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About Suicide Prevention as a Health and Safety Priority in the Workplace

[Excerpts from Spencer-Thomas (2019). We can’t fix mental health with duct tape: A new frontier in safety. Safety Decisions Magazine. https://ehsdailyadvisor.blr.com/resource/spring-summer-2019/]

In the US, the construction industry is the top industry with the highest suicide rates and largest numbers. Historically, mental health and suicide have not been considered safety priorities, until now. In this podcast a global safety expert helps us connect the dots.

Safety professionals are well-versed in “the fatal four” — falls, followed by struck by object, electrocution, and caught-in/between — and know that if they are able to prevent these forms of deaths, they will save almost 600 lives each year (U.S. Department of Labor, n.d.). What most safety professionals are not aware of is that suicide in construction kills takes many more lives. A recent study published by the CDC (Peterson, et al, 2018) found that in their sample 20% of all men who died by suicide in the US were in the construction/extraction industry. In 2017, 47,173 people died by suicide, 27,404 of them were men ages 20-64 (CDC, 2017). If 20% of them were in construction/extraction that means we can estimate that over 5,000 men working in construction/extraction died by suicide — over 9x more than all of the fatal four deaths together.

When a workplace fatality happens, the cause is almost always determined to be “accidental” and a deeper investigation into intent to die is not undertaken. The remedy is then to do more safety training. When we look at the fatal occupational injuries, however, the first two most common (transportation incidents and falls) are also common ways people think about taking their lives (CDistrosby et al, 1999; De Andrade & DeLeo, 2007). Thus, it is possible that some if not many of these workplace fatalities are actually suicide deaths, which then means that safety training may not be effective in preventing them.

The reason suicide has not concerned safety professionals before is that most suicide deaths do not occur at the workplace, and thus, were not considered a work-related fatalities. Today, we know different, and there are many things workplaces can do to make suicide prevention and mental health promotion health and safety priorities.

There are many reasons why mismanaged mental health conditions and unchecked suicidal thoughts can lead to safety concerns:

Distraction: having suicidal thoughts and symptoms of illnesses like depression, anxiety and addition are intense and trying to hide them from other people can make them all-consuming. For example, racing or intrusive thoughts as experienced by people living with bipolar condition, trauma or thought disorders like schizophrenia can be very distracting. This distraction can interfere with decisiveness and safety planning.
Impulsivity, Impaired Perception and Judgment: agitation, tunnel vision, distorted thinking and paranoia are common symptoms among several mental health conditions. When left untreated these symptoms can interfere with workplace security and morale.
Fatigue and Microsleep: sleep disorders are common in many forms of mental illness and suicidal intensity. Insomnia is present in many forms of mood disorders, anxiety disorders and substance use disorders. People living with depression often experience lethargy and what is known as anhedonia – of the inability to feel pleasure. Sometimes extreme fatigue can result in microsleep (Kock, 2016) where the brain involuntarily goes “off-line” to a sudden sleep state for a matter of seconds. This state can have disastrous consequences for many safety-conscious professions.
Other Medical Complications: When mental health challenges reach crisis levels, other physical health challenges involving pain, gastro-intestinal problems and heart functioning can result.
Risk-taking and Disregard for Safety Precautions: When people are overwhelmed by the emotional pain in their life and have come to a place where the only way they can get out of this pain is to die, they often consciously or subconsciously start to take more risks or even practice suicidal behavior as they test out their capacity for self-harm.

About TJ Lyons

TJ Lyons is a safety professional and regional manager for a large mechanical contracting firm in the Northeast. He has had the opportunity to serve as Safety Director for some of our largest general contractors and has extensive experience working overseas. Currently he is overseeing work across the US supporting some of the greatest safety professionals in the world. One particular focus is on the sons and daughters who do our hard work every day. Whenever he gets the opportunity he takes the time to listen to those in the field. Often that results not only in a safer workplace but a happy and more trusting group of what he calls, friends. He lives with his wife Tracy in 200 year old stagecoach stop house near Saratoga, NY.

Show Notes

Psychosocial Hazards at Work: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5285308/

Construction Working Minds: http://www.constructionworkingminds.org/

Construction Industry Alliance for Suicide Prevention: http://www.cfma.org/news/content.cfm?ItemNumber=4570

9 Best Tips for Effective Construction Suicide Prevention -- An Interview with Jorgen Gullestrup of MATES in Construction | Episode 2: https://www.sallyspencerthomas.com/hope-illuminated-podcast/2

3 Ways to Build Resilience at Work: Interview with Judge (Ret.) Mary McClatchey | Episode 8 https://www.sallyspencerthomas.com/hope-illuminated-podcast/8

Leadership, Strategy & System Change: Interview with Stuart Binstock & Michelle Walker https://www.sallyspencerthomas.com/hope-illuminated-podcast/11

Suicide & The Workplace -- Globalization, Job Strain, and the Dark Side of the New Economy: Interview with Dr. Allison Milner | Episode 30 https://www.sallyspencerthomas.com/hope-illuminated-podcast/30

lIRMI (International Risk Management, Inc) Expert Commentary:

National Action Alliance for Suicide Prevention Workplace Task Force: https://theactionalliance.org/communities/workplace

The Role of Union Leadership in Suicide Prevention: https://www.sallyspencerthomas.com/hope-illuminated-podcast/2019/4/34

Mates in Mind: https://www.matesinmind.org/

MATES in Construction: http://matesinconstruction.org.au/

The World Health Organization suicide dashboard https://www.who.int/mental_health/suicide-prevention/en/

What do you say, when they say “yes” to the suicide question: https://www.sallyspencerthomas.com/dr-sally-speaks-blog/whatdoyousay

CDC Suicide Prevention https://www.cdc.gov/violenceprevention/suicide/index.html

Tribal Knowledge: https://www.industryweek.com/recruiting-retention/strategy-capture-tribal-knowledge

Suicide Postvention at Work — Managing the Suicide Crisis: https://www.sprc.org/resources-programs/managers-guide-suicide-postvention-workplace-10-action-steps-dealing-aftermath

Mental Health Conditions and Fatigue at Work: https://performetric.net/blog/mental-health-in-the-workplace-and-the-impact-in-mental-fatigue/

National Safety Week OSHA: https://www.osha.gov/StopFallsStandDown/