1. health and fitness

HR: Suicide is new disturbing trend
Alan Goforth
BenefitsPro | June 01, 2015
Nearly 80 percent of employers offer programs to
promote the physical well-being of their employees.
They may want to expand wellness programs
to address depression and other mental health
issues, based on a disturbing trend documented
in a recent study by the American Journal of
Preventive Medicine.
“Every 20 minutes, someone commits suicide
in the United States,” says Bert Alicea, licensed
psychologist and vice president of EAP and work/
life services for Health Advocate Inc. in Plymouth
Meeting, Pennsylvania. “Given that rate, there is a
possibility of a suicide at your workplace.”
The study found that slightly more than 1,700
employees committed suicide in the workplace
between 2003 and 2010, for an overall rate of 1.5
per one million workers. Suicides declined between
2003 and 2007 but then spiked during the remaining
years of the study. Non-workplace suicides totaled
270,500 during this period, for a rate of 144 per one
million people.
Among the significant findings about workplace
suicides:
• Rates were higher for men (2.7 per one million).
•Workers aged 65 to 74 (2.4 per one million) were
more likely to end their lives.
•
The profession with the highest suicide rate is
protective services such as police and firefighters,
followed by farming, fishing and forestry.
The human toll is devastating, but there also is a high
economic cost. A 2010 analysis estimated the price
of depression at $210.5 billion, with 45 percent to
47 percent attributable to direct costs; 5 percent to
suicide-related costs; and 48 percent to 50 percent
to workplace costs.
Why?
There often are more questions than answers on
this sensitive topic. Why would a person kill him
or herself, and why in the workplace? The journal
article suggests:
Occupation can largely define a person’s identity
and psychological risk factors for suicide, such
as depression and stress, can be affected by the
workplace. Also, as the lines between home and
work continue to blur, personal issues creep into the
workplace, and work problems often find their way
into employees’ personal lives.
Clare Miller agrees with this assessment. She is
director of the Partnership for Workplace Mental
Health, which is part of the American Psychiatric
Foundation in Alexandria, Virginia.
“The line between work and home more and more
is nonexistent,” she says. “More of us work at home
part time or bring work home to do in the evenings,
so there is no line of demarcation.”
- continued -
In other words, home is no longer a safe haven
from work-related stress, and personal issues also
enter the workplace. “Employees may be dealing
with other things in their lives, such as divorce or
separation; financial hardship; or the death of a
family member,” Alicea says.
The increase coincides with the recent recession,
and workplace bullying also can play a role.
“We did a study not long ago that found that asking
people to do more with less can increase stress,”
Miller says. “We also have found more incidences
of bullying, which can be an outgrowth of poor
organizational practices.”
Education is essential
Regardless of the cause, employers have an
opportunity to educate and encourage employees,
and intervene if necessary. As the Journal
article states:
Suicide is a multifactorial outcome and therefore,
multiple opportunities to intervene in an individual’s
life—including
the
workplace—should
be
considered. A method that may reduce the burden
of suicide suggested by the National Action Alliance
for Suicide Prevention Research Prioritization Task
Force was increasing the number of people trained
for suicide assessment and risk management.
Implementing effective and evidence-based
programs for the training of these individuals is
pivotal. The workplace should be considered a
potential site to implement such programs and train
managers in the detection of suicidal behavior….
A successful strategy has two key components—
education and observation. Although society
has come a long way, many people still attach a
stigma to mental health issues. “The objective is
to create awareness and change mental health
from a taboo subject to something that can be
openly discussed,” Alicea says.
Health Advocate Inc. offers a number of printed
resources to its clients. Partnership for Workplace
Mental Health offers a number of free resources to
all employers.
“We have program called the Right Direction
Initiative for employers to use to raise awareness
of depression, which tends to be a leading cause
of suicide,” Miller says. “Not every person who has
depression is suicidal, but it can be a key indicator.
We have a portal through which employers can get
communications materials, posters and information
for company newsletters. We encourage them to
use it as a tool to get employees started talking
about mental health.”
Employee participation
Programs like this will succeed only if employees
are educated, know where to turn for help and are
encouraged to not be afraid to seek assistance.
That information often is lacking. For example,
many employees are not even aware that their
company has an EAP, she says. Although top-down
commitment is important, the best prevention tool
may be peer-to-peer accountability.
“Colleagues really need to reach out to each
other, because they often can see tangible signs
of depression,” Miller says. One practical tool is a
Workplace Mental Health website called ICU, which
is free to access at www.workplacementalhealth.
org/Spotlights/ICU.aspx
The worst outcome is to play “Monday morning
quarterback” and connect the dots only after a
tragedy has happened, Alicea says.
“Don’t be afraid to ask questions,” he says.
“Employees may have a change in appearance, or
say things such as ‘life is not worth living’ or talk
about hurting themselves. One sign by itself may
not be an indicator, so look for different factors.
Have a responsible plan to provide education
before a situation occurs.”
An EAP, if properly implemented, can be a
valuable resource.
“Your EAP can help you see those red flags and
assess risk factors,” Alicea says. “But don’t
implement an EAP simply for the sake of saying
you have one. Show that you care about your
employees, and make it visible. Present it not as a
medical model but as an educational model. If you
do it right, it will have a big return on investment.”
- continued -
One of the best things an EAP can provide is a
nonthreatening atmosphere to talk things over.
“Confidentiality is really important,” he says.
“Employees need to know they can call us
anonymously or even do a depression assessment
on our website.”
Perhaps the most important thing an employer
can do is to counter the stigma surrounding
mental health. “Don’t ignore it,” Alicea says. “It’s
OK to talk about mental health. If employees
are not comfortable, make sure they know it
is confidential.”
Human resource professionals can play a critical
role in helping prevent workplace suicide,
Miller says.
“HR professionals are in a position to really make a
difference,” she says. “I would point to two things.
The first is in their role as a purchaser of health care.
You need to really ask questions of your health
vendor partners. Ask about mental health, because
that issue often is not raised.
“Second, take action to promote awareness of
services to employees. Don’t wait for the perfect
mental health awareness plan, because it will
never happen.”
An ounce of prevention can go a long way
Businesses can take a number of steps to reduce
the risk of workplace suicide. The organization
Workplace Strategies for Mental Health recommends
the following:
General
•
Be aware of individual risk factors. These can
include previous suicide attempts; suicide by
an acquaintance; addiction or substance abuse;
mental illness; access to lethal drugs or weapons;
or stigma that discourages employees from
seeking help.
•Implement a comprehensive psychological health
and safety management system to help improve
overall workplace culture and resolve issues
more effectively.
•Reduce stigma related to mental health issues so
all employees feel safe asking for help.
•
Ensure your EAP provides appropriate support
and counseling services to those who may have
thoughts of suicide.
•Ensure that employees are aware of confidential
EAP or community services that are available to
help them.
Training
•
Be prepared and aware by providing suicide
intervention training.
•
Increase interpersonal and social competency
through training in stress management and coping
skills to help individuals deal with problems.
•Raise awareness of organizational and community
supports, including expertise through human
resource, mental health agencies or EAP to
help managers and union representatives make
appropriate referrals.
•Resolve workplace issues quickly and effectively
to reduce feelings of hopelessness.
Education
•
Offer
evidence-based
suicide
prevention
education to employees. Provide education to
help recognize mental health problems, including
warning signs of suicide.
•
Promote awareness that many suicides are
preventable; make facts available about suicide,
risk factors and prevention approaches.
•Ensure employees understand that they are not
required to intervene or put themselves at risk if
they are ever in the position of responding to a
situation of a potential suicide.
• Expand awareness of mental illness and addiction.
•
Help reduce stigma associated with mental
illness, substance abuse and suicide.
•
Encourage help-seeking behaviorsf for such
problems.
Create a caring work environment in which coworkers support each other. Promote listening
and interpersonal skills to help individuals improve
their relationships.
BenefitsPro | June 01, 2015