How to reach employees who have suicidal thoughts

TW: discussion of suicide, mentions of self-harm and death

Suicide is one of those topics that is most stigmatized. We don’t want to talk about him, we are afraid of him, we don’t know how to approach him. And discussing suicide – and mental health in general – is one of the most important ways to get rid of this taboo. And thus help people who are afraid or ashamed to share their suffering and ask for help.

WHO reports, that annually 1.4% of deaths worldwide are caused by suicide. The percentage seems small, but it’s more than 700,000 deaths – as if all of Krakow had disappeared! And these are just documented cases. In Poland The suicide rate (that is, the number of deaths per 100,000 people) is more than 11%. However, for men it is already much higher, more than 20%! Human lives are at stake here, so it’s time to overcome shame, fear and reluctance and start the conversation.

Warning signs – what to look out for

Even if an employee is reluctant to share his or her condition with us, he or she may exhibit some signs of distress.
These include.
:

• Behavioral changes – large mood swings, nervousness, tantrums or crying, signs of dissociation (the person often seems highly thoughtful, sometimes even uncontactable and difficult to “bring back to earth”), risky behavior
• Changes in functioning – the employee begins to be late or has unexplained absences, has withdrawn from social life at work, isolates himself from others, there has been a decline in productivity due to difficulty concentrating
• Visible signs of self-injury, fresh wounds, burns, injuries, bruises (e.g., from using a rubber band)
• Changes in eating and sleeping (perhaps the employee complained about them)
• Changes in appearance – for example, sloppiness, dressing inconsistently with the dress code, but also a sudden change in style – long sleeves, turtlenecks, long pants, which may be due to the desire to hide traces of self-injury
• Talking (even in jest) about suicide, feeling overwhelmed and distraught, calling oneself a burden/problem for others, and phrases like “soon you won’t have to worry about me,” “who cares if I’m alive,” “sorry I’m alive/am”
• Giving away/disposing of your favorite things

Remember, not every person having suicidal thoughts or planning suicide will behave in the above manner – some act and look the way they always do even when they are experiencing the greatest suffering.

Conversely, the above signs do not necessarily indicate that someone is suicidal. So proceed gently but firmly – in this matter it is better to blow cold. Trust your intuition.

What to do if you think an employee may be having suicidal thoughts

First of all, don’t think about whether or not the person wants to take his or her own life. If you have any doubt, don’t wait – act. If you *make* a mistake, the worst that can happen to you is awkwardness and a moment of embarrassment. If this person actually had suicidal thoughts – the worst-case scenario is incomparably scarier.

So remember – it’s better to be “oversensitive” than to wonder if you could have done more or reacted faster.

Also, don’t forget that you are not responsible* for the choices of others. Whatever happens, try not to feel guilty*. Don’t be afraid to reach out for support from loved ones and professionals in this situation.

How to start a conversation

First of all, be prepared* – learn how to behave so you can respond as quickly as possible in the future. Find out what the protocol is in this situation, who (e.g., HR department, doctor) to turn to when an employee is in severe mental distress or considering taking his own life.

Whether the situation is a crisis or you just want to talk to an employee, try to remain calm. We know how shocking it can be to learn that someone wants to kill himself, but it is extremely important to be calm and not show this shock.

The second important point – don’t judge. This situation can evoke many emotions – fear, anger or helplessness. Whatever you feel, know that it is natural and you have every right to do so. But you don’t have the right to project those emotions onto another person – especially someone in such a fragile state – and judge their feelings and choices. This can only make the situation worse.

The third point – be direct*. Of course, do it with sensitivity and empathy, but without wrapping yourself in cotton. Especially if the situation is a crisis – after all, human lives are at stake here.

If you suspect that the person is in a worse mental state or is suicidal

• 
  Ask
  for help from HR or the unit responsible for employee health and well-being, if you find one in your company
• Try talking to a staff member using the advice in the section above. Describe your observations – making it clear that, precisely, these are only subjective observations. In this way you show why you are worried and create space for further discussion. Try to ask open-ended questions so that the employee has a chance to tell his or her side of the story.
• Try to understand his situation and outline how you can help him.
• If the employee agrees – connect him with the appropriate person from the HR department or another unit (e.g. the contact person of an external psychological care provider, as
  HearMe
  )

If a person has told you about suicidal thoughts

• Stay with her, preferably in a quiet, private space.
• In this situation, call HR or any other department responsible for the health and well-being of employees in your company and outline the situation. It’s best to hand the phone to an employee right away so that the professional on the other end of the phone can make a risk assessment and outline how the company can help.
• If the risk assessment is high and the worker really wants to kill himself, follow the guidelines in the next section.

Crisis action – if a person poses a threat to themselves

• Under
  under no circumstances
  do not leave the person unattended and call an ambulance.
• If she works remotely: make sure where she is located (home, coffee shop, etc.) and whether someone is nearby and can stay with the employee. Call an ambulance at the address given or ask someone else if the employee is alone and you need to stay in contact with him. Don’t interrupt the call/connection!
• Encourage the person to share his or her problems, but don’t promise to keep the conversation private – chances are the content will need to be shared with emergency responders or doctors.
• Ask if there is someone the person would like to call. It can also be a helpline – a list of numbers can be found at the end of the article.
• Stay with her, preferably in a quiet, peaceful place, until professional help arrives.
• Take care of yourself, even if you feel good. The same goes for your employees, who may be agitated by the whole situation. It can be downright traumatic for those involved. Its effects may not appear immediately, but after some time. Don’t downplay it.

What NOT to do in such a situation

• Don’t send simply the employee home – a longer absence from work in the form of sick leave may be necessary, sure, but only on the basis of a doctor’s decision. Don’t *decide* alone whether to give an employee a few days to “get over it,” hoping the problem will resolve itself. Don’t downplay the issue and, above all, ensure the safety of this person.
• If you need to take an employee to the hospital, don’t do it yourself*. Don’t ask someone else to do it, either. An employee may exhibit dangerous behavior, such as trying to jump out of a car – posing a danger to himself, but also to you and other road users. Call 911 and wait together for the ambulance to arrive.
• As we have already written: if an employee poses a real danger to himself, under no circumstances leave him unattended!

Back to work

A person who has thought about suicide or has made a suicide attempt may
feel
Ashamed, guilty, misunderstood and terrified at the prospect of returning to work. It is important to provide this person with adequate support – this is best done by creating a specific return plan together with the employee.

Set realistic goals and working hours, taking into account the employee’s health condition, as well as sessions with a therapist or doctor’s check-ups that need to be fit into the schedule. Don’t assume anything – ask questions, make sure and actively listen to what the person has to say. Both of you also show patience – returning to work – to daily life in general – will be a slow, gradual process.

Additional help: helplines and useful numbers

The following calls do not require personal information and are fully secure.

Crisis Helpline
: 116 123 (open daily from 2 pm to 10 pm)

Antidepressant Phone Forum Against Depression
: 22 594 91 00 (open Wednesday-Thursday from 5:00 – 7:00 pm)

Antidepressant Helpline
: 22 484 88 01 (open Mon-Fri from 3:00 pm – 8:00 pm)

Bereavement support phone
: 800 108 108 (open Mon-Fri from 2:00 pm – 8:00 pm)

Blue line
(telephone for victims of domestic violence): 800 12 00 02 (24-hour phone)

Helpline for addicts
:

• Drug addiction: 801 199 990 (open daily from 4 pm to 9 pm).
• Behavioral addictions: 801 889 880 (open daily from 5 pm to 10 pm).

Telephone psychological first aid: 22 425 98 48 (open Mon-Fri 5:00 – 8:00 pm, Sat 3:00 – 5:00 pm)

Center for Women’s Rights
:

• Legal duty: 22 621 35 37 (open Mon. and Thurs. from 12:00 – 18:00)
• Hotline: 600 070 717 (open 24 hours a day)

LGBT+ support phone
: 22 628 52 22 (open Mon-Fri from 6pm-9pm)