Wednesday, February 20, 2013

Meeting Workplaces Where They Are: Crisis Response, Safety Planning and Cost-Savings

By Sally Spencer-Thomas
Parts of this blog republished in the International Association of Suicide Prevention’s Newsletter

While most of us in the field of Suicidology can see the great benefits of enlisting employers to implement comprehensive approaches to suicide, most employers are not quite ready. They are unfamiliar with the idea of their role in suicide prevention and often find it initially daunting and significantly out of their usual business endeavors. For these reasons, we need to listen well, move slowly and let them lead.
Many well-meaning suicide prevention advocates jump into the work of fixing something before they understand what the obstacles to change are.  The “Stages of Change” model[1] developed by Prochaska and DiClemente, informs us that in order to be effective, we need to craft our strategy of change to the readiness of the people or systems needing change.[2] If the problem is not in awareness, they will not be motivated to take action. If the problem is in their awareness but brings with it some big perceived obstacles to change, they will not be motivated to take action. It’s only when the perceived benefits of change outweigh the consequences of staying the same that change happens. You know you are moving too fast in championing change, when you get a lot of “yes, but” responses such as, “Yes, there may be mental health issues at work, but no one has time/money/expertise (fill in the blank) to deal with it.”
For these reasons, suicide prevention advocates need to take time to listen to workplaces and find out how they are being affected by suicidal behavior, before we prescribe a comprehensive blueprint for change. Those of us interested in of suicide prevention in the workplace have noticed three main areas where workplaces have concerns about suicidal behavior:
1)    After death or a serious attempt has already occurred:  Unfortunately, most workplaces dealing with this issue are doing so in a reactive mode – wondering what warning signs were missed and how best to support their grieving and traumatized staff. To help workplaces in these situations, one goal of the workplace suicide prevention advocates is to provide succinct guidelines on how best to handle the crisis and suggested best practices on how to support bereaved employees.
2)    As they relate to healthcare costs and lost productivity costs: Most for-profit organizations make decisions based on how the choice will impact their bottom line. For this reason, suicide prevention advocates will continue to gather data to make a strong business case for suicide prevention. In other words, we need to demonstrate that engaging in suicide prevention will save the company money.
3)    As they relate to workplace safety: with suicide-homicide cases capturing the attention of employers for decades, much concern exists on how dangerous suicidal people are to others. In order to alleviate this worry, suicide prevention advocates can help link workplaces to policy, protocol and training that allows them to implement “early warning” systems and a process for linking at-risk people quickly to qualified care.
Thus, our general approach is to meet workplaces where they are – crisis support, cost-savings, safety protocol, or whatever other need they have. In order to better serve their needs we need to listen well to their concerns about suicidal behavior as well as their perceived barriers to doing something different. By aligning employers’ goals with the goals of suicide prevention, we will have a much greater chance of successful larger-scale change, as one step can often lead to another.
Contact the Carson J Spencer Foundation for more information about up-coming training on suicide prevention in the workplace and our Working Minds Toolkit (

[1] Prochaska, James, DiClimente, Carlo, Norcross, John (1993). In search of how people change: Applications to addictive behaviors. Journal of Addictions Nursing, 5(1) 2-16.
[2] Edwards, Ruth, Jumper-Thurman, Pamela, Plested, Barbara, Oetting, E. & Louis, Swanson (2000). Community readiness: Research to practice. Journal of Community Psychology, 28(3), 291-307.