Sunday, August 30, 2009

Ask the Question: Suicide in the Workplace

This week's edition of Business Insurance notes that last year there was a 28% increase in the number of suicides completed in the workplace in the United States.  While the numbers are still relatively small -- 251 last year -- the rapid increase is really alarming.  Can you imagine if I told you that cancer rates had gone up by 28% last year?  We'd all be terrified.

However, as you know, I'm a stickler for putting these things in context and so I did some digging to see what other workplace causes of deaths look like in general and looked like last year.  On the one hand, the number of workplace suicides is miniscule compared to the number of deaths from all causes in the workplace in 2008.  Last year, 5,071 people died at work.  You were far more likely to die in a fall at work or by something falling on you than you were to complete a suicide at work.  You were even more likely to be killed during an assault (keeping in mind that this also includes police officers on the job).  Suicides accounted for just about 5% of workplace deaths.  It's also important to note that in 2006 (the most recent year for which statistics are available) there were more than 33,000 suicides in the United States, so workplace suicide is still a tiny fraction of suicides overall.

On the other hand, the year before, suicides accounted for just 3.5% of workplace deaths.  In fact, while suicides went up by more than a quarter, workplace deaths on the whole declined by more than 10%.  So I do think this is worth paying attention to.  Look at it this way.  At your job, which do you think your employer has paid more attention to preventing, employee death in a fire, or employee suicide?  I'll bet you anything it's fire.  But there were more than 30% fewer workplace deaths by fire last year than there were completed workplace suicides.  In fact, there were probably fewer deaths by fire because employers and governments spend so much energy trying to prevent them.

When people complete suicides at work, they usually are sending a message about work.  People who don't have particular issues with their jobs or workplaces do not generally kill themselves there.  So if the suicide rate is going up at work, that tells you that people's stress level around work is also going up.  In other words, as I've said before, it's the economy.  You are more likely to complete a suicide at work if you are about to be laid off, are afraid you are going to be laid off, are mad because others have been laid off, or are stressed by having to do more with a smaller staff.

Unless your occupation has a particularly high rate of suicide (e.g. law enforcement or military), and sometimes even if it does, chances are that your employer does not have any systematic suicide prevention programming for employees.  You may have an Employee Assistance Program (EAP), and if your supervisor is worth her salt she refers people to it from time to time.  The problem is, referring people to EAP is a far cry from actually getting them to get help.  If the workplace is where the issue is noticed, then there needs to be some way for the workplace to do something.

In the absence of some more formal system to prevent suicide among the workforce, here's something you can do at work tomorrow if the need arises.  Ask the question.  If you have a coworker who seems down or depressed, ask them if they are considering killing themselves.  People are afraid to do this because they are afraid it will give the person ideas, but no one has ever gotten the idea to kill themselves solely from someone asking them.  You aren't going to cause any harm.  And if they say yes, they need to be seen at a psychiatric ER right away.

Anecdotally, it appears that the suicide rate overall rose last year.  Statistics are spotty, but they exist for certain locations and segments of society.  Suicides are up in the military, among veterans and  in national parks, and there is speculation that the suicide rate was up among the middle aged.  We are at war, we are in financial straits, and things aren't looking very far up.  Now would be a good time to start taking care of each other a little better.

Big thanks to Nick Arnett over at Bay Area CISM ( for the lead on this story.  Big ups to Business Insurance for pointing out that worker suicides must be followed up by CISM services.


Colleen said...

Huh. Is there information on whether people contemplating suicide will answer truthfully? Is it common for those who know what will happen if they answer honestly to lie?

I'm not suggesting not asking. Asking won't hurt. I'm just wondering how many false negatives one will get with the question.

Anonymous said...

Thoughtful and useful. I especially liked the fire-vs-suicide analogy.

F. Andy Seidl said...

"... no one has ever gotten the idea to kill themselves solely from someone asking them. You aren't going to cause any harm."

I'm curious on what basis do you make this claim?

Naomi Zikmund-Fisher said...

Colleen - The majority of people who show signs of suicide (e.g. say "I don't think this is worth it anymore") are ready to be honest about it. Unfortunately, the people who aren't talking about it are the suicides that are hardest to prevent. Someone who is showing lots of signs is on some level asking for help,and usually (not always) will take it.

Andy- A reasonable question. Perhaps "no one" is hyperbole -- I can't prove that there never has been a person. I can say that asking the question is standard practice in suicide prevention training (including the ICISF Suicide Prevention, Intervention and Postvention training, which is my most recent one) and that these routinely also teach that the notion that asking gives people ideas is a myth.

Anecdotally, people who are depressed enough to consider suicide have many factors going on. While the suicide attempt itself may be an impulsive act, survivors of incomplete attempts don't point to people asking them as the cause. I don't know if there are published studies on this, but I promise to look.

F. Andy Seidl said...

Naomi - Thanks for the clarification. I was not challenging the assertion, but was just curious as to the thinking on that subject. It is useful to know that is the recommendation of those organizations.

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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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