Dr. Sally Spencer-Thomas, a national author, speaker and psychologist with expertise in workplace suicide prevention, works with the Oklahoma Department of Mental Health and discusses programs and workplace practices to prevent suicide.
How does a suicide of a worker impact employees and organizations? A workplace suicide has a major impact for any employer, union or professional association. It has a tsunami effect on the co-workers and the community. Suicide death is often overwhelming and leaves survivors in a wake of trauma and grief. Organizations need to learn best practices in suicide “postvention” to support the co-workers left behind.
Do suicide rates impact industries and occupations differently? Some industries have higher suicide rates than others and are more impacted. The industries most-impacted include most male-dominated industries like construction, mining, oil and gas, transportation and manufacturing. These industries have much higher suicide rates, and thus many more workers have lost friends and co-workers to suicide in these industries. Therefore, these industries need to be even more prepared for suicide prevention, intervention and postvention response.
What are some common risk factors that contribute to workplace suicide, and how can organizations identify and address these factors effectively? “Work-related suicide” means suicide that is explained in part or in whole by work-related factors. There are a number of risk factors that we call psychosocial hazards that happen in a workplace. Research has demonstrated that workplaces that have certain job design elements like low autonomy, low job variety, a new effort-to-reward imbalance and lack of control, they tend to have a correlation with increased risk for suicidal thought, suicide attempts and suicide death. Furthermore, work that impacts work-life balance in a significant way also tends to increase suicide risk. Workplace cultures that are toxic and where discrimination prejudice, bullying, hazing and harassment are common are also at increased risk for suicidal intensity. Lastly, workplaces that have a disconnection between workers and a sense of mission or purpose often leave workers feeling like they are a cog in a wheel of someone else’s profit-making or someone else’s achievement. This usually leaves workers to feel disenfranchised.
In your experience, what are some warning signs or behavioral changes that might indicate an employee is at risk for suicidal thoughts or actions? Sometimes suicidal intensity doesn’t show up at work in a direct way. However, usually there are indirect signs and changes that may indicate that an employee is having a very tough time and might be thinking about suicide. These changes include increased absenteeism or presenteeism. Presenteeism is when workers show up to work but they don’t function at the same level of productivity because they’re highly distracted and overwhelmed. Additionally, you might see workers who have low-stress tolerance or who are quick to anger in response to small stressors or small conflicts. Another indication that a worker is highly distressed is increased use of numbing behavior — alcohol, other drugs or addictive behaviors — to cope more than they have before. Increased errors or safety problems might also be an indicator that the worker is distracted or overwhelmed. Sometimes, there will be a direct warning sign like people expressing a sense of worthlessness or even expressing a desire to die. These warning signs should not be ignored.
How can employees create a supportive and mentally healthy work environment to prevent suicide among the employees? Are there any best practices or programs that you can recommend? In 2019, the Workplace Suicide Prevention and Postvention Committee, co-chaired by myself and Dr. Jody Jacobson Frey, launched the National Guidelines for Workplace Suicide Prevention. These national guidelines offer nine practices and eight guiding principles that help employers and workplace organizations like unions and professional associations develop a strategy and a mentally healthy and psychologically safe culture. The practices are organized into upstream, midstream and downstream approaches. Upstream practices include leadership engagement, cultivating an impactful communication strategy and reducing psychosocial hazards. Midstream practices help people identify problems related to suicide and other mental health challenges when the problems are relatively small. Thus, midstream practices involve things like helping people to self-screen for mental health challenges or suicidal thoughts. The midstream approach also includes a stratified training program. Here, suicide prevention is not just a one-off training event but a tiered training strategy that works on different levels for different types of groups of workers over the course of a worker’s career. The midstream approaches also empower peers to be allies for one another when they’re going through tough times. Formal work-related peer support programs have had great impact in our military services and first responder communities and are the future of mental health promotion across most workplaces in the future. Downstream practices help organizations make sure that the mental health resources that they are offering their workers understand how to help people experiencing suicide intensity, how to respond in a crisis while at the same time upholding workers’ dignity and providing collaboration in their recovery. Recently, United Suicide Survivors International, with the support of the American Foundation for Suicide Prevention and the Workplace Suicide Prevention Committee has developed a new H.O.P.E. certification. H.O.P.E. stands for “Helping Our People Elevate through tough times.” This program was recently piloted in the state of New York with much success in the construction industry.
The H.O.P.E. certification program brings a cohort of organizations through a process of implementing nine practices. They get access to coaching and tutorials to help them execute these practices using evidence-informed tactics. The H.O.P.E. certification program gets at the deep change needed to shift culture and make mental health a priority.
What role do mental health policies and programs play in suicide prevention efforts in the workplace? How can organizations ensure these policies are effectively implemented and accessible to all employees? Mental health programs and policies help ensure that a standard is set for the long term and not just at the whim of a couple of passionate workers. Policies might include protocol that guides managers through difficult questions like: “How do we onboard new workers to make them appreciate that their mental health matters at work? How do we respond when people are having challenges to help support them with accommodations and leave?” Just like we would someone who is experiencing cancer or recovering from a car accident and should someone need to take a leave for suicide experiences. How should we reintegrate an employee with dignity and respect after they have been away for addiction recovery treatment or after a suicide loss. Mental health programs might include things like general awareness training, manager training, peer support programs, mental health resource benefits and much more. Organizations who have these policies and programs should then make sure that they are well-socialized throughout the workforce. This effort needs to be a priority beyond just your human resources and benefits staff. A core group of mental health champions can help in the effort of increasing awareness about these resources, policies and programs so that all employees are aware and can respond proactively.
How can managers and supervisors be trained to identify and address mental health concerns among their team members? What support should they receive to effectively intervene and offer assistance? Managers and supervisors should be trained early and often around mental health promotion and suicide prevention and addiction recovery. These issues should be embedded in any leadership development program as part of the skill sets needed to help manage teams and support employees. This mental health and suicide prevention training should be based in collaborative and compassionate understanding of mental health challenges people experience as well as a practiced skill set that helps managers have constructive conversations with workers to let them know they’re not alone. Managers should also be trained on how to be an effective bridge to resources. When managers are in intense situations surrounding mental health challenges with workers, they, too, should know that there is a pathway that they — the managers — can get support. Managers should become confident in reaching out to their employee assistance program or crisis resources like 988. Managers and supervisors should know what to do in times when workers are having crises or suicidal thoughts. This type of manager training needs to be repeated over time so that it stays fresh in the minds of managers and not just be a one-and-done event.
What role can employee assistance programs or mental health resources play in preventing suicide in the workplace? How can organizations promote the utilization of these resources effectively? Employee assistance programs (EAP) should be a key benefit for any employer — not just the large employers but everyone. Employee assistance programs usually provide counseling services not just for the employee but for all their dependents. Often, EAPs offer a number of sessions per issue per person per year, but they also do much more. They tend to also offer financial counseling, legal counseling, sometimes support for children or elders and a lot of other services. In order for EAPs to work well, they have to become a strategic partner of the organization. Leaders should develop relationships with the EAPs so that when there is a mental health emergency, there can be a warm hand-off to support other types of mental health resources that should also be offered beyond the employee assistance program. These might include a relationship with the county mental health system 988, other crisis resources or other online programs for addiction recovery centers. Developing relationships with these resources before there is a crisis will help the transition in crises go much more smoothly.
Organizations can promote mental health resources in a number of ways. They can bring awareness about the resources up in team meetings, through newsletters and social media, during the onboarding process, during leadership development training, during all hands meetings and much more. Not only should information be shared on how to connect with these resources, but organizations should work to bring them to life so that employees know what to expect. They can do this by conducting a mental health resource audit or by bringing the mental health service to the workers — like a brown-bag lunch or some other meet and greet. That way workers see that the providers of these resources are just other human beings and that they deeply care. Managers should also go “kick the tires” of the mental health resources so that they can become intimately familiar with how they work and how best to engage workers in their services. The more we can come to understand mental health resources, the better that chain of survival will function.
Looking ahead, what do you believe are the most critical steps organizations should take to prioritize workplace suicide prevention and support the mental well-being of their employees? Organizations just need to start taking action — moving beyond just raising awareness. Organizations need to be training workers across the scope of their career to play different roles in advocating for well-being and assisting people during mental health emergencies. Beyond this, it is essential that organizations understand the root causes of employees’ distress and despair. One of the best things that any organization can do is deep listening. By undergoing a “needs and strengths assessment,” organizations can understand what some of the drivers of distress are among their workforce. A deep-listening approach leads to a much more robust strategy and so much more. Listening helps increase worker buy-in for the development of any type of future mental health program, and listening also helps the organization customize its strategy to the particular needs of its workforce. Finally, workplaces that recognize and reward vocal, visible and visionary efforts in mental health promotion and suicide prevention will continue to reap the rewards of changing culture.
So we ask – “Is it possible for us to highlight the success of some leaders in mental health and psychological safety like we highlight the success of others in productivity and financial rewards?
What else do you think we should know about concerning the mental health of employees or suicide rates that we haven’t discussed? Emotional well-being of workers will make employers future-proof. As we know most of our work roles of today will most likely be taken over by artificial intelligence or other types of technology in the future — but emotional needs are human needs. And it’s unlikely that machines will be able to do this as well as humans do in empathy and collaboration. So, for organizations that are looking to the future and want to recruit and retain the top talent, having a strong mental health program that goes beyond just raising awareness and providing stress relief, like yoga and meditation. Am initiative will also provide support for really difficult mental health issues like depression, anxiety, addiction, trauma and suicide. Organizations that do this well will survive and thrive.