What is your organization doing to protect workers from death by suicide?
What is your organization doing to prevent workers from engaging in death by suicide?
Why is this a worthy question for CEOs, boards and senior leadership? Because suicide ideation is happening much more than the average leader, OHS or HR professional may know.
For example, research from 54 studies reported the prevalence of suicide ideation during the pandemic was 10.8% of the workforce. Though dropped, today it is higher than pre-pandemic, estimated at 4.2%. Putting that into perspective, how much suffering goes unnoticed daily in the workforce?
Regardless of size, I would like to see all Canadian organizations question and dig in. Hopefully, one finding is employers plan to remind and educate their workforces about the Canadian Radio-television and Telecommunications Commission’s new free 9-8-8 line scheduled to come online on November 30. Once all carriers get this up and running, employees will be able to call or text for immediate mental health crisis and suicide prevention support.
How psychological health and safety support preventing death by suicide
We are fortunate in Canada to have the CSA Z1003 National Standard on Psychological Health and Safety that provides a North Star for all employers to reduce mental harm and promote mental health. The HOW is left to employers to determine how they will act. All employers should get a baseline of what psychosocial factors are charging and draining their workforces. They can use an evidence-based tool, listen directly to employees’ experiences, or adopt a Plan-Do-Check-Act (PDCA) approach to workplace mental health regarding the methods used to prevent and support workers’ well-being.
Psychological health and safety’s prime objective is to positively impact employees’ feelings (e.g., percentage of time spent in pleasant versus unpleasant emotions). It should also take accountability for driving out fear and silence to create inclusive, welcoming, and belonging cultures committed to removing fear of judgement and stigma. This will help workers who feel overwhelmed, stressed, confused by their thoughts and losing hope know it is OK and safe to ask for help.
Workplace Mental Health Suicide Prevention Checklist
When I talk to workers about death by suicide, I often use the analogy of a car not starting.
I say something like, “When I get in my car and it does not start, I ought to know that something is wrong. I do not conclude that because I do not know the answer, there is none.”
I do this because after more than 30 years of clinical experience helping people in mental health crises, I know the first step is to gently help them look beyond their perception and discover new perspectives and possibilities that promote hope and opportunity.
The tragedy of death by suicide is how often a person can suffer in silence for years with their mental health unknown to others. One death-by-suicide profile that can leave friends, family and peers shaken is when the person appears as always being upbeat and happy, demonstrating no signs, symptoms or warnings of suicide.
I’m often asked by those left behind why individuals do it. I typically say, “We may never really know.” However, I have learned something from the individuals I have worked with. They have tried unsuccessfully to make their lives fit the profile of a happy and contented person. They explained their mental process to make what I define as “the utopia decision.”
Moving from unconscious to conscious suicidal thoughts started to consume their mental energy. Whether the trigger that sparked this mental process was substance use, suffering from a mental illness in silence, loss of a relationship or financial loss, the focus was the same: to stop the emotional pain. With the absence of hope and not knowing — or, more importantly, believing because of their perception, nothing would ever change—the decision to die by suicide was perceived as the only option to stop the pain.
I have been told more than once by those who have survived that once the decision was made, it released a sense of calm that provided space for final planning to move from thought to engaging in the final event to facilitate their death by suicide. For people with this profile, how long this mental process takes from the first suicide ideation to execution varies.
This is why I am advocating more and more that suicide prevention is critical for every workplace mental health program so more employees will share their pain and thoughts that can trigger early intervention. Mental health intervention can be impactful and helpful for a person to discover new perspectives, provided it is activated.
Make suicide prevention a priority within the PDCA workplace mental health strategy — Ensure that Duty to Inquire and suicide prevention are adopted to facilitate early intervention and support from mental harm due to mental health crises and suicidal thoughts. An employee sharing they are having suicidal thoughts is an opportunity, not a burden, as it creates a path for changing perspective. Shame, stigma and mental health state (living in unpleasant emotions and thoughts) can fuel internal bargaining and the tragic utopia decision.
There is a significant difference between first unconscious, random thoughts about suicide and moving to consideration and planning. For example, the estimated daily prevalence of suicidal ideation in the Canadian workforce of more than 18 million workers is approximately 4.3%, hundreds of thousands. It is estimated there are 12 suicides a day in the general Canadian population. Suicide prevention can reduce stigma and increase the opportunity for those moving from unconscious, random suicidal ideation to conscious ideation to know there is help and hope in times of need.
Awareness Campaign — Educate workers about suicide ideation. Normalize it and ensure employees know there is often a significant jump from automatic thoughts to conscious planning. Under stress, the unconscious mind can spawn unfiltered ideas such as eat potato chips, drink alcohol and even “There is nothing to live for.” Life can feel overwhelming, and a person questioning whether life is worth living is a warning sign. Education and caring can build a bridge to asking for assistance.
Education can remove the myth that talking about death by suicide makes it worse. The goal needs to be normalizing how the brain works under stress, options, employer support resources and the 9-8-8 line. Meaningful campaigns and education are not one-and-done. They are thoughtful and need a PDCA approach that sets the goal that the employer deeply cares about every struggling employee. It is also beneficial to ensure HR and leaders are trained and guided on their role of preventing death by suicide.
Employers can leverage the Mental Health Commission of Canada’s resources on suicide prevention or engage subject matter experts with clinical experience to create materials using the most current research.
Audit all employer’s mental health supports — Many employers outsource their mental health support to credible employee and family assistance providers to access private mental health professionals and short- and long-term disability and return-to-work programs. Through the CSA Z1003 Standard lens, the most critical action steps an employer can take are ensuring the “check” in PDCA is being done. Beyond obtaining statistics from providers, employers must audit and ensure their programs are doing what they are supposed to. The stakes are high regarding mental health concerns and substance use, and it is prudent to ensure the help being provided is having an impact.
Dr. Bill Howatt is the Ottawa-based president of Howatt HR Consulting.