A Construction Industry Blueprint: Suicide Prevention in the Workplace

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A Constuction Industy Bluepint: Suicide Pevention in the Wokplace

The Issue The Constuction Industy is at High Risk fo Suicide Hee is why the nation should make suicide pevention a pioity: National Statistics Constuction Industy Statistics Ove 41,000 suicides occu each yea making it the 10th highest cause of death fo all ages (CDC). Men out-pace women fou to one in suicide deaths and white woking-age men have the highest suicide ates. Howeve, among women, wokes with the highest suicide ates wee in constuction and extaction (134.3 pe 100,000). Each yea, self-inflicted injuy accounts fo 836,000 emegency depatment visits (CDC). Suicide is the 2nd leading cause of death fo men 25-54 in the United States (CDC). The constuction industy is in the top nine occupations at isk fo suicide (BLS). Moe people die fom suicide than fom moto vehicle cashes (CDC). Men in high skill and high stakes occupations (i.e. supevisos of heavy constuction equipment) ae almost 1.5 times moe likely to die by suicide (Business Inside)[1][2]. People in occupations equiing no education afte high school ae moe at isk fo suicide (Review of 34 Studies)[3]. You can t fix you mental health with duct tape. - ManTheapy.og We have a tough guy mentality suck it up and get though whateve is thown at you. The idea to be open to something that is pesonal, at wok, is difficult. Usually thee is a peception that you ll be met with indiffeence. The Opeations Staff needs to undestand that it is okay to discuss pesonal issues. - Tade Supeviso [1] Lubin, G. (2011, Octobe 18). The 19 Jobs Whee You e Most Likely To Kill Youself. Retieved August 5, 2015. [2] NIOSH (2015). National Occupational Motality Suveillance (NOMS). U.S. Depatment of Health and Human Sevices, Public Health Sevice, Centes fo Disease Contol and Pevention, National Institute fo Occupational Safety and Health, Division of Suveillance, Hazad Evaluation and Field Studies, Suveillance Banch. Retieved August5, 2015. [3] Milne, A., Spittal, M., Pikis, J., & Lamontagne, A. (2013). Suicide by occupation: Systematic eview and meta-analysis. The Bitish Jounal of Psychiaty, 203(6), 409-416. doi:10.1192/bjp.bp.113.128405 A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 2

Industy Risk Factos Access to lethal means: People who have access to, and familiaity with, lethal means like fieams, pills and high places, ae often less afaid and moe capable of self-inflicted ham by these means. A big pat of the depession is dinking o using. A lot of times the issue is pain. We ae in labo, so liteal physical body pain. The moe in pain they ae, the moe they dink o take a couple exta dugs... - Field Manage Capability fo fealessness: When a wokplace has a cultue of ecklessness, bavey and/o stoicism, and people ae ewaded fo being tough, they ae often less likely to each out and ask fo help. Exposue to physical stain o psychological tauma: Wokplaces that expose employees to physical o psychological injuy though taumatic life-theatening events can expeience symptoms of chonic pain, post-taumatic stess, o bunout that can contibute to suicide despai. Cultue of substance abuse: Wokplaces that infomally suppot a cultue of self-medication to elieve stess can expeience escalating substance abuse poblems that also incease the isk of suicide. Fagmented community/isolation: When wokes ae often in tansitoy o seasonal employment, they can expeience a lack of belongingness and a highe level of uncetainty that adds to a sense of isolation and lack of meaning. Humiliation/Shame: When a humiliating job failue occus and the employee s main souce of identity is thei wok, this event can tigge depession and suicidal thoughts. A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 3

Industy Risk Factos (continued) Entapment: When employees feel that they must do something they would not nomally do because they see no othe way to meet thei goals, hopelessness can esult. Sometimes wokes in the industy expeience the golden handcuffs phenomenon: feeling entapped into the one line of vey stessful wok because they see no othe way to sustain a cetain standad of life fo themselves and thei families. Wokplaces involved in community suicide deaths: Constuction sites that include bidges and buildings ae sometimes the death sites fo suicide. These types of community suicides can tigge suicidal thoughts o depession in job site wokes. I know one peson who killed himself and thee moe that OD d. That s a lot. A lot of guys just don t think that they measue up, and all day they ae just told to get it done, get it done, get it done. - Field Manage Natue of the wok: Cyclical wok with egula peiods of lay-offs and e-hiing causes uncetainty about employment. Wokfoce and skill shotages esult in laboes woking ovetime to complete pojects. The combination esults in a pessue cooke atmosphee that can ovewhelm employees. Sleep disuption: Woking long o abnomal hous can effect sleep, causing mental and physical exhaustion. This effects pefomance, inceases the pobability of injuy, and can exacebate othe mental health concens. A guy who woked with me stated doing dugs, he always dank like a lot of wokes do. He tuned to meth and it went downhill. He needed someone to talk to. -Tade Supeviso A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 4

The Goal: Zeo Suicide In the Constuction Industy Wokplaces that adhee to a stong cultue of safety set a goal of zeo wokplace-elated fatalities. Suicide is no exception. What if constuction industy leades believed that suicide could be eliminated and did eveything in thei powe to pevent it? Leadeship and ole modeling mattes! This bluepint helps us stat to build the policies and pactices we need to have in place fo zeo suicide to become a eality. No one should die in isolation and despai. All lives ae woth saving! What you leade values is what you value. - Tade Supeviso A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 5

How Pepaed is You Company? Wokplace Checklist: Impotant Things to Note Check if these qualities ae often tue of you wokplace Chaacteistics of Wokes: Male dominated wokfoce Pesonality of machismo and fealessness: These individuals ae least likely to admit to any type of peceived weakness and least likely to seek help on thei own. Self-medication though alcohol o substance abuse Tansitoy/seasonal wokfoce: When wokes ae often in tansitoy o seasonal employment, they can expeience a lack of community and a sense of isolation. Sleep disuption: Woking long o abnomal hous can effect sleep, causing mental and physical exhaustion. Chonic pain: Employees expeiencing physical injuy o chonic pain can expeience depession and hopelessness and the desie to escape though death. Undiagnosed and unteated mental health conditions: Many baies to pope diagnosis and teatment of mental health conditions exist. Sometimes it has to do with the stigma of having a mental illness. Sometimes is has to do with access to adequate cae. Fequently, people do not connect physical symptoms of insomnia and agitation to undelying mental health conditions. Because of this disconnect, when these symptoms ae pesent, they ae not fully addessed. Lack of access to quality mental health cae: Because of tempoay and contact labo status, many people in the constuction industy do not have adequate insuance to cove teatment fo mental health conditions and addictions. Stained maiages and family conflict: Family poblems can intefee with wok poductivity and long wok hous and substance abuse can often contibute to divoce and family conflict. Financial stain: Debt and lack of egula job oppotunities cause financial hadship and can contibute to significant anxiety and instability. Access to lethal means (such as constuction sites) Shame: When a humiliating job failue occus and the employee s main souce of identity is thei wok, this event can tigge suicidal thoughts. Entapment: When employees feel that they must do something they would not nomally do because they see no othe way to meet thei goals. Wokplaces involved in community suicide deaths: Sometimes constuction sites like bidges and buildings ae involved in suicide deaths and wokes can sometimes be taumatized witnesses. A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 6

How Pepaed is You Company? (continued) Wokplace Checklist: Impotant Things to Note Check if these qualities ae often tue of you wokplace Cultue of Wokplace: Employe values do not make wellness a pioity. Communication pactices do not model openness and suppot. Wokplace involved in community suicide deaths. Stigma fo mental health conditions exists. Pessue Cooke Stess is the nom. Mental health benefits not offeed o not coveed at the same level as othe physical disodes. Wokplace doesn t have an Employee Assistance Pogam, o has one but doesn t pomote it to employees. Wokplace doesn t outinely offe educational pogams and taining on mental health topics. Wokplace doesn t distibute mental health awaeness mateial (bochues/postes/fact sheets). Wokplace doesn t encouage sceening fo mental health conditions like depession, anxiety, and substance abuse. Wokplace doesn t have Standad Opeating Guide fo how best to handle suicide cises. Wokplace not awae of geneal local mental health esouces. Answeing yes to even one of these should make you ask youself how ae you and/o those aound you doing? What can be done to lowe the isk? A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 7

Waning Signs Some behavios may indicate that a peson is at immediate isk fo suicide. The following thee should pompt you to immediately call the National Suicide Pevention Lifeline at 1-800-273-TALK (8255) o a mental health pofessional. 1. Talking about wanting to die o to kill oneself. Communication may be veiled, such as: I just can t take it anymoe. o What s the use? 2. Looking fo ways to kill oneself, such as seaching online o obtaining a gun. 3. Talking about feeling hopeless o having no eason to live. Othe behavios may also indicate seious isk - especially if the behavio is new, has inceased; and/o seems elated to a painful event, loss, o change. Talking about feeling tapped o in unbeaable pain Talking about being a buden to othes Inceasing the use of alcohol o dugs Acting anxious o agitated; behaving ecklessly Sleeping too little o too much Withdawing o feeling isolated Showing age o talking about seeking evenge Displaying exteme mood swings (SPRC) Waning: An Inceasingly Medicated Wokfoce Employes undeestimate how many employees stuggle with mental health issues, but the use of medications has been significantly inceasing ove time. One study indicated that usage inceased 22% between 2001 and 2010, and that appoximately one in five adults is taking at least one pesciption medication fo psychological issues. Antidepessants ae the second most commonly pescibed dug in the U.S. 1 1 Ameican Psychological Association I have had a couple of guys who pobably needed to talk to someone, but I don t know how to bing that up. - Foeman A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 8

Potective Factos Cultue that pomotes the impotance of safety Emphasis on teamwok Cultue of employee engagement and connectedness, poviding a sense of bothehood Cultue of wellness that values mental health Access to insuance and mental health cae (e.g., Employee Assistance Pogam) Infomational suppot systems (buddy systems) Leadeship and supeviso taining The buddy system was oiginally set up as a safety concen. We d ask each othe, Do you have eveything planned out so you ll be safe? The buddy system gave new people an oppotunity to say something if they saw anything happening that was wong. But it was neve geaed towad how ae you doing today? - Field Manage A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 9

Toolbox Talk #1: Wold Suicide Pevention Day is Septembe 10 th Evey Yea Field Manage Pesentation: Today, we ae ecognizing Wold Suicide Pevention Day. The safety of ou employees is a high pioity fo us. Suicide is a majo health and safety issue. The pain that leads people to take thei lives is had to imagine. Thei deaths leave families and fiends gieving, and often have a huge effect on communities. Evey yea, ove 800,000 people die fom suicide globally; this is about one peson dying evey 40 seconds. The numbe of lives lost each yea fom suicide is moe than the numbe of deaths fom mude and wa combined. Mental health challenges (especially depession and alcohol use) ae a majo isk facto fo suicide. Wold Suicide Pevention Day bings togethe individuals and oganizations with an inteest in suicide pevention, and mobilizes effots to save lives. Connectedness is cucial to people who might conside suicide. We know that isolation can incease the isk of suicide and, that having stong human bonds can be potect people fom it. Reaching out to those who have become disconnected fom othes and offeing them suppot and fiendship can be a life-saving act. Moe info on Wold Suicide Pevention Day: iasp.info/wspd 1-800 - 273 - TALK (8255) suicidepeventionlifeline.og A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 10

What Should You Say if You ae Woied Someone Might be Suicidal? Fist: I ve noticed (list specific behavios), and I am concened. Second: Given what you ve been going though, it would be undestandable if you wee thinking about suicide. I am wondeing if this is tue fo you. Thid: Tell me moe about you thoughts of suicide and you distess. [LISTEN] Fouth: Thank you fo tusting me. I am on you team; you ae not alone. I have some ideas that might help. Fifth: Suggest esouces: 1-800-273-8255 (National Suicide Pevention Lifeline) Employee Assistance Pogam ManTheapy.og Othe local mental health esouces Souce: WokingMinds.og A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 11

Recommendations fo Effective Suicide Pevention Bake it in, don t bolt it on. - D. Covington, Executive Committee Membe of the National Action Alliance fo Suicide Pevention, on the impotance of integating suicide pevention stategies into existing cultue and stengths of oganizations. UPSTREAM Pevent Poblems fom Happening in the Fist Place Shift Wokplace Cultual Pespective: Make mental health and suicide pevention health and safety pioities. Leadeship must model this, clealy communicate benefits and answe questions fo concen. Regulaly pomote mental health pactices and a ange of esouces e.g., new employee oientation, benefits enewal, newslettes. Develop Life Skills: Offe taining in conflict esolution, stess management, communication skills, financial planning, goal setting, paenting o othe skills-based pogams fo employees. Impove Mental Health and Addiction Knowledge: Delive egula toolbox talks and awaeness communication on mental health topics and how to impove wellness. Consistently link mental health with wellness and safety pogams. Pomote Social Netwoks: Ceate a healthy community and foste genuine wokplace suppot. MIDSTREAM Identify Poblems Ealy and Connect People to Help Identify People at Risk: Detect ealy symptoms fo depession, anxiety, substance abuse and ange. Pomote Help-Seeking: Pomote esouces like the National Suicide Pevention Lifeline 1-800-273-TALK (8255), povide pee assistance taining and nomalize help-seeking behavio. Incease Access to Quality Cae: Povide affodable mental health sevices wellvesed in state-of-the-at suicide isk assessment, management and suppot and a ange of effective teatment options. DOWNSTREAM Safe and Compassionate Responses to Mental Health Cises Pomote Woke Use of Mental Health Sevices: When wokes ae stuggling, supevisos can take the lead in connecting employees to immediate mental health and cisis sevices. Restict Access to Potentially Lethal Means: When potential fo suicide is high, emove access to guns, pills and othe means of suicide. Povide Suppot afte Suicide: Follow cisis management pocedues and longe-tem suppot in the aftemath of a suicide as outlined in A Manages Guide to Suicide Postvention in the Wokplace [available as fee PDF at www. WokingMinds.og]. A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 12

Toolbox Talk #2: Pacticing a Convesation fo Life: Notice, Ask, Listen, Suppot and Follow-up Field Manage Pesentation: Stating couageous convesations about mental health isn t easy. We can lean the basic steps, but unless we pactice and put them into ou own language, we ae likely to foget them. Let s imagine what we might do in this common scenaio. Fo example, you notice that someone on you team has been going out to the ba a lot afte wok. She o he is not always getting to wok on time and seems petty distacted. 1. Tell them you have noticed something is wong. What types of things might you say? Get 2-4 examples fom you team. 2. Ask them if thee ae some ways you can help Get 2-4 examples fom you team. 3. Let them know that the EAP and/o wellness coach can help them make a plan to feel bette. Get a few examples of how they might offe this esouce. 4. Offe to do an alcohol-fee activity with them outside of wok. Get 2-4 examples fom you team. 5. Check in with them afte a few days to see how things ae going. Get a few examples of how they might check in. 6. Escalate intevention if no impovement seen in attitude o behavio. Consult with EAP o othe mental health pofessional. Simple intevention convesations like these can save lives and help potect you cowokes, fiends, and family membes. You can t fix mental health with duct tape, but you can connect with people to help them find solutions that wok. A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 13

Call to Action Take action and save lives. Fo immediate help with a suicide cisis call 1-800-273-TALK (8255). Complete the Wokplace Checklist to help you detemine if you need to evolve to a moe suppotive cultue; detemine how you could implement some of the ecommendations. Implement ecommended Toolbox Talks (see pages 12-13). To lean moe about the compehensive appoach to suicide pevention, visit the National Action Alliance fo Suicide Pevention: actionalliancefosuicidepevention.og/task-foce/wokplace/cspp Contact the Cason J Spence Foundation fo an initial consultation on developing a stategy o taining options. CasonJSpence.og Offe wokplace sceening fo mental health: mentalhealthsceening.og/pogams/wokplace Implement suicide pevention skills taining. Fo infomation on best pactice taining models such as Woking Minds, ASIST, and QPR, visit: taining.spc.og/couse/desciption.php#couse4 Lean how best to manage mental health elated pefomance issues: mhwellnesswoks.og Get to know you EAP o community mental health pofessionals. Invite them to get to know the employees and the cultue of the constuction industy. A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 14

Poduced by the Cason J Spence Foundation in patneship with the National Action Alliance fo Suicide Pevention Sponsoed by 2015 Cason J Spence Foundation, All Rights Reseved Fo moe infomation about this esouce contact D. Sally Spence-Thomas, CEO & Co-Founde of the Cason J Spence Foundation at: Sally@CasonJSpence.og This document may be epoduced without pemission fo non-commecial use. Acknowledgment is appeciated. Published by: Cason J Spence Foundation 1385 South Coloado Boulevad, Suite A-316 Denve, CO 80222 1. To download pintable vesions of this bluepint o to ode had copies, submit a equest: http://www.casonjspence.og/contact/ 2. Fo moe infomation on suicide pevention in the wokplace: WokingMinds.og 3. Fo moe infomation about the public-pivate patneship advancing the National Stategy fo Suicide Pevention: Actionalliancefosuicidepevention.og CITATION: Cason J Spence Foundation & National Action Alliance fo Suicide Pevention (2015). A Constuction Industy Bluepint: Suicide Pevention in the Wokplace. Denve, CO: Cason J Spence Foundation. Additional contibutos and eviewes ae epesentatives fom: ACIG BCRC Administation, Inc. Cato, Ruma & Associates Coloado State Univesity Denve Meto Chambe of Commece G.H. Phipps Lakeside Industies RK Shaw Constuction Suescape Insuance Sevices, LLC. U.S. Depatment of Labo OSHA, Region VIII 1-800 - 273 - TALK (8255) suicidepeventionlifeline.og A Constuction Industy Bluepint: Suicide Pevention in the Wokplace 15