1. Suicide Awareness and Prevention in the Workplace
Cal Beyer
Lakeside Industries, Inc.
September 19, 2017

2. Suicide Prevention are the Next Frontier in Safety
Why Mental Health and
Suicide Prevention are the
Next Frontier in Safety

3. Why This Topic…? Suicide is a pressing national public health concern
> 44,000 deaths in 2016
Construction is a “high risk” industry
Industry & demographic factors
Suicide is preventable
Part of Safety 24/7 culture

4. Personalizes Safety:
“Work, Home & Play”
Personal responsibility & crew accountability

5. Shift From Professional to Personal

6. Problem vs. Prevention True Killer: Silence + shame = stigma
Suicide is Preventable
Break the silence (elevate the conversation)
Reduce the stigma (build sensitivity)
Training supervisors (increase awareness and commitment)
Integrate with wellness and employee benefit programs (encourage interaction and intervention)
Build a caring culture (cast safety net)

7. “DIE BY SUICIDE”
WHY these words (and others) matter
Michelle

8. Why this is a Workforce Issue?
Depression and anxiety disorders
25% of population experience a diagnosable mental illness in their lifetime
Less than 20% of people with mental illness will seek help
80% Success rate of overcoming with early treatment
Results in 200 million lost work days per year

9. Absenteeism & Presenteeism
In 3 month period, a “typical” depressed individual will:
Miss on average 4.8 days of work and
Experience 11.5 days of reduced productivity

10. Substance Use Disorders
“Self-medicating”
Only about 10% of people with substance use disorders seek treatment
Societally treated as “moral weakness” and addressed through criminal justice system
40% of people with a substance abuse disorder have a diagnosable mental illness but less than 50% of those receive treatment for either
Treatment gap exists for the same reason as other mental illness – shame, access to care, fear
Cal

11. Opioid Addiction National epidemic
171 overdose deaths daily in US (estimated, likely far higher)
1,000+ ER visits per day
6 in 10 Overdose deaths are prescription painkillers or heroin
Quadrupled since 1999
Affects 7 out of 10 workplaces
Total overdose deaths in 2016 = >62,000 (19% increase over 2015)
Car crashes = 37,757
Those at risk of mental illness more susceptible to addiction
Cal

12. Harsh Reality of Suicide
121 deaths by suicides per day
10th leading cause of death for all ages
2nd leading cause of death for men in the United States
78% of suicides are by men
51% with guns
25 attempts for every suicide
Survivors significantly impacted for every suicide

13. “Men in the Middle” Phenomenon
White, middle-aged men aged years old with less than a college education
22% increased mortality due to suicides, substance abuse and alcohol addiction
Source: New York Times article (11/2/15) citing study by Nobel Peace Prize winner in Economics

14. What Are The Warning Signs?
Noticed by co-workers, friends & family:
Appearing Sad Or Depressed Most Of The Time
Talking About Feeling Trapped, Wanting To Die, Being A Burden, Feeling Hopeless Or Helpless
Extreme Mood Swings
Increased Drug Or Alcohol Use (Self-medicating)
Sleeping Too Much Or Unable To Sleep
Acting Anxious, Agitated Or Reckless
Withdrawing
They May Be Able To Keep “Performing” Well At Work Through These Issues Which Is Why Relationships At Work Are Important, So That These Warning Signs Can Be Noticed! DJ

15. What Are The Warning Signs?
Performance Management
Increased Tardiness/Absenteeism
Decreased Productivity
Increased Conflict Among Co-workers
Near Hits, Incidents And Injuries
Decreased Problem-solving Ability
Decreased Self Confidence DJ

16. Why is This a Construction Issue?
Construction industry is #1 in number of suicides and #2 in suicide rate per 100,000 employees
When combined with Architecture & Engineering – moves to #1
Suicide is a pressing national public health concern: 44,193 deaths in 2015 / 121 deaths per day
Michelle

17. Construction Industry Risk Factors
Stoic, “old school” & “tough guy” culture
Promotion of supervision without leadership training
Family separation and isolation with travel
Sleep disruption/deprivation due to shiftwork
Seasonal layoffs and end of project furloughs
Fearlessness and “thrill seeking”

18. Industry Risk Factors (cont’d)
Tolerant culture of alcohol and substance abuse
Chronic pain
Industry with highest use of prescription opioids
Access to lethal means
Pressure and humiliation
Skills gap to do something else;
Trapped in job with no way out and needing to provide for family

19. Workplace Issues to Address:
A focus on performance:
How is the issue affecting job performance, not what is wrong with the person
ADA concerns:
If these are a diagnosable illness/addiction, may need to provide reasonable accommodations
If it is not safe for a person to work with the issue, keeping them in their role isn’t reasonable anyways
Michelle

20. How Employers Can Address Issues
How to maintain employment while treating issues:
Second/last chance agreements
Policy audit “softening” consequences of “Zero Tolerance” statements for attendance, safety infractions and failed drug tests
Being prepared with resources,
referrals to get help
Michelle

21. Creating a Caring Culture
GOAL: Remove the stigma
Obtain leader support of cultural shifts needed
Build the case with statistics, needs analysis
Designate an internal champion
Ideally someone with lived experience who can share a message of hope
Preferably someone in a position of influence
Cal

22. Address Policy, Compliance & Legal Issues
GOAL: Remove the fear
Remove barriers to employees seeking help or referring co-workers for help
Rewrite policies to remove fear of negative repercussions
Integrate practices to allow for treatment while still addressing performance, compliance issues
Include mental illness in anti-discrimination/anti-harassment training
Educate employees on using EAPs and confidentiality of them
Educate employees on group health benefits – confidentiality and affordability
Understand real issues vs. misconceptions of ADA/HIPAA concerns in addressing mental health, substance abuse and addiction issues
Michelle

23. Communication
Make a part of routine language in the company – newsletters, lunch & learn invitations, benefit notices
Include in conversations and discussions among leaders that employees observe/hear – so when they are engaged in conversation it isn’t viewed as “scary or weird”
Use posters as a communication and discussion tool – but talk about first so they aren’t “avoided”
Cal

24. Organizational Role: Leadership
Upstream Approach
Be bold!
Establish caring company culture
Share lived experience, stories of hope
Commitment to Zero Suicide
Promote Social Networks
Peer Leadership
Cal

25. Organizational Role: Safety
Upstream, midstream & downstream opportunities
Make Suicide Prevention a Health & Safety Priority
Incorporate into Toolbox Talk subjects
Add to daily THA/JHA process:
“Is everyone physically and mentally ready to work today?”
Add questions to Near Miss & Incident/Accident investigations and reports to address
Cal

26. Organizational Role: Safety
Critical Incident Debriefing:
A critical incident is any situation faced by individuals that causes them to experience unusually strong emotions which have the potential to interfere with their ability to think clearly.
Need to have:
Notification process
Follow up process
Referral as necessary
Cal

27. Organizational Role: HR
Performance reviews and disciplinary actions – incorporate mental health as a performance management tool
Understand your EAP and educate employees on how to utilize it
Obtain and study utilization reports
Have completely separate 3rd party resources available for those concerned about confidentiality
MIchelle

28. Organizational Role: HR
Educate employees on behavioral health benefits in group medical plans
Find local American Foundation for Suicide Prevention (AFSP) or National Alliance on Mental Illness (NAMI) to identify local resources, also local & regional Suicide/Crisis Hotlines: Provide this resource info to employees
Michelle

29. Organizational Role: Field Supervision
Upstream, midstream & downstream opportunities
Front line interface with employees
Observe performance, changes in behavior
Build relationships, trust, opportunities for sharing
Likely who “first report” of concern would go to
Gatekeeper Training:
Warning Signs
Referral process DJ

30. Training for Field Supervision
Supervisory Training including:
Relationship building with employees
Reinforcing the Caring Culture
Identifying and dealing productively with disciplinary issues (using as a learning/building opportunity, not destructive)
Importance of teams/bonds – creating peer support systems – considering in dispatch/scheduling
Promote “My Brother’s Keeper”
mentality – watching out for each other DJ

31. Organizational Role: Union Liaison
Understand union health plans, especially crisis care and behavioral health components
Do your Locals have Member Assistance Program?
Have you discussed your interest in understanding what the locals are doing to care for their employees well-being?
Have you offered to invite the locals’ leadership to training or conduct it for them to explain why this is important to your company?
Develop a common Resource Directory with your locals for various employee mental health issues?
Cal

32. Resources

33. National Suicide Prevention Lifeline

34. Crisis Text Line
Text CONNECT to

35. National Safety Council Prescription Drug Employer Kit
Begin addressing prescription drug use in your organization
Free Employer Kit contains:
A guide "The Proactive Role Employers Can Take: Opioids in the Workplace"
Tools to examine and update your drug free workplace and employee benefit programs
Fact sheets and handouts with helpful information to educate your employees
5-minute safety talks
Poster series focused on home safety and disposal

36. QPR Institute https://www.qprinstitute.com/ Question.Persuade.Refer.
Online “gatekeeper” training
60 minutes online for $29.95
Learn:
How to use QPR method
Common causes of suicide
Warning signs of suicidal behavior
How to get help for yourself and/or others
Cal

37. Cal

38. Cal

39. Construction Industry

40. The Starting Point (Sept. 2015)

42. Construction Industry Alliance for Suicide Prevention (CFMA)

43. Alliance Members*
*As of 6/15/17

47. Articles

50. Needs Analysis
Will help you to identify where in your organization there are areas to enact change
Cal

51. Checklist
Tool to provide structure to integration.
Michelle

52. Integrate with Safety, Wellness & Human Resources
Processes

54. Additional Resources
American Foundation for Suicide Prevention
Man
Partnership for Workplace Mental Health
QPR Institute – Question. Persuade. Refer. Gatekeeper Training
Screening for Mental Health, Inc.

55. Contact Information
Cal Beyer
Director of Risk Management
Lakeside Industries, Inc.
Issaquah, WA
Phone: 425/
Cell: 425/