklist for applying 10 action steps in dealing with the aftermath of a suicide—framed in three phases of immediate, short term, and longer-term responses. It is important to remember in supporting staff that individuals respond differently to suicide loss over time and in comparison to one another.
“When employers are dealing with the aftermath of a suicide crisis, they often have the ‘deer in the headlights’ experience because they never thought it would happen to them.
Instead of a knee jerk reaction, which can often cause more harm than good, managers can respond thoughtfully to alleviate the impact of suicide or suicidal behavior and support their workforce through this difficult time,” said Sally Spencer-Thomas, PsyD, CEO and co-founder of Working Minds: Suicide Prevention in the Workplace, a program of the Carson J Spencer Foundation.
The manager’s guide also includes tools such as sample communications that can be used in the case of a suicide, as well as a decision-making flowchart that walks managers through various response scenarios appropriate for a near-fatal attempt at suicide, an employee death by suicide, or an employee bereaved by the suicide death of someone they know. The decision-making flowchart is also informative as it speaks to both prevention and postvention. In the case of a near-fatal suicide attempt, the response would include prevention, and the reaction in the workplace would still require a great deal of sensitivity and leadership from the employer.
“Most business leaders have never been taught about suicide prevention nor how to respond to suicide in the workplace.” Bob VandePol, former President of the Crisis Care Network, explained, “These tools can build on the leadership skills many employers already exhibit in supporting their employees — in life and death situations where expertise is desperately needed.” Leaders and managers are often thrust into the role of responding to suicide and suicide attempts. Postvention materials become crucial, as many people are not informed about resources that are available or have never had to face the issue of suicide. The manager’s guide and information sheets will help in such crises but will also provide information that leaders can share and can use to help turn postvention into prevention.
Tips for Employers
Know the Warning Signs & Intervention Steps
Content included in The Role of Co-Workers in Preventing Suicide in the Workplace (Suicide Prevention Resource Center, 2013) describes the most effective way to prevent suicide is to increase awareness of the warning signs and to intervene by reaching out to the person in distress. Employers can take an active role by educating managers and employees about the warning signs and appropriate action. The figure here, from a wallet card from National Suicide Prevention Lifeline, lists the warning signs that require intervention and the steps suggested in the co-worker information sheet. The first three signs require immediate action, which could include calling 9-1-1 or the crisis line, 1-800-273-TALK. In these cases, it is essential to stay with the person in crisis or to make sure the person is in a private, secure place with another caring person. If someone appears to be experiencing other warning signs, it is important to reach out to the person directly.
How to Intervene at the Workplace
Ask how he or she is doing.
Listen without judging.
Mention changes you have noticed in the person’s behavior and say that you are concerned about his or her emotional well-being.
Suggest that he or she talk with someone in the employee assistance program (EAP), the human resources department, or another mental health professional. Offer to help arrange an appointment and go with the person.
Continue to stay in contact with the person and pay attention to how he or she is doing.
When signs are unclear or when employees are unsure how to respond, employees should be instructed to talk with their EAP or human resources department, or call the crisis line.
National Strategy for Suicide Prevention, released by the U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, and National Action Alliance for Suicide Prevention (2012)
Kate A. Burke, MA was associate director of the Partnership for Workplace Mental Health.
Centers for Disease Control and Prevention (CDC). (2010). Web-based injury statistics query and reporting system (WISQARS).
Crisis Care Network (CCN). (2013). Collaborative effort produces manager’s guide to help workplaces with aftermath of suicide.
Rockett, I. R., Regier, M. D., Kapusta,N. D., Cohen, J. H., Miller, T. R., Hanzlick, R. L., . . . Smith, G. S. (2012). Leading causes of unintentional and intentional injury mortality: United States, 2000– 2009. American Journal of Public Health. 102(11):e84-92. doi: 10.2105/AJPH.2012.300960
U.S. Department of Health and Human Services (HHS), Office of the Surgeon General and National Action Alliance for Suicide Prevention. (2012). 2012 National Strategy for Suicide Prevention: Goals and Objectives for Action.