Need to know:
- A clear commitment to employee wellbeing can help to erode the stigma around suicide and mental ill-health and encourage staff to engage with support services.
- Communication and training is key to ensuring employees and line managers have a good understanding of the benefits available to them and how to access these.
- Developing a postvention strategy can prepare an organisation so that it is equipped to provide effective support to employees following a suicide.
Suicide can have a far-reaching impact: on the family of an individual who has taken their own life, on friends, colleagues, and beyond. The death of an employee by suicide can affect those who worked with the individual directly, as well as the business and workforce more widely. But there are steps that employers can take to support staff that have lost a loved one or colleague, and to ensure that employees experiencing suicidal thoughts or behaviours feel able to access the help they need.
A culture of wellbeing
The causes of suicide are complex, yet the development of a supportive workplace culture can help to ease employees’ fears about discussing any issues they are experiencing. Louise Aston, wellbeing at work director at Business in the Community (BITC), which published two toolkits for employers alongside the Samaritans and Public Health England in March 2017, Reducing the risk of suicide and Crisis management in the event of a suicide, says: “If [employees] don’t feel like they can disclose that they have suicidal thoughts or that they are suffering from mental health distress, then they don’t have an opportunity to access the appropriate support.”
Vocal and sustained support from senior leaders can help to reinforce an organisation’s commitment to employees’ overall wellbeing and create an environment that encourages staff to make use of the support systems available to them. Vanessa Sallows, benefits and governance director at Legal and General Group Protection, says: “[It] stems from the top. If managing directors, chief executives, and the board are open, they create that culture of honesty and openness. They have to live and breathe it, it has to be really embedded within the environment.”
Awareness initiatives and programmes such as mental health first-aid training and mental health champions, can also increase understanding about suicide and mental ill-health in the workplace, equipping staff to recognise early-warning signs, have empathetic conversations, and to signpost colleagues in need of assistance to support services.
Access to support
There are a number of employee benefits that can play a role in suicide prevention. Employee assistance programmes (EAPs) can provide staff with support on a range of issues both in and outside of the workplace, such as financial concerns, legal matters and relationship problems. As such, positioning an EAP as a life-support service rather than an assistance programme can encourage staff to engage with it, says David Price, managing director at Health Assured. EAPs can also offer support for certain behaviours that can indicate a risk of suicide, such as alcohol or drug abuse.
Line managers can also make use of an EAP’s manager referral facility to direct employees to support. Paul Avis, marketing director at Canada Life Group Insurance, says: “One of the services under the employee assistance programme that is often overlooked is manager referrals, which can be done both formally and informally while retaining confidentiality for the employee unless they give explicit consent to share information.”
However, if a manager is to make use of this service, then it is first vital that they are aware of it. Beate O’Neil, head of wellbeing at Punter Southall Health and Protection, says: “Unless [they] have used an EAP before then [they] might not know what it is, even as a line manager, and if [they] don’t know how to use it then [they’re] not going to be able to promote it.”
In addition to ensuring line managers are fully aware of how an EAP and other available support services can be utilised, organisations can communicate these benefits to staff via a variety of methods, including during induction and training sessions, displaying posters in communal areas and on the back of toilet doors, and via the intranet. These can be accompanied by contact information for external charities and helplines, such as the Samaritans. It is important to consider whether all members of the workforce are covered by these communication channels, including employees who work remotely, such as field workers, says Brendan Street, professional head, cognitive behavioural therapy (CBT) at healthcare and emotional wellbeing provider Nuffield Health.
EAPs provide staff with access to a designated number of telephone, and in some cases face-to-face, counselling sessions, but employees that require further assistance, for example in- or out-patient treatment for a mental health condition, can access this through certain private medical insurance (PMI) schemes.
Organisations can also look to develop mental health pathways to deliver comprehensive support to staff. This would involve co-ordinating the services offered by health and wellbeing providers, such as private medical insurance (PMI), EAP, occupational health, on-site healthcare, and the early intervention services available through group risk benefits, says Dr Wolfgang Seidl, workplace health consulting leader, UK and Europe at Mercer Marsh Benefits. “It all needs to be connected and used in a meaningful way,” he adds.
Whatever support mechanisms for mental health an organisation may have in place, its efforts can be undermined by a lack of clear workplace policies, says Street. “[An employer] needs policies and procedures that underpin mental wellness, [such as] anti-bullying, domestic violence or financial insecurity, because [it] can’t have mental wellness thriving unless other areas are supporting it,” he explains.
Returning to work
Supporting an employee back to work after a suicide attempt may involve increased sensitivity in terms of both the employee and their employer or manager, says Nuffield Health’s Street. An employee may choose not to disclose a suicide attempt, but it is important that line managers are trained on how to talk to employees about mental health and sensitive issues such as suicidal thoughts. Managers can also turn to the EAP for support if they have any concerns or require guidance, says O’Neil.
Where an employee does choose to share the reason for their absence with colleagues, an awareness of the complex causes of suicide and the ability to have open and informed discussions about mental health can help to erode any associated stigma. “[Employees] need to be encouraged to be as natural as possible and to offer their help,” says Mercer’s Seidl. “Because one thing that in suicide prevention lay people often misconstrue is that if [they] ask someone about depression or suicidal ideation then [they] push them into suicide, which literature is very clear is not the case.”
An employee should only return to work once they have been assessed by occupational health or a healthcare professional, and a tailored return-to-work plan should be developed to ensure the employee is supported back into the workplace. This might involve certain adjustments to work load or working patterns, such as a phased return or reduced hours, and access to support services where appropriate. “One should never assume that it’s the same for everybody, it has to be an individual plan,” says Seidl.
Support after a loss
In the sad situation where an employee takes their own life, extra support may be required for colleagues. This could include occupational health support, or critical incident management, available through some EAPs, which provides on-site counselling for groups and individuals following a trauma.
However, not everyone will react to loss in the same way. Eugene Farrell, head of trauma support services at Axa PPP Healthcare, says: “A counsellor might be useful for some people to talk to, but others may not be interested in that and prefer talking to their colleagues.”
Ensuring that employees are aware of the various support services available to them, while allowing them the time and flexibility to process the situation can help employees to react in a way that is comfortable for them.
Staff may also require support beyond the immediate aftermath of a death by suicide. “The organisation has to be sensitive to the anniversary, and that’s maybe a time for softly reminding [employees] that there is support available,” says Farrell.
Employers should ensure that employees continue to be signposted to support where needed. Legal and General’s Sallows says: “Some people won’t want to talk about it and others will do, so it’s making sure that [employers] are aware of any signs that if people are bottling it up it isn’t affecting them.”
Suicides can sometimes lead to a sense of guilt because people may speculate about whether they could have done anything to help prevent the death. Axa’s Farrell says: “That’s particularly difficult for line managers who might feel that they had a responsibility to see [signs of suicidal behaviour] or that they should have referred them to occupational health or the EAP, or done more. They could be living with that for a long time and we don’t want that to happen.”
Access to counselling services can help staff to address these feelings.
These wellbeing benefits can also provide assistance to an employee that has lost a loved one to suicide, and employers can signpost staff to their GP or dedicated bereavement charities. Access to bereavement counselling and probate support may also be available through group life insurance schemes. Canada Life’s Avis says: “It’s sometimes more appropriate to leave a period of normalisation where life has returned to normal without the person who has [died by] suicide, so counselling can sometimes work best six to 12 months after the event rather than six to 12 hours or days after the event.”
Again, it is important to bear in mind that there is no standard timeline or way in which people grieve. “People mourn in different ways and generally people are quite vulnerable in dealing with loss,” says Health Assured’s Price. “It’s [about] acknowledging the loss, supporting them, and if [the employer] can communicate throughout the year that employee wellbeing and the welfare of employees is important it can negate any stigma around it.”
A postvention strategy
In addition to emotional support, there are also practical issues to consider when employees lose a loved one or colleague to suicide, such as communications and time off for funerals. Establishing a postvention plan can ensure that organisations are positioned to respond in a timely and sensitive manner to a suicide, with procedures that include both emotional and practical matters within their scope.
A postvention committee that brings together key stakeholders across the business and takes into account relevant health and wellbeing providers can be formed to develop an appropriate postvention plan. “We would urge every employer to put suicide prevention and suicide postvention protocols in place,” says the BITC’s Aston. “It’s about being a responsible employer, it’s about risk mitigation, and there’s also a really strong business and moral case for taking prevention and postvention planning into account. It’s not as simple as producing some policies, it’s more complicated than that.”
In the UK, the Samaritans can be contacted for free at any time on 116 123 or visit www.samaritans.org. [repeat this at the bottom of each pull out column/case study please]
Linklaters raises awareness of suicide through workplace seminars
In 2016, law firm Linklaters held two seminars for employees on the topic of suicide. The first seminar was held in October and featured Michael Mansfield QC and Yvette Greenway, founders of Silence of Suicide (SOS). The couple set up the organisation following the deaths by suicide of Mansfield’s daughter and a friend of Greenway’s, with the aim of breaking down the stigma around suicide and enabling people to talk openly talk about it. Jenny Lloyd, diversity and wellbeing advisor at Linklaters, says: “The focus of that session was really to start the conversation on suicide. They reminded us that it is still quite a taboo subject and it’s not one that a lot of people are touching on.”
The second seminar, which took place in November, was led by mental health campaigner Jonny Benjamin. Benjamin featured in the Channel 4 film The Stranger on the Bridge, which documented Benjamin’s #FindMike campaign to identify the man who had stopped him from taking his own life in 2008. “That was [also] a really powerful session,” says Lloyd. “What it taught us is that actually [suicide] is something that does affect our people but it’s just about having that conversation and letting people feel they can talk about it.”
The events were held at Linklater’s London and Colchester offices and the organisation’s occupational health nurse was in the room to provide support to anyone that needed it. The sessions were full, reaching their maximum 200-person seating capacity. The organisation also received positive feedback about the seminars and their role in beginning to break down the taboo around suicide, says Lloyd.
The seminars form part of the law firm’s wider strategy to support the health and wellbeing of its 2,500 UK employees. In addition to providing access to an employee assistance programme (EAP), private medical insurance (PMI), an on-site occupational health nurse, and on-site GP, Linklaters also runs a variety of awareness initiatives. The law firm, which is a founding member of the City Mental Health Alliance, focuses on a different wellbeing topic each month through a series of lunchtime seminars. This includes a focus on mental health in October to coincide with World Mental Health Day, men’s health in November in alignment with Movember, and financial wellbeing in December ahead of the festive period. Women’s health, sleep, exercise and nutrition are among the other topics covered throughout the year, which are communicated to staff via newsletters and email.
The organisation also runs lunch-and-learn sessions as part of its VisAbility Network, which launched in May 2016’s Mental Health Awareness Week. The network supports employees with a disability or mental health condition, as well as staff who are indirectly affected through friends and family. The lunch and learns include topics such as self-stigmatisation and talking therapies.
In addition, the organisation took part in the 2016 This is Me campaign, an initiative led by the Lord Mayor’s Appeal that encourages employees to share their experiences of mental health issues. Linklaters issued desk-drop postcards that featured part of employees’ stories, and staff could then read more on the intranet. The webpage had over 1,000 visits and the staff that shared their stories were recognised through the organisation’s internal awards.
Linklaters has also begun offering mental health first-aid training for managers within its business services functions, and plans to roll this out to partners later this year.
Viewpoint: Create an environment where staff feel able to talk openly about mental health
Every suicide is a tragedy. The causes of suicide are many and complex and vary from person to person. We know that often people struggle in silence and find it difficult to know how to ask for help.
Figures from the Office for National Statistics, published in 2014, show that male suicide is three times higher than the female suicide rate. Men are still less likely to talk about their mental health than women, and are less likely to seek help from a health professional if and when they are struggling with their mental health.
It is vital that workplaces create an environment where staff feel able to talk openly about mental health, and know that if they do, they will be met with understanding and support, rather than facing stigma and discrimination. Small, inexpensive measures such as flexible-working hours, generous annual leave and regular catch-ups between staff, can make a huge difference to the wellbeing of staff in workplaces.
If you think a colleague is experiencing suicidal feelings one of the most important things you can do is to talk to them about how they feel and be there to listen. You may feel pressure ‘to say the right thing’, but just being there and listening in a compassionate way is vital to helping that someone feel less isolated and frightened.
Losing a colleague or friend is an incredibly difficult thing to deal with, particularly if it is sudden or unexpected, as is often the case when someone takes their own life. Employers should ensure measures are taken to support the wellbeing of their staff, whether that is formally through offering a bereavement counsellor, or an employee assistance programme (EAP), or informally such as regular catch-ups with colleagues and managers.
Tips to support someone who might be experiencing suicidal feelings include:
Listen non-judgementally: it is understandable to feel shocked or even angry if someone close to you thinks about taking their own life. It is important, however, to try not to judge that person or blame them for the way they are feeling.
Encourage them to get help: even when someone appears to be determined to take their own life, it is important to explore every possible source of support with them. They may know what has worked in the past already, otherwise you can suggest they get an emergency GP appointment, dial 999 or go to accident and emergency (A&E), contact their local crisis home treatment team, or call the Samaritans on 116 123.
Encourage them to stay safe: encourage them to remove from easy reach anything that could cause harm, such as sharp objects or large amounts of medication. If you feel able to, you could offer to stay with them until they can get some emergency support. If you are not able to be there in person you could offer to chat over the phone or online.
Respect confidentiality: remember mental health information is confidential and sensitive. Do not pass on information unnecessarily, not least because this breach of trust could negatively impact someone’s mental health.
Look after yourself: knowing someone you care about is having suicidal feelings can be very distressing and emotionally draining. It is important to look after your own physical and mental wellbeing. Make sure you get enough sleep, eat regularly and do things you enjoy.
Emma Mamo is head of workplace wellbeing at Mind
Viewpoint: Everyone has a right to go home fit and well every day
Over the last 40 years, we have seen a step change in the safety performance of workplaces in Britain. There have been improvements in workplace health as well, however, the issue of mental health remains a real challenge. One in six workers in the UK are suffering from stress, anxiety or depression, according to Mind, which means that over 350,000 people are affected by mental ill-health at any one time. Suicide is estimated to be killing 10 times more construction workers than falls from height.
To make a difference we need to see more inspirational leadership on this important issue.
Our mental wellbeing is influenced by a variety of factors. Physical illness or injury generally manifests itself through visible symptoms, obvious to those around us, presenting opportunities for them to offer help or support. Meanwhile, mental health issues, worries, stress and depression are not clearly identifiable; people often suffer in silence, feeling isolated and alone.
Conversation can break down these barriers, allow people to share their concerns and offer support to each other. A growing number of organisations train and employ mental health first aiders to support this process.
If we are to break down the stigma around mental health, we need to inspire people to talk about how they feel and the things that are worrying or concerning them. We can all get involved in leading this change by asking open questions and taking the time to listen to others.
We all believe that everyone has a right to go home fit and well every day. To make a real difference, we need to have the confidence to demonstrate this in our everyday actions and show our commitment to looking after the people with whom we work.
Information, advice and support is available on the Mates in Mind website, a charitable programme to improve and promote positive mental health in the construction industry.
Louise Ward is policy and communications director at the British Safety Council
