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What You Need To Know About Suicide ( And How Your EAP Should Help)

Nov 23, 2019 is Survivor Day, a nationally recognized day for those affected by suicide to join for support and healing.  Why is it important to recognize such a day?  As a leading Employee Assistance Program provider (EAP), we see first hand the loss and devastation that occurs after a suicide – for a family, friends and co-workers.  That’s why we know how important it is to talk openly about suicide and help employers understand how they can help their employees who may be in need.

 

The Suicide Rate Has Been Increasing

Suicide happens far more frequently than you might think. The suicide rate in America is up 33% in less than 20 years. Suicide is now the second leading cause of death among those aged 10-34 and fourth leading cause of death among 35-54 year olds.

The suicide rate is up 33% in less than 20 years

 

Why the suicide rate has increased so rapidly is open to debate. Alcohol and substance abuse, increasing rates of depression, the declines in the family structure and sense of community, economic woes, even smartphone usage have all been associated with suicide in one way or another.

What’s more mystifying about the suicide rate is the fact that the rate today is about the same as it was 30 years ago.  Death by suicide in the US declined in the 80’s and 90’s before reversing course at the turn of the century.

 

Suicide is Preventable

The reasons for the increase in the suicide rate may be complicated, but what is clear is that suicide is preventable. In 2017, 47,173 people died by suicide in the US. The number of suicide attempts was nearly 30 times higher than that. That’s over 1.3 million people who attempted suicide, but survived.

Survivors often describe that it wasn’t the desire to die that drove their suicide attempt, but a desire to escape pain. That pain can be physical, but is often mental pain. Mental pain can be difficult to acknowledge because of the stigma that exists around mental health issues.

Woman looking despondent

What Should Employers Do?

Employers can play a significant role in helping reduce the number of suicides. The first step for employers is to help eliminate the stigma of mental health. Too often, those who most need help are reluctant to ask for it. According to Suzanne Delbanco, in How Employers Can View Mental Health Stigma, employees may be afraid to admit, even to themselves, that they need support with mental health. Or they may not be aware that their suffering may be due to anxiety or depression. Those who do recognize the need for treatment may be afraid to leave the office for therapy appointments for fear that co-workers will notice. Many also fear if their employer finds out they have a mental health condition, there may be negative repercussions. A 2017 survey showed that 31% of employees say they would be afraid of being labeled as weak, and 22% fear it would impact their opportunities for promotion.

Employers can help remove the stigma of mental health and it’s in their best interest to do so. Here’s what we’ve seen work:

  1. Your EAP, if it’s truly a comprehensive EAP, can be your most powerful weapon in combating mental health stigma and increasing employee access to help. Beware if you have a “free” EAP embedded in a disability insurance bundle though as these EAPs are less likely to offer the full array of services found in a comprehensive EAP.
  2. Awareness and education are critically important. Your EAP should be very willing and adept in helping to build awareness and educate your employees. Initiatives we’ve seen work include:
  • Hosting lunch and learns and guest speakers on behavioral health topics in the workplace
  • Offering a monthly topical webinar for employers to use to educate their employees and normalize behavioral health issues
  • Providing educational newsletters
  • Providing special presentations to educate managers and supervisors about key mental health issues: mental health first aid, suicide prevention, PTSD awareness and substance abuse
  1. Work with your EAP to promote awareness of the services offered and promote easy access to behavioral health treatment services at company benefit fairs.
  2. Create a culture of acceptance. For example, when speaking to employees about medical benefits, include behavioral benefits and issues in the conversation, thereby normalizing behavioral health. Also, incorporate language in company policies to prevent stereotyping and eliminate improper language/ labeling or bullying of employees with behavioral health challenges.
  3. Provide access to an Interactive Screening Program allowing employees to anonymously take a screening test for stress, depression and anxiety. Then, if they wish, they can dialogue with a behavioral health professional to understand their screening results and, if needed, connect them to the appropriate form of assistance – a therapist, psychiatrist, treatment program or self-help or support group.

At Espyr®, we offer an industry-first Interactive Screening Program (ISP) that provides employees with a convenient, anonymous way to connect with a qualified counselor about available service options through their EAP – and address their concerns before they escalate. Offered in association with the American Foundation for Suicide Prevention, the program has been especially effective. As one participant put it, “I was finally able to let someone know how badly I was feeling without any judgment.”

  1. Develop a Peer Support Program to train employees to assist distressed employees and encourage them to access professional behavioral health services.
  2. Larger companies should consider placing behavioral health clinicians on-site at workplaces to assess, refer and provide short-term counseling. A 2015 survey by the The National Association of Worksite Health Centers claims that 45% of all employers offer some sort of on-site health clinic. Adding a behavioral health clinician to an on-site clinic is a natural wellness extension and further helps normalize the concept of mental health.
  3. As behavioral health professionals, let your EAP help you draft policies that permit employees to leave work to keep behavioral health or EAP appointments. Structure benefits and policies with the awareness that many areas are underserved in terms of psychiatrists, and alternatives to psychiatry may be needed.

Awareness and education through frank and open discussions and training is critical in removing mental health stigma. Studies have shown that more accepting workplaces have happier employees with better productivity.

 

Recognize The Warning Signs of Depression

In addition to removing the stigma of mental health, employers need to learn to recognize the signs of depression and provide appropriate training for managers and supervisors.   Beyond the obvious benefit to employees, identifying and addressing depression is in employers’ best interests.  Depression is the leading cause of disability in the United States, and the CDC estimates it’s also the cause of 200 million lost workdays per year, costing employers $44 billion in lost productivity.

Depression can manifest itself in many different ways: physically, behaviorally and emotionally. Physically, changes in appetite, aches and pains, changes in sleep habits and feeling extremely tired can all occur. Behaviorally, those with depression may exhibit irritability, restlessness, trouble concentrating or difficulty completing daily routines. Increased alcohol consumption or reckless behavior can occur. Emotionally, a strong and consistent feeling of sadness, anxiety or hopelessness may be noticed.

 

50% of those who die by suicide were afflicted with major depression

 

Your EAP or wellness program provider should be ready to work with you to develop training programs for managers and employees on how to recognize signs of depression.  Policies need to be in place directing employees on what to do when at-risk employees are identified.  Recognizing someone who is suffering from depression is important because 50% of those who die by suicide were afflicted with major depression, and the suicide rate for people with major depression is eight times greater than that of the general population.

 

Observing Survivor Day

If you are a suicide survivor or you know someone who is, please encourage them to reach out this Survivor Day.

To locate support groups, or to join other survivors in Survivor Day events near you, visit Espyr’s partner in suicide awareness and prevention programming, the American Foundation for Suicide Prevention at www.afsp.org.  Or reach out to your Employee Assistance Program (EAP).   Your EAP can provide support for survivors and help them access healing communities and other resources.  If you are not sure if your employer offers an assistance program, contact your human resources representative.

 

About Espyr

Espyr is a leader in comprehensive EAP and behavioral health coaching programs.  Our innovative programs are designed to support our mission of helping people and organizations achieve their full potential. To learn more about how Espyr can help your company click here or call 888-570-3479.

 

 

 

 

 

 

 

 

 

The Surging Suicide Rate; What Should Employers Do?

Today’s news headlines that life expectancy for Americans fell for the second time in the past 3 years painted a disturbing picture of life in America.   The primary reasons for the decline? Increasing deaths from opioid abuse and suicide.

The suicide rate in America is up 33% in less than 20 years. Suicide is now the second leading cause of death among those aged 10-34 and fourth leading cause of death among 35-54 year olds.

The suicide rate is up 33% in less than 20 years

Why the suicide rate has increased so rapidly is open to debate. Alcohol and substance abuse, increasing rates of depression, the declines in the family structure as well as sense of community, economic woes, even smartphone usage have all been associated with suicide in one way or another.

Mental health and suicide

The reasons for the increase in the suicide rate may be complicated, but what is clear is that suicide is preventable. In 2016, 45,000 people died by suicide in the US. The number of people who attempted suicide was nearly 29 times higher than that. That’s over 1.25 million people who attempted suicide but survived.

Survivors often describe that it wasn’t the desire to die that drove their suicide attempt, but a desire to escape pain. That pain can be physical, but is often mental pain. Mental pain can be difficult to acknowledge because of the stigma that exists around mental health issues.

The role of employers

One in five Americans will suffer a mental health issue in a given year

Employers have a vested interest in recognizing the importance of mental health.  Employees suffering from mental health issues such as depression will miss approximately five workdays and experience 11.5 days of reduced productivity every three months. This isn’t an isolated issue either. One in five American adults will suffer from some type of mental health issue in a given year.

How can employers help? First, companies need to eliminate the stigma of mental health. Studies have shown that more accepting workplaces have happier employees with better productivity. Awareness and education through frank and open discussions and training is critical in removing mental health stigma.

Second, employers need to learn to recognize the signs of depression. Depression can manifest itself in many different ways: physically, behaviorally and emotionally. Physically, changes in appetite, aches and pains, changes in sleep habits and feeling extremely tired can all occur. Behaviorally, those with depression may exhibit irritability, restlessness, trouble concentrating or difficulty completing daily routines. Increased alcohol consumption or reckless behavior can occur. Emotionally, a strong and consistent feeling of sadness, anxiety or hopelessness may be noticed.

Many companies offer exercise programs or wellness classes such as yoga or meditation. Unilever, one of many companies that have established comprehensive programs designed specifically to support employee mental health, provides regular employee workshops on sleep, mindfulness and exercise, all of which have been linked to good mental health and psychological wellbeing.

One of the most effective ways to support employees with mental health conditions is taking advantage of your Employee Assistance Program (EAP). Comprehensive EAP programs offer information workshops and training for employees and supervisors on mental health. This training helps employees recognize the symptoms of depression and prepares workers and supervisors for actions that need to be taken when suicide prevention measures are called for. Employees have access to counselors through the EAP who are trained and certified to handle mental health issues such as depression.

Of course, many people in need don’t seek help. They’re afraid to come forward because of the stigma of mental health. They’re worried about confidentiality or they fear their mental health conditions may jeopardize their employment.

At Espyr®, we offer an industry-first Interactive Screening Program (ISP) that provides employees with a convenient, anonymous way to connect with a qualified counselor about available service options through their EAP – and address their concerns before they escalate.

Offered in association with the American Foundation for Suicide Prevention, the program has been especially effective. As one participant put it, “I was finally able to let someone know how badly I was feeling without any judgment.”

Learn more

As a leading behavioral health provider, Espyr has extensive experience working with employers to recognize and deal with employee mental health issues such as depression or feelings of suicide. To learn more how Espyr can help your organization call us at 888-570-3479 or click here.

 

 

Dying For Help: Addressing Mental Health Stigma In The Workplace

Polished.  Buttoned up.  Accomplished.  Funny.   This was how Sally Saba, MD was described.

And on March 5, 2017 she attempted to take her own life.

So it was only natural that the filled auditorium was hushed when Dr. Saba, Vice President of Operations, Performance and Compliance in Diversity and Inclusion at Kaiser Permanente Health Plan in California described her battle with depression and attempted suicide. Dr. Saba was speaking at the #Findyourwords Forum on Mental Health Stigma sponsored by Kaiser Permanente in Atlanta October 15.

Along with Dr. Saba, the Forum featured a panel of distinguished mental health experts, one of which was Norman Winegar, Chief Clinical Officer for Espyr.  I interviewed Mr. Winegar who shared his valuable commentary on mental health stigma, depression and suicide prevention for this article.

Golden: Mr. Winegar, why are people who suffer from depression and other mental health conditions reluctant to get help?

Winegar: There is a pervasive social stigma associated with seeking help for behavioral health conditions. People fear negative repercussions, both professionally and personally.  They’re concerned about a potential lack of promotions at work or alienation from friends and family.

Golden: Why should employers be concerned about mental health stigma?

Winegar: There are many reasons. Undocumented and untreated behavioral health conditions can have serious outcomes. Mood disorders are the leading cause of lost workdays in the world according to the World Health Organization.

Left untreated, behavioral health conditions can increase the cost of medical care. Compliance with treatment plans can be negatively impacted.   There is a high co-occurrence of mental health and physical health conditions, which can complicate and undermine medical care. Furthermore, people with undiagnosed mental health conditions use non-psychiatric healthcare services (including costly Emergency Department visits) 3 times more than those who do get treatment.

Employee performance is affected via absenteeism, presenteeism, turnover, decreased safety and increased risk. All these issues can and will affect team cohesion, customer service and can create disciplinary issues. Depressed employees for example are 20-30% more likely to become unemployed.

Overall, the cost of behavioral health conditions to US employers is estimated at $80-100 Billion annually (NIMH), so employers have a strong economic incentive to be concerned about mental health stigma.

Golden: What can employers do to reduce stigma and encourage employees to get assistance?

Winegar: Generally speaking it’s a combination of education and policy change.

  1. Use respectful language. Avoid terms like “crazy” or “he/ she is bipolar”
  2. Provide professional development opportunities for your employees (especially supervisors and managers) around diversity and mental health awareness
  3. Foster an inclusive workplace culture
  4. Create and communicate polices that make it safe for people in distress to come forward and access treatment. For instance, Kaiser Permanente has developed a Mental Health, Wellness and Resiliency Strategy to support the company-wide awareness of Mental Health issues and to create a stigma-free environment.
  5. Support educational programs in the workplace to educate about mental health issues and to encourage peer support
  6. Implement a suicide awareness and prevention program

Golden: Do suicide prevention programs work?

Winegar: Absolutely! Let me give you a few examples.

  • The US Air Force implemented a suicide prevention program and saw a 33% reduction in suicides over 6 years
  • The University of California, San Diego School of Medicine implemented in 2009 an online anonymous Interactive Screening Program after 10 physicians and medical students committed suicide over a period of 15 years. Since 2009, 300 physicians and trainees have accepted referrals to treatment via this anonymous, confidential program.
  • A large Federal customer of Espyr’s has since 2016 offered a similar Interactive Screening Program that has referred over 120 people to treatment in 2 years.

Golden: Is there a correlation between type of occupation and the severity of stigma around mental illness?

Winegar: Yes.

Healthcare professionals experience stigma as it relates to policies that may cause them fear of losing their professional license.

Government employees experience stigma as it relates to policies that cause them fear that if they seek treatment they may lose their security clearance, and hence their job.

Attorneys (and law students) experience stigma as it relates to policies that may cause them fear of losing their bar status or not being able to take the bar exam.

Law Enforcement and First Responders experience stigma as it relates to Fitness for Duty policies that cause them fear that disclosing a behavioral health condition may cause a temporary or permanent removal of their badge or weapon.

Golden: How can employers measure the mental health of employees?

Winegar: Employers have several tools at their disposal.

  • Holistic analytics can provide insight into the health of the workforce, beyond just claims analysis.
  • Health Risk Assessments (HRAs) should include not only questions about emotional wellbeing but also about employee awareness of employer-sponsored resources and whether managers are supportive of team members’ mental and emotional wellbeing.
  • Utilization of their EAP. For instance “free EAPs” usually have 1-2% usage, but employers know that 20+% of employees are having some type of mental health issue each year that can affect their work and therefore their employer’s profitability. So going cheap in this important area is unwise and poor business sense. Many factors can influence use of an EAP, but generally look for case utilization in the 8-12% range; look for your EAP to reach and impact 20-30% of your workforce through some form of activity.

Golden: What should I say to someone who is reluctant to get help?

Winegar: Have what I call a caring conversation. Ask if they are Ok. Note the behavioral changes you’ve seen. And it’s okay to ask someone if they are thinking about suicide or self-harm. This caring question will not “put the idea in their mind”.  Listen and be non-judgmental. Provide support and encouragement. Point out resources like a Primary Care Physician or the EAP. Keep faith-based resources in mind for some people. Follow-up and check in with the person.

If you think the person is in imminent danger to themselves or others, call 911 or if you are at work, speak with a manager or call security.

Golden: What was it that you wanted people to walk away with from your comments at the #Findyourwords event?

Winegar: Stigma drives silence and silence prevents those in need from getting help. This can have disastrous personal and business consequences. Breaking this silence encourages people to get help. This starts with each one of us.

When people feel safe, they are more likely to access sources of assistance and treatment.

Businesses need to act in responsible ways when it comes to their most valuable asset, their employees. Employers need to pair robust healthcare services with proactive programs like comprehensive EAP services and other specialized programs to reduce social barriers to seeking help (such as Interactive Screening Programs; Peer Support programs, Mental Health Awareness education, etc.). This makes good business and people sense.

 

To read more about addressing mental health stigma go to this prior Espyr post  See this post to read more about how employers can address the rise in suicides.

As a leader in behavioral health, Espyr is frequently called upon to help our clients and their employees deal with depression and suicide prevention. For more information on how Espyr can help your company deal with these issues, or any other behavior health issue, call Espyr at 866-570-3479 or go to espyr.com.

 

 

Suicides On The Rise: What Can Employers Do?

Earlier this year, we endured a one-two punch of the suicides of fashion icon Kate Spade and author/TV personality Anthony Bourdain.   As always happens following celebrity suicides, a barrage of TV, news and social media stories followed exploring, in intricate detail,  how they died and what led up to their fateful decisions. Unfortunately, these tragedies – and the ever-present news coverage – often lead to more of the same. In a study published by the International Journal of Epidemiology, media reports of suicides of well-known figures can trigger suicides in viewers and readers. When someone struggling with mental health issues sees that someone with similar issues responded to that suffering by killing themselves,  “It puts death on the table”, says news site Vox.

But these stories can also have a positive effect; they can cause employers concerned about the physical and mental health of their employees to evaluate their healthcare plans and determine if they’re doing enough.

Causes of Suicide

While the cause of suicide is not known, it most often occurs when the stresses of life exceed the coping abilities of someone already suffering from a mental health condition. In these cases, at these moments, stressors and health issues converge to create strong feelings of hopelessness and despair, something that seems impossible to overcome through any other method than death.

Most people who actively manage their mental health conditions go on to engage in life. Regrettably, it’s more common for those conditions to go untreated. Depression is the most common risk factor associated with suicide, and it’s often one that is undiagnosed or untreated. Other risk factors include anxiety, substance abuse, bipolar disorder and a family history of suicide.

Any of the conditions mentioned, especially when unaddressed, increase the risk for suicide.

The Cost of Suicide

The Centers for Disease Control and Prevention (CDC) shares the latest statistics on suicide, and it’s not good news. Here are just a few of the startling facts:

  • Since 1999, suicide rates in the U.S. have risen nearly 30%.
  • Almost 45,000 Americans die each year by suicide – about 123 per day.
  • For every documented suicide, there are 25 suicide attempts.
  • Suicide costs the U.S. $69 billion annually in medical costs and work loss.

To make matters worse, since the stigma surrounding suicide leads to underreporting, the CDC estimates these numbers to be higher.

The Employer’s Role

Those employers who currently provide some sort of behavioral health counseling benefit – better yet, a comprehensive Employee Assistance Program (EAP) – are already going in the right direction. Same with school administrators providing a Student Assistant Program (SAP). Their employees (or students) have a place to go when they feel the need to seek help.

More comprehensive EAPs and SAPs, however, don’t stop at basic counseling. Some offer early suicide identification services and 24/7/365 intervention. Others conduct suicide prevention training activities on location or, in the aftermath of a suicide, critical incident trauma responses to help the rest of the community deal with their feelings.

Of course, many people in need don’t seek help. They’re worried about confidentiality, they fear their mental health conditions may jeopardize their employment or they believe “things will just work out.”

At Espyr®, we offer an industry-first Interactive Screening Program (ISP) that provides employees and students with a convenient, anonymous way to connect with a qualified counselor about available service options through their EAP – and address their concerns before they escalate. Here’s how it works:

  1. Employee/Student visits the anonymous ISP website
  2. Takes a brief stress and depression questionnaire
  3. Receives a personal response from an EAP counselor
  4. Exchanges messages with counselor – asks and learns about available services
  5. Gets feedback and encouragement
  6. Requests an appointment or referral

Offered in association with the American Foundation for Suicide Prevention, the program has been especially effective. As one participant put it, “I was finally able to let someone know how badly I was feeling without any judgement.”

If you’d like to learn more about how you can help your employees (or student population) deal with feelings of suicide – or any other behavioral health issue click here.