Suicide and the Workplace

Suicide and the Workplace: Literature Review

 

The workplace is one of key environments affecting mental health and well-being.1 Gainful employment provides experiences that promote mental well-being through the provision of structured time, social contact, collective effort and purpose, social identity, and regular activity.1 Unfortunately, the workplace can also be the source of nonproductive stress leading to physical and mental health problems, including suicidal thoughts and behaviours and suicide.

 

Statistics

 

Suicide in the workplace is a rare event, with one study estimating that less than 5% of all suicides occur at work.2 Data from the Census of Fatal Occupational Injuries indicates less than 1% of all suicides in each year from 2005 through 2009 occurred in the workplace.3

 

 

Data Year

Number of Workplace Suicides3

Total Number of Suicides4

Percentage

2005

169

32,637

0.5

2006

201

33,300

0.6

2007

196

34,598

0.5

2008

261

36,035

0.7

2009

263

36,909

0.7

 

In America, however, suicide occurs most frequently among individuals of working age, 25-65 years, highlighting the critical need for prevention initiatives and intervention training for this population.4-7

 

 

Data Year

Number of Suicides,
Age 25-65 Years4

Total Number of Suicides4

Percentage

2005

22,993

32,637

70.5

2006

23,853

33,300

71.6

2007

25,142

34,598

72.7

2008

26,133

36,035

72.5

2009

26,768

36,909

72.5

 

 

The Cost of Mental Illness and Suicide

 

The financial cost associated with mental illness and suicide is significant. Spending on depression alone is estimated to be $30-40 billion in the United States.1 Data from the Centers for Disease Control and Prevention show that in 2005 the medical and work loss costs of deaths by suicide, among people age 25-64 years, was over $20 billion.8

 

Other direct costs that may be incurred in the case of suicide attempts include nursing home care, psychological and/or physical rehabilitation, and pharmaceuticals. There may also be costs associated with lost productivity by family and friends caring for injured victims.9

 

The cost of workplace suicides extends far beyond what the monetary figures indicate. Intangible and human costs include the emotional and mental health effects (pain, grief, suffering, and quality of life) on co-workers, the workplace culture, family, and friends.

 

Help-Seeking – or not – in the Workplace: the Importance of Stigma

 

Various studies have found many individuals who attempt or die by suicide never seek help.6-7, 10 Only about one-third of workers with depression will seek help from a mental health professional, physician, or employee assistance program.2

 

Some employers may not see work or the workplace environment as contributing to mental health issues.1 Others may avoid the topic of suicide believing incorrectly that talking about suicide may stimulate or perpetuate suicide ideation among their employees or that silence on the issue will be protection against liability if a suicide occurs.7, 10

 

The above factors, while important, are overshadowed by the role of stigma in determining whether or not an employee will seek help for mental health or suicide-related issues. Stigma, whether real or perceived, can create a negative workplace where employees do not seek help because:

  • A mental health issue may result in a demotion or change of job, perhaps even being fired.1
  • Career advancement may be impeded.2
  • They fear confidentiality breaches.2
  • There are negative reprisals from co-workers or management.2
  • Co-workers blame them for their mental health issues.11
  • Using the services of an employee assistance program may raise questions about competence and employment suitability.12

 

When Mental Health Issues and Suicide Happen in the Workplace

 

Colleagues may not want to intervene with a person-at-risk because they do not want to cause difficulty for the individual or damage the working relationship they have with them.A suicide attempt may elicit awkwardness and embarrassment from coworkers who do not how to act or what to say in the aftermath. A death by suicide may leave coworkers feeling as if they somehow contributed to the suicide or they may blame themselves for not having prevented the death. Colleagues who were particularly close to the deceased may experience feelings of anger, rejection, and betrayal. Managers may feel blamed by others for the suicide.2

 

Some people may struggle with feelings of guilt and be challenged by unanswerable questions of what they could have done to help. Depressive reactions or thoughts of suicide after a colleague’s suicide are not unknown.13

 

Employee Assistance Programs and Suicide Prevention

 

By 2005, Objective 4.4 of the National Strategy for Suicide Prevention sought to “increase the proportion of employers that ensure the availability of evidence-based prevention strategies for suicide” (67). Employee assistance programs (EAPs) were identified as an example of a worksite-based program to help prevent suicide.14

 

Paul and Jones (2009) assert employee assistance programs are perhaps the most qualified and best-positioned within an organization to lead suicide prevention efforts as often they are already involved with prevention, employee education, outreach, and early intervention. Given the fact that many people do not seek help when suicidal, the authors suggest employee assistance programs work with organizations to identify individuals at risk, reduce modifiable risk factors and enhance protective factors.6

 

Figures on the savings an EAP-based suicide prevention program might generate are not available. However, a study found that for every dollar invested in an EAP to treat depression, the return on investment was $2-$4 in savings. EAPs can also contribute to increased productivity and decreased absenteeism.15

 

Suicide Prevention Training in the Workplace and LivingWorks Education

 

Aside from the pain and suffering engendered, the suicide of an employee is costly for business. But preventing suicide is also very cost-effective with average savings of $1,182,559 being realized for each death so prevented.5

 

Key elements in workplace suicide prevention are: (1) creating a workplace culture in which help-seeking behaviours are encouraged,2, 5-6 and (2) training.1, 6-7, 14

The benefits of creating a workplace culture that supports worker health and safety are substantial and include reduced absenteeism and presenteeism, reduced medical expenses, increased productivity, and a sense of loyalty that increases morale and helps to retain staff. Such an environment signals the company is investing in its greatest asset, namely, its workers.5 Companies must clearly communicate messages of their commitment to create a caring environment with the accompanying development and promotion of policies and procedures that will accomplish this goal.2, 6

 

The World Health Organization report on preventing suicide in the workplace (2006) states “few managers currently have sufficient knowledge and skills to recognize and manage mental health problems at work or deal with a suicidal worker” (13).2 Paul and Jones (2009) name training, including instruction on risk factors, protective factors, steps to take when risk is identified, as a key element in suicide prevention programs.6

 

 

References

 

  1. Harnois, G., & Gabriel, P. (2002). Mental health and work: Impact, issues and good practice. Geneva, Switzerland: World Health Organization.
  2. World Health Organization. (2006). Preventing suicide: A resource at work. Geneva, Switzerland: Author.
  3. U.S. Bureau of Labor Statistics. (2012). Census of fatal occupational injuries. Retrieved from http://www.bls.gov/data
  4. Centers for Disease Control and Prevention. (2012). WISQARS fatal injury reports, national and regional, 1999-2009. Retrieved from http://webappa.cdc.gov/sasweb/ncipc/mortrate10_us.html
  5. Spencer-Thomas, S. (2011, October). What workplaces can do to prevent suicide. IndustryWeek.com. Retrieved from http://www.industryweek.com/PrintArticle.aspx?ArticleID=25846
  6. Paul, R., & Jones, E. (2009). Suicide prevention: Leveraging the workplace. EAP Digest, 29(1), 18-21.
  7. Paul, R. (2004). Suicide prevention: A call to action for EAPs. Behavioral Health Management, 24(5). Retrieved from http://valueoptions.com/company/Coverage/pdfs/Suicide_Prevention_A_Call_to_Action_for_EAPs.pdf
  8. Centers for Disease Control and Prevention. (2012). Cost estimates of violent deaths: Figures and tables [Suicide, Table 3]. Retrieved from http://www.cdc.gov/violenceprevention/violentdeaths/table3.html
  9. Centre for Suicide Prevention. (2010, June). The cost of suicide [newsletter]. SIEC Alert, 74, 1-2.
  10. ValueOptions. (n.d.). Building organizational support. Retrieved from http://www.valueoptions.com/suicide_prev/html%20pages/Support.htm
  11. Spencer-Thomas, S. (n.d.). Suicide prevention in the workplace: Whose responsibility is it? A call to action for business leaders. Retrieved from http://www.WorkingMinds.org
  12. Stuart, H. (2004). Stigma and work [Discussion Paper]. HealthCare Papers, 5(2), 100-111. Retrieved from http://www.longwoods.com/content/16829
  13. Suicide Prevention Resource Center. (n.d.). The role of co-workers in preventing suicide. Retrieved from http://www.sprc.org/sites/sprc.org/files/library/CoWorkers.pdf
  14. U.S. Department of Health and Human Services. (2001). National strategy for suicide prevention: Goals and objectives for action. Rockville, MD: Author.
  15. National Alliance on Mental Illness (NAMI). (2010, January). Mental illness and the workplace. Retrieved from http://www.nami.org/Content/NavigationMenu/State_Advocacy/About_the_Issue/Workplace.pdf