RETURNING TO WORK FOLLOWING A SUICIDE ATTEMPT: AN EXPLORATORY STUDY

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1 RETURNING TO WORK FOLLOWING A SUICIDE ATTEMPT: AN EXPLORATORY STUDY Francis Roy Ph.D.c Center for Research and Intervention on Suicide and Euthanasia University of Quebec in Montreal, Canada Oslo, Norway, Sept th 2013 The XXVII World Congress of the International Association for Suicide Prevention

2 Introduction Recovering from a suicide attempt can be hard and overwhelming Risk of repetition: 9% to 32% in the first year Risk of death by suicide: 0,5 to 2% in the first year Work can promote mental health well-being Opportunities to develop and use our skills Social contact and support Sense of identity and personal achievement Work can also be a source of psychological distress

3 Methodology Qualitative approach: Grounded Theory 24 participants recruited through 6 ER and 3 SPC Gender: 8 men / 16 women Age: years old (mean = 39) 5 professionals / 5 technicians / 3 office workers / 8 service workers / 4 manual workers Semi-structured interviews focused on the individual s experience Length: min. (mean = 106 min.)

4 Results Suicide attempt (n = 24) 1-12 months = 21 / months = 3 15 Drug poisoning / 8 Cutting / 1 Hanging All at home (or near home) Work status 21 have RTW: 13 still working full time 4 were back on sick leave 4 were unemployed (1 fired / 3 resignations)

5 Life events preceding the suicide attempt and their impact on RTW Accumulation of stressful life events and difficulties at home and sometimes at work Working conditions before the suicide attempt can have a negative impact on the issue of the reintegration process For Christine, resignation was a first step toward recovery: I realized that I wasn t happy at work and that my work environment wouldn t change. I realized that it was time for me to go, that it was the easiest aspect of my life that I could change. For Jane, resignation was to the only way to recovery: If I go back there again, I sign my own death warrant. It s my life! I almost died for work. Is it really worth it?

6 RTW and the recovery process Work plays an important part in the recovery process. For me, work is a lifesaver, work is health. It keeps me busy, socially and intellectually. After one week being at home, I was starting to go crazy. Veronica Suicidal thoughts have stopped soon after I start working again, with the help of the medication and the restoration of my self-esteem, and my social life at work Mike Returning to work was really important for me. I was getting my life back. If they have stopped me again, I think I would have reattempt. When I stay home alone, my thoughts stays negative Work is my life. - Gaston

7 Feelings and apprehensions about RTW Fear of having lost their ability to work / loosing their job Fear of falling sick again Feeling guilty of having been on a sick leave Feeling like a stranger, like a different person It takes all the space. I dream about it, it s part of my daily life. I loose a lot of energy thinking about going back to work. Jane I didn t sleep well the night before. I was so nervous. You re in the street, walking to the office, and you only think about that. - Martine

8 Return to work and support offered Gradual return was favored by many workers (10) Gradual return is essential. The first week, you observe, you relearn how to work. You re in your office and you feel like a stranger. Jane Support from supervisor was appreciated. I was really lucky because, on my very first day, my boss made me feel that it was ok. He told me: Nobody knows about it. If you need to leave early today or if you need to talk, I will be there. Work can wait. Think about yourself first. Martine He was the only person at work who didn t judge me. Everyday he came to see me: How are you doing today? If there s anything, don t be shy, come to see me. Don t wait until its too late Gaston

9 Support from coworkers: To tell or not to tell Workers felt ashamed. They didn t want to talk about it, they wanted to hide from their coworkers. Everyone is going to think that I did this to get their attention. This is why I didn t want to talk about it. I was ashamed to have failed. (...) If there was more people who knew about it, I wouldn t have been able to return Martine After the attempt, you feel so ashamed that you just want to hide. I didn t talk to anyone. You don t talk about that. Carole Strategies for dealing with coworkers curiosity

10 Support from coworkers: rumors and stigma One worker had to deal with judgements and stigma: When I came back to work, the first thing the guys told me was: You ve been on vacation all summer long!. For them, depression is impossible. It doesn t exist. - Gaston Everybody knew about it. Usually, when I arrived at work, people were friendly with me. But then, when I came back, people had trouble saying hello to me communication was shut down. ( ) I tried to figure out what was going on but nobody answered me. With time, I learned that they all knew: you can t hide anything in that shop! - Gaston

11 Support from coworkers is a key factor For Mike, the way that his coworkers welcomed him facilitated his return to work When I came back to work, my colleagues almost roll out the red carpet for me! All the guys were like Mike!, Mike! Mike!. Its the fact that people were happy to see me, that they acknowledge my work that helped me the most Mike Having a trusted friend as a coworker to rely on I m fortunate to work with my best friend. I was feeling supported. I was sitting at my desk, knowing that she was right across whenever I didn t feel good - Martine

12 Support from coworkers is a key factor Coworkers response to disclosure was positive and they were very supportive in many cases. They stopped and they listened carefully to what I told them. They said: Man, we almost lost you!. Mike They told me: You should have called us. Gilles Workers felt closer to their colleagues after disclosure, some becoming a confidant for others. I have become a confidant for one or two of my coworkers who were going through a rough patch. I once encouraged one of them to call the suicide hotline. I told him: And, if you ever need medication for a few months, its ok. It s not a failure, its even a success. - Serge

13 Discussion and conclusion Return to work plays an important role in the experience of recovery. Working conditions before the suicide attempt can have a negative impact on the reintegration process. Workers have a lot of apprehensions about RTW Support from supervisors and colleagues are key factors in the reintegration process.

14 THANK YOU! For more information: