INTEGRATING SUICIDE PREVENTION INTO YOUR SAFETY CULTURE A huge THANK YOU to The Builders Association and the Midwest Conference Committee for their: Recognition that we have a problem Recognition that it is an INDUSTRY issue Recognition that there is a safety related solution
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
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
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
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+
Why is this a workforce issue? o o o o o o 25% of population experience a diagnosable mental illness Less than 20% of people with mental illness will seek help 60% of adults with mental illness did not receive any MH services during previous year 80% Success rate of overcoming/managing with early treatment Results in 200 million lost work days per year Absenteeism & Presenteeism: o In 3 month period, a depressed individual will miss on average 4.8 days of work and suffer 11.5 days of reduced productivity
Why is this a construction issue? 2 nd leading cause of death for men 25-54 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
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
Why construction check out the risk factors! Family separation and isolation with travel Sleep disruption/deprivation due to shiftwork
Why construction check out the risk factors! Seasonal layoffs and end of project furloughs Tolerant culture of alcohol and substance abuse
Why construction check out the risk factors! Chronic pain Access to lethal means
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
Upstream / Midstream / Downstream Approaches
Upstream Leading indicators GOALS: Build Protective Factors Prevent Problems Identify & Promote Resources ACTIONS: 1. Leadership Engagement 2. Integrate with safety, health, wellness and employee benefits, coordinate with labor unions 3. Creating social networks within the workplace (Peer Support) 4. Nurture mental health literacy 5. Teach life skills
Midstream Leading indicators still GOALS: Early Identification Link to Care ACTIONS: 1. Learn warning signs and responses (Gatekeeper training) 2. 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
Downstream Lagging indicators GOALS: Manage crises Restore functioning ACTIONS: 1. Restrict Access to Lethal Means 2. Know resources to contact (lifelines, postvention) 3. Dignity & Empowerment 4. Grief & Trauma Support
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
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!
THE STIGMA OF MENTAL ILLNESS WHAT DO YOU FEEL WHEN SOMEONE SAYS THAT THEY HAVE A FORM OF CANCER? WHAT DO YOU FEEL WHEN SOMEONE SAYS THAT THEY HAVE BIPOLAR DISORDER? HOW ARE YOUR FEELINGS DIFFERENT? WHY ARE YOUR FEELINGS DIFFERENT? HOW IS THE LANGUAGE DIFFERENT? DO WE COMMIT CANCER? WHAT IS THE IMPACT OF THIS STIGMA? MENTAL ILLNESS IS REALLY A PHYSICAL DISEASE OF THE BRAIN.
SUICIDE MYTHS ASKING SOMEONE IF THEY ARE THINKING OF SUICIDE WILL PUT THE IDEA IN THEIR HEAD PEOPLE WHO TALK ABOUT SUICIDE ARE JUST TRYING TO GET ATTENTION PEOPLE WHO ATTEMPT SUICIDE WILL NOT ATTEMPT SUICIDE AGAIN
The Wall trying to see beyond the obstacles Mental Illness Loss Identity Family Health Relationships Financial Issues Work
Opioid Addiction 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
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
Efficacy of pain mediations Acute pain Percent with 50% pain relief 62 37 40 37 28 21 Ibuprofen 200 mg Acetaminophen 500 mg Ibuprofen 400 mg Oxycodone 15 mg Oxy 10 + acet 1000 Ibu 200 + acet 500 25
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
Suicide Prevention is a TEAM effort FIELD/PROJECT MANAGEMENT HR & SAFETY CORPORATE LEADERSIP
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
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
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
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
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
FNF CONSTRUCTION, INC. PUTTING SUICIDE PREVENTION INTO ACTION
Posters Newsletters Weekly Health Alerts Wellness Program EAP ID/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.
RESOURCES Where to get help Next steps TEATER HEALTH SOLUTIONS 36
www.cfma.org/suicideprevention
Alliance Members
www.cfma.org/suicideprevention
Checklist Tool to provide structure to integration.
Text HOME to 741741
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
Carry a Message of Hope
QUESTIONS?