2. Suicide prevention in the construction workplace
A huge THANK YOU to MHA and the Seeds Conference Committee for their:
Recognition that my industry has a problem
Opportunity to apply my industry thoughts to ALL workplace environments

3. Let’s go back 35 years Mental Health Association of Arizona
The challenges
Struggle for recognition of mental health challenges
Struggle for parity with physical illness
Struggle for STIGMA elimination
The successes
Declaration of May as Mental Health Month in AZ
Parity recognition = footing with physical
Annual “Seeds” conference established in May!!

4. Fast forward to Fall, 2015
Construction Financial Management Association SW Regional Conference
Construction in “Top 9” industries for Suicide Deaths
Time to attack this industry issue; started in Phoenix, AZ
First Construction Industry Suicide Prevention Conference

5. Fast forward to July, 2016
Center for Disease Control comes out with report
Suicides by industry segments
Suicide deaths highest per 100,000 employees
Farming, forestry, fishing 84.5 per 100,000
Construction
Construction/Extraction 53.3 per 100,000
Architect/Engineering 32.2 per 100,000
Suicide deaths by the numbers – Construction/Extraction ranks #1

7. Why the workplace?
“The workplace is the last crucible of sustained human contact for many of the 30,000* people who kill themselves each year in the US. A co-worker’s suicide has a deep, disturbing impact on work mates. For managers, such tragedies pose challenges no one covered in management school.”
Sue Shellenbarger, Wall Street Journal (2001)
*Current statistics put the number of REPORTED suicides deaths at
45,000+

8. Why is this a construction issue?
2nd leading cause of death for men
78% of suicides are by men
More people die of suicides than in auto accidents
More likely cause of construction worker death than falls
Suicide CAN BE preventable
Part of a Safety 24/7 , Zero Injury & Incident Culture
Work, Home & Play
Personal responsibility & crew accountability

9. Why construction – check out the risk factors!
Stoic, “old school”, “tough guy”, “suck it up” culture/mentality
Promotion of supervision without leadership training
High Pressure/Low Margin for Error

10. Why construction – check out the risk factors!
Family separation and isolation with travel
Sleep disruption/deprivation due to shiftwork

11. Why construction – check out the risk factors!
Seasonal layoffs and end of project furloughs
Tolerant culture of alcohol and substance abuse

12. Why construction – check out the risk factors!
Chronic pain
Access to lethal means

13. Why construction – check out the risk factors!
Skills gap to do something else; trapped in job with no way out and needing to provide for family
Poor access to and/or Utilization of Behavioral Health Care

14. How our industry – and YOUR businesses should approach this issue:
Upstream / Midstream / Downstream Approaches

16. Upstream – Leading indicators
GOALS:
Build Protective Factors
Prevent Problems
Identify & Promote Resources
ACTIONS:
Leadership Engagement
Integrate with safety, health, wellness and employee benefits, coordinate with labor unions
Creating social networks within the workplace (Peer Support)
Nurture mental health literacy
Teach life skills

17. Midstream – Leading indicators still
GOALS:
Early Identification
Link to Care
ACTIONS:
Learn warning signs and responses (Gatekeeper training)
Screenings – mental health to go along with biometrics
3. Include mental health as part of performance management
4. EAPs & Employee Benefits:
Do they provide access to Quality Mental Health Services?
Know & communicate benefit programs to employees

18. Downstream – Lagging indicators
GOALS:
Manage crises
Restore functioning
ACTIONS:
Restrict Access to Lethal Means
Know resources to contact (lifelines, postvention)
Dignity & Empowerment
Grief & Trauma Support

19. We strive to educate our employees: What are the warning signs?
performance:
Increased tardiness/absenteeism
Decreased productivity
Increased conflict among co-workers
Near hits, incidents and injuries
Decreased problem-solving ability
Decreased self confidence

20. More warning signs we discuss
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! !

21. “The Wall” – trying to see beyond the obstacles
Mental Illness
Loss
Identity
Family
Health
Relationships
Financial Issues
Work

22. Opioid Addiction – we know this is an issue in our industry - - yours?
National epidemic
90+ deaths daily in US (estimated, likely far higher)
Life expectancy in US falls second year in a row
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 2015 = 52,404
Those at risk of mental illness more susceptible to addiction

23. Opioid Addiction
In addition to immediate physical dangers, indirect risks exist:
Engaging in risky behaviors (removes inhibitions)
Criminal behaviors to support addiction
Shame quickly leads to downward cycle of depression, anxiety
Like other addictions, successful treatment possible with early intervention, behavioral therapy, removing shame/stigma

24. Efficacy of pain mediations Acute pain

25. TEATER HEALTH SOLUTIONS
Workplace actions
Protect employees by directing occupational medical providers to reduce opioid prescribing
Update Drug and Alcohol policy to:
Do random testing on employees in safety-sensitive positions
Refer positive tests to an EAP that can evaluate and treat
Educate employees about the dangers of opioids
TEATER HEALTH SOLUTIONS

26. FIELD/PROJECT MANAGEMENT
Suicide Prevention is a TEAM effort – How to apply to your workplace structure
CORPORATE LEADERSIP
HR & SAFETY
FIELD/PROJECT MANAGEMENT

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

28. 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

29. Organizational Role: Managers/Foremen/Superintendents
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

30. Organizational Role: Managers/Foremen/Superintendents
Supervisory Training including:
Relationship building with employees
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

31. Organizational Role: HR
Addressing ADA, HIPAA concerns:
ADA really REQUIRES intervention when an employer is made aware of a health issue (mental health included)
Reduces risk of litigation as employee can be assisted to restore them to fully functioning – if it is ignored, and gets worse resulting in termination – litigation much more likely
Accommodations only have to be reasonable
HIPAA – primary importance in EAPs – educate employees that all information they provide to EAPs is confidential

32. FNf Construction, inc. PUTTING Suicide prevention INTO ACTION

33. TEATER HEALTH SOLUTIONS
Posters Newsletters Weekly Health Alerts Wellness Program EAP IDShield/LegalShield Wallet Cards Company Charge Card Sleeves
TEATER HEALTH SOLUTIONS

34. FNF’s Safety Director commented: 
I’m trying to get to know everyone in the field, work history, family, hometown, etc. Trying to build that relationship not only to get the most out of each employee but also to establish their trust that if someday they needed to reach out to me for assistance in this area they would.

35. RESOURCES Where to get help Next steps
TEATER HEALTH SOLUTIONS

37. Alliance Members

39. Checklist
Tool to provide structure to integration.

41. Text HOME to

42. Carry a Message of Hope

43. Questions?