In one of life’s strangest coincidences, Sarah spent a good chunk of the week of 8th to 14th September, 2013, in her local Accident and Emergency department. You may or may not know that this was National Suicide Prevention week in the UK. It was also the week that Sarah, in the grip of suicidal thinking, took a number of actions which were designed to give her relief from her unrelenting thoughts and to keep her from committing the ultimate act of self-harm.
If you’d asked me a year ago about my experience of suicide, I would have had to stop and think hard. In recent weeks, however, I have come to understand how close to home suicide – and the risk of suicide – actually is. My brother reported two suicides this year within a mile of his home. One man threw himself under a train, struggling to cope with his own illness and his wife’s dementia in old age. Another man killed himself with a sword, leaving behind his wife and young son. Looking back, I remember the shock we experienced as a family when the son of a friend committed suicide. I experienced the same level of shock as a member of the London Symphony Chorus when one of our members took his own life.
Let me pause here, and invite you to reflect on your own experience. How often has your train been delayed for reasons which are unknown or, quite clearly, for a fatality? When you survey your family tree, or your wider friendship group, is there someone – often overlooked or maybe actively pushed out of view – who committed suicide? Have you ever known of someone in your workplace who has attempted to commit suicide?
What’s the scale of the problem?
In the UK, the Samaritans report that 1 million people across the globe die by suicide each year. That’s one suicide every 40 seconds. They also report that more people die by suicide each year than by murder and war combined. They see these statistics as conservative – many suicides go unseen. Suicides go unreported because of social stigma or because the cause of death is given as something else, such as a road traffic accident or drowning.
Suicide is the second largest source of death worldwide amongst 15-19 year-olds. It’s not, though, only a young person’s problem. The Samaritans report that male suicide rates are on average 3-5 times higher than female rates and say men aged 30-44 are in the group with the highest rate of suicide. Both male and female suicide rates are increasing. Anecdotally, I know of more men than women who have committed suicide and it does seem that men who attempt suicide use methods which ensure their success – though I struggle, in this context, with the word “success”.
Suicide and the work-place
Sarah’s recent experience made me reflect on suicide and work-related stress. It didn’t take much research to find the Canadian Association for Suicide Prevention, which highlights the workplace as one of the key environments affecting mental health and well-being:
The workplace is one of the key environments affecting mental health and well-being. 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. Unfortunately, the workplace can also be the source of non-productive stress leading to physical and mental health problems, including suicidal thoughts and behaviours and suicide.
It’s clear to me that if you’re a manager or working in HR, you’re in a privileged position as the first port of call for people in distress and even if you’re not, you need to know how to respond if a friend, family member or colleague comes to you for support.
Equally, if you are under stress and having thoughts of suicide or self-harm, you need to know what to do next.
If you’re in distress
If you’re in distress, you need to turn – as soon as you can – to appropriate professionals. These professionals are likely to be outside the workplace and include your GP and local mental health services and voluntary organisations, such as the Samaritans. Make an appointment to see your GP as soon as you start to experience suicidal thoughts or, if you’re struggling to resist the call to self-harm, go immediately to your local Accident and Emergency department. Call the Samaritans at any time of day or night.
I want to say to you that I hear your “buts” and I know how hard it can be to reach out. My heart goes out to you for everything that you are experiencing right now. I don’t know what to say to you that will help you to reach out except this: please, seek help.
Responding to someone in distress
Whether you are a line manager, working in HR or in some other role, if you want to provide support, you need to be alert to clues that an employee is in distress and to take those clues seriously. It is not enough to encourage people to “push through” whatever difficulties they may have: you need to know that people may come to you for help and to be ready to talk openly with them and without judgement about what they are experiencing. People who are experiencing extreme distress may find it hard to speak openly about their experience but they do give clues and you need to follow up by asking – openly and directly – if an employee is having thoughts of self-harm.
Nor is it enough to think that you can provide the appropriate support. Adrianna Scott, in an article for the American Society for Human Resource Management about how to deal with suicide in the workplace emphasises the limitations of the HR professional’s responsibilities and the need to seek out professional support. She writes:
Marina London, spokeswoman for the Employee Assistance Professionals Association, based in Arlington, Va., says labelling employees as having a mental illness is on her list of HR “no-nos.”
“It’s not the HR person’s job to diagnose the person who is clinically depressed or bipolar,” London stressed. “The HR position should be supportive of the employee and get them to a professional.”
If you want a happy ending for employees in distress, you need to act sooner rather than later and to know your own limitations as a line manager or HR professional. In time, you may be able to help employees to find better strategies than suicide or self-harm for handling stress. First though, you need to support employees in distress in finding the right professional help.
Life beyond suicidal thinking
The Samaritans report that between 10 and 14% of people have suicidal thinking throughout their lifetime and approximately 5% of people attempt suicide at least once in their life. Some people don’t make it. Some people (including – so far – Sarah) do.
What happens once the immediate crisis is over? I hope that, for many, therapy of various kinds can be transformative. I have, for example, been drawn to revisit an approach called “family constellations” via a core text: Love’s Hidden Symmetry: What Makes Love Work in Relationships, by Bert Hellinger, Gunthard Weber and Hunter Beaumont. I remembered that Hellinger and his co-authors had touched in this book on connections between family dynamics and suicide and I found, on re-visiting this book, a wealth of wisdom and examples in a field which is about resolution – finding ways to resolve unconscious family dynamics so that family members can embrace life fully.
Suicidal thinking is characterised by extreme black or white thinking and a lack of connection with one’s most essential needs – perhaps even a lack of permission to have needs. For this reason, I find myself wondering how much the workplace has to contribute – way before an employee reaches crisis-point – by nurturing the emotional intelligence and thinking skills of employees. As a line manager, for example, any investment you make in coaching members of your team can be an investment in their mental health as well as contributing to their effectiveness at work. Equally, the skills of empathy and the ability to put yourself in another person’s shoes and to see things from their point of view can be essential for the manager dealing with an employee in distress. The same skills can also transform a sales process or create bridges between departments which are otherwise entrenched in silo thinking.
Being a witness to Sarah at a time of extreme distress has been a humbling experience for me and still, I want to make it count. I thank you for reading this article and reaching this point and I hope that in ways I cannot yet foresee it might make a difference to you or to someone you know at a time of crisis.
I wrote this article for Discuss HR blog where it was published on Monday 21st October, 2013.