Wednesday, July 24, 2013

Five Things Employers Need to Know about Workplace Mental Health and Suicide

Here is the bad news…
1.       Depression is a top driver of health care costs to employers.[1] [2] Depression represents employers' highest per capita medical spending (per-capita annual cost of depression is significantly more than that of hypertension or back problems, and comparable to that of diabetes or heart disease. People with depression also have more sick days than people suffering from other conditions)[3].
2.       If we take a snapshot of any workplace at any given point in time, at least one in five people will have a diagnosable mental health condition.[4] The most common among these are mood disorders like depression or substance abuse disorders like alcohol abuse.
3.       The majority of people who die by suicide are working aged people. While other groups’ suicide rates are holding steady or decreasing, the rates for men and women in the middle years has increased significantly over the last decade.
Here is the good news…
4.       Everyone on a workplace plays a role in mental health promotion and suicide prevention. By engaging in simple preventative steps (e.g., stress management, depression screenings, etc.) anyone can help maintain their own mental health and by learning practical tactics (e.g., becoming suicide prevention gatekeepers, referring coworkers to employee assistance services, etc.) employees help promote the mental health and safety of others.[5] [6]
5.       A comprehensive and evidence-based approach to suicide prevention and mental health promotion exists,[7] is cost-effective[8] and gives employers a clear guide on what to do. By being “visible, vocal and visionary” leaders, employers can set the expectation that a culture of health and safety is a priority and that mental health promotion and suicide prevention are a critical part of that priority.
For more information:
About the author:
Sally Spencer-Thomas, Psy.D., is CEO and co-founder of the Carson J Spencer Foundation, a Colorado-based nonprofit established in 2005 after the suicide of her brother. The foundation is known for “sustaining a passion for living” through innovation in suicide prevention. Working Minds, a program of the Carson J Spencer Foundation, focuses on helping workplaces build capacity to promote mental health and prevent suicide.

[1] Mental Health America (n.d.) Depression in the Workplace. Retrieved from
[2] Witters, D. (2013, July 24). Depression Costs U.S. Workplaces $23 Billion in Absenteeism. Retrieved from
[3] Managed Care Magazine (2006, Spring) Depression in the Workplace Cost Employers Billions Each Year: Employers Take Lead in Fighting Depression. Retrieved from
[5] Paul, R. & Spencer-Thomas, S. (2012). Changing Workplace Culture to End the Suicide
Standstill. National Council Magazine. (2), 126-127.
[6] Spencer-Thomas, S. (2012). Developing a workplace suicide prevention program. Journal of
Employee Assistance, 42(1), 12-15.
[7] National Action Alliance for Suicide Prevention (2013) Comprehensive Blueprint for Workplace Suicide Prevention. Retrieved from
[8] National Institute of Mental Health (2007, September) Workplace Depression Screening, Outreach and Enhanced Treatment Improves Productivity, Lowers Employer Costs. Retrieved from

Monday, July 22, 2013

Reasons2Ride: One Man’s Story on How Riding a Bike Saved His Life

Reposted with permission from the American Association of Suicidology 

Guest Author: Joel Phillips

Flash back to late fall of 2009, I tip the scale at 377lbs…I am employed as a shipping clerk for a printing company, the same type of job I held when I entered into the printing industry in 1989.  In the wake of my journey through life thus far are a failed sales career, divorce, bankruptcy and bouts with paralyzing depression.  My gall bladder has just been removed and my doctors are insisting I do something about my weight and general physical fitness. 

After quite a colorful discussion, I agree to start riding my bicycle during lunch.  The next day I put my bike, a red Diamond Back Accent EX, circa 1987, into my truck and take it to work.  There, I lean it against a wall on the dock outside of my office window, where it sat for about three months.  The intent was to ride it at lunch and get some type of cardio workout, but it was easy to always talk myself out of riding.  Then, one particularly “bad” Monday, I decided Tuesday I would ride my bike at lunch, so…that Monday night I got everything ready for the ride at lunch the next day.

My wife left for work before I did, we kissed goodbye and I gave her a little extra with the hug, I could see in her eyes she sensed something different.  Charlie, my Boston terrier, was in his bed, on a chair, in our bedroom window and I caught a glimpse of him as I tossed my backpack of stuff for the ride on the passenger seat of my truck.  In the backpack there was nothing any cyclist would ever take on a ride.  However this wasn’t just any ride for me, I had decided it would be my last ride.  In my backpack was a note of apology to all of those I felt I had hurt during my life, along with a loaded 9mm handgun.  I was going to ride my bike to a secluded spot along the Platte River trail and end my life.  I could see no other solution and just wanted the heartache and misery to end.

As I rode past Mile High Stadium and made the turn north where the path parallels Elitch Gardens, I remember feeling the burning in my legs and chest as the trail went from flat to sloped, the water in the river seemed louder, making it’s presence known.  Then feelings I had as a little kid, when I got my first bike, came back; not just bits and pieces, but like a flash flood.  For the first time in a LONG time I felt alive!  I could feel my heart pounding and my breathing was very heavy as I rolled my 377lb frame into Confluence Park.  I stopped and took in what I was seeing, the Platte River and Cherry Creek converging, the Rocky Mountains towering above the horizon, beyond the cityscape.  My bicycle had breathed the will to live back into my soul, and opened my eyes not only to a new world of possibilities, but a world where anything is possible.  

Today, I am joyfully alive, 100 pounds lighter and deeply passionate about empowering others to choose life and health by finding the joy still living within their hearts.  When I am not teaching spin classes at About Time Fitness, I am the Founder and Executive Director of the newly formed non-profit, Arapahoe County B-cycle and associated for profit marketing business, Reasons2Ride.   However, we are creating much more than just a bike sharing program and encouragement to ride.  The organizations are about giving people inspirational and motivational reasons to move and at the same time connect with each other and with local businesses.  The goal is to offer programs and services that create not only an inspired, healthy and mentally fit society but also hope, connectedness, economic stability and common unity in our local community.  Beyond just a bicycle program, the vision is to inspire new possibilities for living joyfully.

To say the bicycle has left me touched, moved and inspired is an understatement; for it has truly been my vehicle for personal transformation.  I chose life three and a half years ago and now I am living a life I could never imagine.  It’s not been easy, like riding a bicycle, there always seems to be hills to climb, yet if you keep pedaling no mountain is too steep.

“Pure Joy” self-portrait taken in the morning on day 2 of 2012 Ride the Rockie…before any REAL climbing began

The Forgotten Survivors: Family Members of People who Attempt Suicide

Re-posted here with permission from the American Association of Suicidology

Guest Blog: Juliet Carr
Founder of and author of Attempted Suicide: The Essential Guidebook for Loved Ones to be published. She lives in Montrose, Colorado with her husband, 3 children and many rescue and adopted animals.

Juliet pictured here with her children in Montrose, CO
What would you do if faced with a family member’s or friend’s nonfatal suicide behavior? Where would you search for help? How would you deal with the isolation, stress, anger, blame and guilt while also worrying and working to keep that person alive?
Is this subject even important? And if it is, why hasn’t the field of Suicidology been talking about it?
According to the American Foundation for Suicide Prevention in 2010, there were 38,364 reported suicide deaths and there are an estimated 8-25 attempted suicides for every suicide death. A suicide attempt is defined as “the act of intentionally ending one’s life that does not result in death”. In other words, the person who tried to end their life is still alive. If we use the number six as the number of people dramatically affected by a suicide, we can estimate that somewhere between 1,841,472 and 5,754,600 are affected annually in the United States by a suicide attempt of a loved one, including the attempter.

Estimated Suicide Completions 2010
38,364 reported suicide deaths
230,184 people affected in the US annually
4.45 million Americans are bereaved by suicide

Estimated Suicide Attempts 2010
Between 1,841,472 & 5,754,600 are affected annually in the US by a suicide attempt (including the attempter
30 million Americans have survived a loved ones suicide attempt

So many people are affected by suicidal behavior, and yet, we know very little about their experiences and needs. In fact, family members of people who attempt suicide are in many ways the forgotten survivors in our field.

I know about this, because I am one of those forgotten survivors. My father worked through 16 years of therapy and 14 ECT treatments before his first suicide attempt, which was an overdose. Eight months later he shot himself in the head and lived through that suicide attempt as well. My family and I searched, begged and pleaded for help from professional organizations, support groups and coalitions to find that while there are books, websites, studies, chat rooms and organizations dedicated to people bereaved by a suicide loss there was absolutely nothing for someone who had a loved one attempt suicide.

We are sent home from emergency rooms, mental health institutions, and state mental hospitals with no discharge papers, no instructions, no safety plans and no support. We are often blamed for the suicide attempt by professionals and friends but then sent home with my father by those same professionals with the charge of keeping our loved one alive. The strange thing about this is that most of us haven’t even taken a college psychology course let alone have the strength, support system and knowledge to keep a suicidal person alive, but that is what the profession asks of us and society demands.  Because of this experience I began my own healing process and then became motivated to help other families who experience this same tragedy.

I have spent the last 5 years researching, interviewing people, and creating resources for loved ones affected by a suicide attempt. To date I have interviewed 33 people worldwide who have had a loved one attempt suicide, or have attempted suicide themselves. The people I interviewed were between the ages of 20 and 70, were male and female, and had daughters, sons, sisters, brothers, fathers, husbands, wives, mothers, and friends attempt suicide or had also attempted suicide themselves. The interviews have been conducted in person, over the phone, or via email questionnaire. Everyone interviewed who had a loved one attempt suicide searched in vain for resources, support, and answers to their questions only to find nothing helpful or specific to the subject of a suicide attempt, not a suicide completion. For many reasons, most of my research participants wanted their coping process to remain anonymous and possibly work through their grief at their own pace, not in a support group or chat room setting. 

Some of the common questions from loved ones were:
·         What do I say to someone who has attempted suicide? How can I help them?
·         What do I tell my children, my boss, and my friends?
·         How do I support everyone who is affected while keeping myself as healthy as possible?
·         Will I ever feel better and if so, how long will it take?
·         Is what I am going through common or normal?

Common experiences after a suicide attempt included:
·         Isolation
·         discrimination from professionals
·         feelings of disbelief, anger,
·         guilt
·         fear
·         somatic problems: headaches, intestinal problems, feelings of being kicked in the gut,
·         memory loss
·         lack of sleep
·         PTSD and other anxiety problems
·         depression
·         financial repercussions
·         gallows humor
·         suicidal thoughts and actions of their own after the attempt
·         a need to work through their grief.

I found it difficult to find loved ones who were willing to be interviewed. It seems asking a person to return to that time in their life has a very strong effect on people who love someone who has attempted suicide, even years after the attempt.

Additional challenges loved ones faced after a suicide attempt included:
·         legalities from states where suicide and attempting suicide are illegal
·         questions of when to report a suicide threat as it was very common for long periods of time for the person who attempted to threaten but not attempt;
·         blame from professionals
·         72 hour hold laws for someone threatening suicide
·         Complications with health insurance; inability or difficulty in getting health and life insurance after an attempt;
·         How to face the person who attempted
·         How to deal with means restriction after the attempt (One mom described this as feeling like a prisoner in her own home. She chose to lock all means of self-harm in her bedroom away from her daughter after two suicide attempts. So when she needed a knife for cooking she would have to unlock her bed room to retrieve a cooking knife, when she needed scissors she had to unlock her room door to get scissors. In addition, she was surrounded by all means of self-harm in her bedroom, which prior to this event she regarded as her private safe haven);
·         emotional blackmail;
·         threats of future suicide attempts;
·         working to rebuild trust, boundaries and lives;
·         financial problems because of the cost of recovery and/or the inability to be as productive or present at work.

People who had a loved one attempt suicide started to feel like themselves two to five years after the most recent attempt. This is important information because it provides an honest expectation and hope that their lives can return to good.
From these research findings, I developed a website that is designed to help loved ones of people who attempt suicide: On this website people can learn:
·         What to say, What not to say
·         What to expect in the first 72 hours, first month and first 6 months for suicide attempters and for loved ones,
·         What you can do to care for yourself,
·         What you can do to help the attempter,
·         Information for professionals,
·         Material for friends of loved ones,
·         A downloadable blank safety plan,
·         A downloadable blank daily goals sheet and tools for wellness
·         Statistics, links to suicide prevention organizations,
·         A blog
·         A storefront.

Family members who are caring for a person who has attempted suicide are usually working to keep someone alive who is working to die.  This is arduous work they have been forced into while being unprepared, uneducated, and until now, unsupported. To answer the above question; I know this work is important because people who have a loved one attempt suicide experience their own suicidal thoughts and their own challenges. I believe the reason the field of Suicidology has not talked about this subject is because of stigma, fear, and difficulty in finding people willing to be interviewed and honest about their personal experience with attempted suicide. While this work has been personally challenging it has allowed me a way to find commonalities in our experiences, set personal expectations of my own healing process, allowed a gap to be filled in the human race that is desperately needed and given me the ability to teach myself, children and friends warning signs for mental illness and tools to help keep us all well when we are faltering.

For more information:

Wednesday, July 10, 2013

New Video Provides Guidance to our Nation’s Firefighters in Coping with Suicide

Einar Jensen being Interviewed

Self-care steps and risk reduction measures detailed in first-of-its-kind educational video

Denver, CO – The Carson J Spencer Foundation, in partnership with the National Action Alliance for Suicide Prevention, and the American Association of Suicidology, launched a new video today entitled Firefighters Coping with the Aftermath of Suicide, detailing self-care steps, peer support measures, suicide warning signs, and available resources to assist firefighters nationwide in coping with suicide.

“Fire service professionals can sometimes be overlooked when thinking about the impact of suicide. When a suicide occurs, their role often shifts from rescuer to fellow griever. This can sometimes be challenging for firefighters who may be unprepared for the intense, complicated, and lengthy trauma involved with suicide,” said Sally Spencer-Thomas, CEO and Co-Founder of the Carson J Spencer Foundation and producer of the video.

The video features real firefighters, many from South Metro Fire Station 34 of Lone Tree, CO, who describe their struggles in coping with the difficulty of a suicide call or the suicide of a fellow firefighter and how vital it is for fire safety departments to work on raising awareness of this issue among firefighters, who are trained to face traumatic events but are sometimes unprepared for the unique trauma associated with suicide.

To watch Firefighters Coping with the Aftermath of Suicide, please visit

 “AAS is proud to be affiliated with this effort to recognize and mediate the impact of suicide on firefighters, as first-finders.  We hope this video helps the healing that must come after such a loss,” said Alan L. Berman, PhD, Executive Director of the American Association of Suicidology. 

Colorado Fallen Firefighters Foundation, Fire and Life Safety Educators of Colorado, the Beanstalk Foundation, and dozens of individual donors supported the funding of this project.

Jeff Dill, founder of Firefighter Behavioral Health Alliance, said, “What a tremendous honor to be involved with this project. It addressed the need to educate my brothers and sisters on behavioral health, especially in the area of firefighter suicide awareness and prevention and subsequently the pain that families and fire departments must deal with and coping skills they need after a loss."

The American Association of Suicidology (AAS; a membership organization founded in 1968 for all those involved in suicide prevention and intervention or touched by suicide. AAS leads the advancement of scientific and programmatic efforts in suicide prevention through research, education and training, the development of standards and resources, and survivor support services.
Contact: Alan L. Berman, PhD, ABPP, Executive Director, 202-237-2280,

The Carson J Spencer Foundation ( is a Colorado nonprofit, established in 2005. We envision a world where leaders and communities are committed to sustaining a passion for living. We sustain a passion for living by:
·         Delivering innovative and effective suicide prevention programs for working-aged   people.
·         Coaching young leaders to develop social enterprises for mental health promotion and suicide prevention.
·         Supporting people bereaved by suicide.
Contact: Sally Spencer-Thomas, PsyD, CEO & Co-Founder, 720-244-6535,

The National Action Alliance for Suicide Prevention (Action Alliance; www.ActionAllianceforSuicidePrevention) is the public-private partnership advancing the National Strategy for Suicide Prevention (NSSP) by championing suicide prevention as a national priority, catalyzing efforts to implement high-priority objectives of the NSSP, and cultivating the resources needed to sustain progress. Launched in 2010 by Health and Human Services Secretary Kathleen Sebelius and former Defense Secretary Robert Gates, the Action Alliance envisions a nation free from the tragic event of suicide with a goal of saving 20,000 lives in five years.

Contact: Eileen Sexton, Director of Communications, 202-572-5383,

Wednesday, July 3, 2013


See guide at:
In the U.S., the majority of people who take their lives are working-aged people, and yet workplaces are often unprepared to deal with this crisis. Today the American Association of Suicidology (AAS) and the National Action Alliance for Suicide Prevention (Action Alliance) announce the launch of a collaborative publication, in partnership with Crisis Care Network (CCN), and the Carson J Spencer Foundation entitled A Manager’s Guide to Suicide Postvention in the Workplace: 10 Action Steps for Dealing with the Aftermath of Suicide.

For every suicide death, an estimated minimum of six people are affected, resulting in approximately six million American “survivors of suicide” in the last 25 years. The creation of the guide came as a logical step for the collaborators. “The demographics of suicide inform us that the working-age individual, in particular working-age male, is most at risk for suicide,” explained Dr. Alan Berman, Executive Director for the AAS. “A sizeable proportion of these deaths by suicide occur on the worksite, or otherwise affect the worksite, pointing to an increased need for postvention in the working population. These guidelines are most important for systems of employment, in the worst case possibility that such a tragedy occurs.”

Manager's Guide Cover
The guide provides clear steps for postvention, giving leadership a sense of how to immediately respond to the traumatic event, have a plan in the short-term for recovery, and consider long-term strategies for helping employees cope down the line. Dr. Sally Spencer-Thomas, CEO & Co-Founder of the Carson J Spencer Foundation, explained: “We collaborated to create succinct procedures with checklists and flow charts to be a go-to guide for people dealing with the crisis of suicide. Our goal is to help to reduce the impact of the suicide event by offering a blueprint to handling these challenging situations. The guidebook allows for immediate access to clear steps to take for moving forward, and helps workplaces plan to move from a solely reactive position on these issues into policy development and trainings.”

“In many postvention responses we saw business leaders forced to operate well outside of their training and expertise, grappling with unanswered and unanswerable questions,” said Bob VandePol, President of CCN. “When there is a death by suicide, all eyes turn to leadership and people take their cues based upon how leadership responds. It’s also true that people under the influence of traumatic stress look to leadership and make assumptions about their own personal worth within the company, so there is tremendous power in a calm, compassionate presence by management during this time.”

The collaborators worked to create a set of guidelines that are useful across varied types of workplaces, and they expect a range of individuals within these organizations and companies to find the information immediately helpful .“This guide can be useful to managers at all levels–from the CEO of a large business to a front-line supervisor of a small organization,” asserted Action Alliance Executive Secretary, Dr. David Litts. The Action Alliance played a key role in bringing these groups together to develop this resource.

To download your own copy of these guidelines and to review others, please go to

American Association of Suicidology
Founded in 1968, AAS is a membership organization for all those involved in suicide prevention and intervention, or touched by suicide. AAS leads the advancement of scientific and programmatic efforts in suicide prevention through research, education and training, the development of standards and resources, and survivor support services.
Contact: Alan L. Berman, PhD, ABPP, Executive Director, 202-237-2280,

National Action Alliance for Suicide Prevention
The National Action Alliance for Suicide Prevention, a public-private coalition, works to advance the National Strategy for Suicide Prevention by championing suicide prevention as a national priority, catalyzing efforts to implement high priority objectives of the National Strategy, and cultivating the resources needed to sustain progress. Launched in 2010 by Health and Human Services Secretary Kathleen Sebelius and former Defense Secretary Robert Gates, the Action Alliance envisions a nation free from the tragic event of suicide. For more information, see
Contact: Katie Deal, Deputy Secretary, 202-572-3722,

The Carson J Spencer Foundation ( is a Colorado nonprofit, established in 2005. We envision a world where leaders and communities are committed to sustaining a passion for living. We sustain a passion for living by
·         Delivering innovative and effective suicide prevention programs for working-aged   people.
·         Coaching young leaders to develop social enterprises for mental health promotion and suicide prevention.
·         Supporting people bereaved by suicide.
Contact: Sally Spencer-Thomas, PsyD, CEO & Co-Founder, 720-244-6535,

Crisis Care Network
Founded in 1997, Crisis Care Network (CCN) is the EAP industry’s premier provider of Critical Incident Response for the workplace. CCN helps individuals and organizations return to work, life, and productivity following critical incidents. We mitigate the human and financial costs of workplace tragedy such as workers' compensation claims, low morale, employee attrition, and litigation. CCN has established the nation's largest network of master’s- and doctoral-level clinicians trained as Critical Incident Response Specialists, responding more than 1,000 times per month to workplace incidents for EAP’s, insurers, and employers in communities throughout the United States and Canada.

Contact: Judy Beahan, MSW, Clinical Manager, 888-736-0911,

Tuesday, July 2, 2013

On Being Bold in Suicide Prevention: Innovative Approaches in Innovative Places

Windows by Nina Matthews Photography
   By: Dr. Sally Spencer-Thomas  
     I had been in the field of mental health 16 years before my brother Carson took his life in 2004, and I would say that since then I have learned much about the “gaps” that need to be filled in the field of suicide prevention. In the aftermath of his death, our family and his friends came together in our grief,  as many people do, with a strong sense to “do something” and formed the Carson J Spencer Foundation (CJSF).                
     From CJSF’s inception, what quickly became obvious was the huge “gap” between the target population of most suicide prevention efforts and population that most represented by those who were dying.. We were shocked to learn that most people who took their lives were just like Carson: white, working-aged men. We made the commitment to be bold and try to fill this “gap” with innovative approaches in innovative places.
     Innovation is critical in the field of Suicidology because it helps us engage untapped resources, explore new partnerships and ultimately expand our capacity. Without innovation, we will just keep repackaging the same methods and will be limited in our ability to create the significant change we all envision. Innovation begins with an idea to take a radically different approach – especially if it’s difficult.
     In hindsight, we can usually see the benefits of innovation, but at first they are sometimes considered radical ideas. Where would we be if that first crisis call center had never emerged or if the Air Force had decided like so many others had before, that there was nothing that could be done to prevent suicides? Often because innovation challenges convention of how things get done, initial backlash and doubt ensue.               
     Inevitably, trial and error cycle as the innovative idea evolves. Sustained change comes as the context of discovery moves into the context of justification, and rigorous evaluation helps us better understand the cause and effect cycle of change.
     Since my brother Carson was a gifted entrepreneur and not afraid of risk-taking, the founders of CJSF not only dedicated our mission to preventing what happened to him from happening to others, , but also to celebrating his gifts as a dynamic and bold visionary.  
     When taking an inventory of existing suicide prevention efforts, we noted that very few people were addressing suicide prevention in the workplace, and this gap became ours to fill. In 2007 CJSF launched the Working Minds program ( and in 2009 we published the Working Minds Toolkit, which was accepted to the National Best Practice Registry in 2010. The goal of these efforts is to build capacity in workplaces so that they are better able to implement comprehensive and sustained suicide prevention programs.
     Today, with the help of the National Action Alliance for Suicide Prevention’s Workplace Task Force, workplace suicide prevention efforts are better able to leverage the influence of leaders from across the country and create a “tipping point” of change. We are bringing together executives and industry leaders to be spokespeople for the cause; we are pulling together resources to outline a blueprint for change; and we are partnering with the Public Education and Awareness Task Force to “Change the Conversation.”
     The Workplace Task Force in partnership with CJSF and others, has launched three new innovative resources for workplaces:

     In addition, we need innovation to reach those at highest risk for suicide – men of working age with multiple risk factors who are also least likely to seek care. For years, the same message – “if you are depressed, seek help” – was repackaged with little success in reaching this demographic.  What the effort needed was a brand that was compelling to high-risk men. In 2007, the Carson J Spencer Foundation, Cactus Marketing and Colorado’s Office of Suicide Prevention – a public-private-nonprofit partnership – came together to find a new way to reach high-risk men by using “manspeak” and humor.
Hope Lights by Nina Matthews Photography
     On July 9, 2012, after four years of research, development and planning, the partnership launched the one-of-a-kind Man Therapy™ campaign ( with an article in the New York Times. While the unconventional approach raised a few eyebrows, our initial results look promising so far – the campaign seems to be reaching the target audience and having the intended effect. In just nine short months, the website has experienced over 200,000 unique visitors averaging over 6 minutes per visit. More than 60,000 people have completed the 18-point head inspection (a self-screening tool) and 15,000-plus have accessed information on crisis services. The qualitative feedback we have received from men and therapists alike is that men’s thinking about mental health shifts during their interaction with  and they are more likely to do something different about their problems as a result.

     While innovation is particularly unnerving in a profession where lives are at stake, we must “be visible, be vocal, be visionary. There is no shame in stepping forward, but there is great risk in holding back and just hoping for the best.” (Higher Education Center)