What Employers Need to Know About Suicide Prevention
What should organizations do to help prevent suicide among its employees — and to help support suicide survivors after the death of a coworker? Research suggest first leaders and managers must recognize the workplace predictors of suicide. Then, create a respectful and inclusive work environment, learn to identify employees who might be at risk, and create a plan to take action. In cases where an employee dies by suicide, ensure you can offer their coworkers psychological first aid, crisis intervention, and both short-term and long-term support.
Between 1999 and 2018, the rate of suicide deaths in the United States increased by 35%. Each year, approximately 47,000 Americans die by suicide, which equates to approximately 130 deaths each day. The majority of suicide deaths occur among working age individuals, and statistics show that the number of suicides enacted at work have reached record highs.
As the world continues to battle an ongoing pandemic, more individuals are at risk for experiencing decreased mental health as well as increased suicidal thoughts and behaviors. Now, more than ever, it is critical for organizations to evaluate the role they play in preventing suicide deaths, as well as strategize about ways to aid those considering suicide and effectively support suicide survivors after the death of a coworker.
Workplace Predictors of Suicide
Suicide is a complex phenomenon that is influenced by several intersecting life factors, including individual attributes, environmental conditions, and access to lethal means. As a result, identifying employees at risk for dying by suicide is a complicated process. Our research has shown that one important piece of the puzzle involves employees’ work experiences, including characteristics of the job itself (e.g., meaningfulness, autonomy, variety) and social interactions with coworkers. Take, for example, the suicide deaths or attempts of 13 employees at the Chinese manufacturing company Foxconn in response to extreme working conditions, or the suicide deaths of 35 employees at the French-based telecommunication company Orange as a result of managerial bullying. These situations underscore the very real and adverse effects that the workplace can have on employees’ psyches and behaviors, which can ultimately result in suicide.
We conducted a review of more than 500 studies related to work and suicide to uncover the work-related factors that predict employees’ suicidal thoughts and behaviors. At the core of the review, we identified social and psychological pain to be the central causes of suicide-related behavior. According to the interpersonal theory of suicide, social pain occurs because individuals are unable to establish meaningful connections with others or perceive themselves to be a burden to others. On the other hand, the psychache theory of suicide focuses on psychological pain that is akin to mental suffering or extreme anguish. Individuals who experience either type of pain may enact suicide to end their suffering, especially when they perceive their situations as unchanging or hopeless.
Workplaces are inherently social institutions. While they can provide a sense of community, they can also engender feelings of both social pain and psychological pain. Our review of the literature uncovered a multitude of factors that predict suicide-related thoughts and behaviors among employees, including interpersonal relations, work-family conflict, unstable employment, unemployment, burnout, fatigue, job demands (e.g., workload, stressors, scheduling), job characteristics (e.g., meaningfulness, autonomy, variety), and the physical work environment (e.g., ergonomic and safety features).
As apparent from this varied list, the predictors of suicide are not limited to a single industry or occupation; any job can engender suicidal ideation. Indeed, suicide develops from experiences of social and/or psychological pain, which can develop from detrimental aspects of any workplace. For this reason, all organizations must be cognizant of their influences on employees’ mental well-being, as well as actions they can take to reduce suicides. Additionally, organizations must be prepared to respond to an employee’s suicide death — actions known as postvention strategies.
Organizational Prevention Strategies
In light of the relationship between workplace factors and suicide, organizations have an obligation to prevent suicide-related deaths. The Suicide Prevention Resource Center (SPRC) is federally funded and uses research to create infrastructures to prevent suicide deaths. The SPRC recommends that organizations can use three primary strategies to proactively address suicide: 1) create a respectful, inclusive work environment, 2) identify employees who may be at risk, and 3) create a plan to respond to take action.
Create a respectful work environment and foster social inclusion.
Social connectedness is essential for fulfilling employees’ belongingness needs and helping them to feel part of the work community. While important for all employees, fostering social connectedness will become increasingly important as more employees engage in telework or work in isolation, both due to the current Covid-19 pandemic and changing technological innovations. Thus, inclusion should be a key component of a workplace suicide prevention program.
Organizations can foster a sense of connectedness by establishing mentoring programs and encouraging team-based work projects that allow employees to share ideas and collaborate to reach goals. Providing opportunities for employees to informally engage with another can also build social bonds and has been shown to predict job satisfaction and affective well-being. In providing such opportunities, it is important for organizations to create workplace social norms that favor respectful communication and behaviors. Research has demonstrated that incivility and bullying are on the rise within workplaces. Such deviant behaviors not only degrade social bonds but also isolate employees at work, therefore making possibly at-risk employees more susceptible to experiencing suicide-related thoughts and behaviors.
Identify employees who may be at risk.
Managers and HR professionals are important gatekeepers for recognizing individuals who are at risk of suicide and aiding those who need help. In addition to workplace specific factors, prior research has identified the following as risk factors of suicide: 1) health conditions such as mental illness, alcohol and substance abuse disorders, as well as major physical illnesses; 2) negative life events including unemployment, job loss, and loss of key relationships; 3) a personal history related to suicide such as a family history of suicide deaths, previous suicide attempts, and a history of trauma or abuse; and 4) access to lethal means, which includes accessibility to means to enact suicide such as a firearm and other weapons or lethal medications.
Tackling these risk factors may be extremely challenging for leaders, however. Directly asking employees about certain topics may be protected under the Americans with Disabilities Act, such as asking employees to disclose mental illnesses. It is important to refer to continuously managed resources, such as those provided by the Society for Human Resource Management and the Job Accommodation Network, to determine whether it is legal to ask specific questions.
Despite this challenge, it’s important for managers to understand these factors so that they can provide employees with adequate social support and access to resources — even when an employee has not explicitly indicated suicidal intentions. For instance, when organizations undergo restructuring or have to make layoffs, these changes in employment status could contribute to suicidal ideation or behaviors among the affected employees. Thus, an important component of any organizational change or severance package would be access to mental health resources and health care.
Additionally, while a manager is restricted in the types of questions they can ask employees, employees may voluntarily disclose information that would indicate their potential risk for suicide. As an example, a person might reveal that they own a gun. While this information on its own isn’t alarming, it would be important knowledge to have if that employee were to experience a serious negative work event such as being written-up or passed over for a promotion. In this instance, if a manager felt concerned about the employee’s safety, they could take actions to contact the appropriate individuals (e.g., the police or a mental health professional).
Keep in mind that, although the factors discussed above are risk factors to suicide, not all employees who meet these criteria will be affected by suicidal thoughts or behaviors. For instance, having a mental illness does make one more vulnerable to dying by suicide, but not all individuals with a mental illness die by suicide. Rather, knowing this information can be vitally important in certain contexts or in the presence of other concerning behaviors.
Because of this, it’s also essential for employers to pay attention to employees’ language and behaviors that might indicate someone is experiencing distress, such as withdrawing oneself, acting anxiously, or experiencing extreme mood swings, or talking about being a burden to others, feeling hopeless, or having no reason to live. For example, if an employee has recently undergone a divorce and has been very withdrawn at work for several weeks, managerial intervention would be valuable. Intervention could include checking in on the employee and referring the employee to available mental health resources (e.g., employee assistance programs, local psychological service providers, support groups).
There may also be times when a manager perceives an employee to be at risk, but the employee is not – even in these instances, no harm is done by reaching out and offering extra support. In other words, managers should not be fearful about getting it “wrong.” Equally important, it is necessary to develop a climate within which employees feel comfortable reaching out to others rather than relying on others to notice their risk factors or behaviors to receive help. Practitioners can refer to previous HBR articles that provide guidance on how to create these inclusive and supportive climates.
Create a plan to take action.
Recognizing that an employee is in need is not enough on its own. Managers and HR professionals need to be prepared to help individuals get help. This preparation includes training managers about mental health concerns, creating strategies for having difficult conversations, and developing an action plan that can be enacted should a crisis arise. To act swiftly and appropriately in these situations, organizations should prepare a decision-making flowchart that outlines who and in what order to contact should an immediate risk arise (an example of what such a flowchart might look like is on page 17 of this report). Managers should also compile a list of available resources and make these publicly available to employees, including contact information for EAPs, local mental health providers, and community resources such as support groups or treatment programs.
Managers should perform routine check-ins with employees (especially those at risk) to gauge their well-being and to listen to any concerns without passing judgment. These conversations provide opportunities for managers to inform employees of available resources as well as to remind the employee that they are supported and cared about in the workplace. Although managers are often important gatekeepers who can monitor changes in employees’ behaviors, their primary role is to provide employees with information and resources for help-seeking — the managers themselves are not expected to counsel or solve the employees’ struggles. Maintaining this boundary is important for protecting the well-being of the manager as well.
Finally, organizations should invest in suicide and mental health training that builds employees’ and managers’ efficacy for having difficult workplace conversations and reduce the stigma associated with suicide. By making mental health a priority in organizations, individuals may feel more comfortable reaching out for help if a need arises. Most importantly, managers, and HR professionals should err on the side of caution and intervene anytime they believe someone is at risk for suicide – a quick response is critical, as once a suicide occurs the window for prevention is permanently closed.
Organizational Postvention Strategies
Unfortunately, organizations may not be able to prevent all suicide deaths, and they need a plan for postvention — psychological first aid, crisis intervention, and support offered after a suicide death.
First and foremost, recovery from a suicide death is a process that should be handled with intention and sensitivity. In the immediate aftermath of suicide, managers’ responses fall into the acute stage that requires protecting the privacy of the deceased, communicating quickly and clearly to quell rumors or misinformation, and offering practical assistance to family members. The short-term response involves identifying affected employees and providing them support through EAPs and other resources. Importantly, not all employees will be impacted the same way and grief can manifest differently. In this time frame, it is necessary to be flexible and patient as employees come to terms with the loss, and to allow time and space for employees to grieve (which likely necessitates changes in expectations for productivity).
Finally, in the long-term response, managers should be mindful of important milestones or anniversaries that may be difficult for suicide survivors — and to honor those who have died by suicide in a respectful manner. This process involves continued investment in suicide prevention programs and policies to minimize the likelihood of future suicide deaths.
While many companies are embracing the importance of well-being, few have focused specifically on the role of suicide. To be effective, policies and practices must specifically target suicide, as conventional well-being programs (e.g., mindfulness, yoga) will likely fail to identify employees who are at the greatest risk. Most importantly, organizations can support employees in crisis by investing in suicide prevention programs. If even just one person is helped, the investment will pay dividends many times over.
If you or someone you know is having thoughts of suicide, please use the resources below to seek help.
- USA: 1-800-273-8255 (CHAT)
- U.S. Crisis text line: 741741 text HOME
- United Kingdom: 116 123
- Trans Lifeline: 877-565-8860
- List of suicide crisis lines around the world (Wikipedia)
- National Suicide Prevention Lifeline