Wednesday, June 29, 2016

Responding to Suicide Grief at Work Part I

This first article in a two-part series on suicide grief in the workplace describes the many ways workplaces are challenged in responding effectively to this type of tragedy.

Sally Spencer-Thomas and Jess Stohlmann-Rainey

Organizations are often ill-equipped and ill-informed to handle grieving employees. Allotted bereavement leave is determined by the kinship, defined by family structure, not closeness of relationship or needs defined by the bereaved employee. Most often this means: four days leave for the loss of a spouse, child, or parent; three days for the loss of a sibling, grandparent, grandchild, or parent-in-law; one day for the funeral of a sister-, brother-, son-, or daughter-in-law. Bereavement policies fail to account for the grief experiences of employees and that the return to work for many is often marked by distancing or demands rather than compassion. This is particularly true for the suicide bereaved, who experience the double silencing of workplaces ill-equipped to cope with grieving employees and stigma related to the type of loss.

A mother whose son died by suicide the day after he was discharged from his military service, shared this, 
“I had only been at my present position for 90 days, my probation period. I was given some money, they had collected. Other than that nothing. I was hurting very much. When the holidays came I put a candy cane, and a note asking for prayers in every one's mailbox. Nothing. No words, no notes, no nothing. One day I was walking down some steps, and I just wanted to let go of the railing [and fall to my death].  I talked to my supervisor and asked if I could just come in a little later on the Saturday mornings. I said I would stay late and be the last one to leave. She said to me, ‘I thought you were already over that.’  I wanted to ask her which one of her 3 sons she would ‘be over’ in less than 2 years.”
Figure 1
Disenfranchised grief is associated with a number of negative psychological outcomes, and often exacerbates painful feelings of grieving and prolongs the grief process. The incompatibility of these roles can leave the bereaved person balancing the roles, often in ways that look “troubled” or “inappropriate” to others in the workplace. As the dual process model suggests, grieving employees vacillate between grief work and restoration work. They are not always able to predict or control which role they are occupying at a given moment, so grief can enter the workplace in ways that surprise both the grieving employee and those around them. When the grieving employee loses a loved one to suicide, the silencing and stigma that may accompany that grief can make these surprising moments more uncomfortable and poignant for everyone involved. When grief work is stifled by stigma, the period of time during which these “disruptive” moments of grief surfacing in the workplace can be extended even further. Figure 1 (Carson J Spencer Foundation, 2015) illustrates the balancing act in which bereaved employees engage.

Type of death is also associated with disenfranchised grief, suicide being among the most likely types of death to cause disenfranchisement (Bento, 1994). With the compounded risk of the disenfranchised grief, the role of the workplace as a supportive environment is paramount for an employee bereaved by suicide. This need can be complicated for workplaces; employers must balance the role of productive employee with healing employee. Many characteristics of grieving are directly at odds with characteristics of productivity, including impaired decision making, lack of motivation, inability to concentrate, confusion, higher accident rates, and tardiness (Bento, 1994).

A teacher at the time of her teen-aged daughter’s suicide shared, 
“the principal called me into his office [the day after the suicide]. The two assistant principals were there seated glaring at me as I walked in. The principal told me that they did not want me to come to school the next day or when school began. I was very insulted. I argued and told them that I had shown up every day, I had done my job, and I needed to be in the classroom for the children. They just listened stone-faced. Finally, one of the assistance principals told me that no one could bear to look at me because the pain in my face and eyes was so terrible. That shocked me. I had no idea that my grief showed. (I guess I had not really looked in the mirror.) So then, I gave in, and I told them I would stay home for one week. They assured me they would get a professional retired teacher for my class and to stay home as long as I needed. I assured them I would be back in one week. I left school then and drove home very upset. After I got home, though, I suddenly felt a great relief, and I ended up staying home for seven weeks. It turned out that they knew best after all. After I returned to work, there were days I could not make it, so I called in sick. They never complained about me staying home too much. There were a few times I'd look at a little girl in class who reminded me of [my daughter], or something like that, and I'd break down. If I sent word to the office, they immediately sent a substitute teacher down so I could go home.”
Another employee shared how his son’s suicide affected his work performance, 
“I returned to work one week after [my son’s suicide]. I was under the illusion that I could suppress my pain and go on with my life as if nothing happened. The day I was placed on involuntary leave, I was facilitating a class of about 100 people. Someone interrupted me with an off topic question. Rather than gently deflect and move on, I went into an uncontrollable rage, comparing that person’s inane question to my pain over my son’s suicide. I was replaced in the classroom immediately. When I went to the corporate offices, they acknowledged my loss; however I was told to take a month off and see if I could return to full performance. Oddly, now that I've ‘cleaned up my act,’ there is a bit of empathy from management.”
Figure 2
Suicide postvention in the workplace to support a single employee affected by a suicide, which has occurred outside the work context, death can usually be accomplished through compassionate response and flexibility with work and expectations. This type of postvention can require much less investment from workplaces than the suicide death of an employee, client/customer, or other important person to the organization. Supporting a single employee comes with some simplicity because the rest of the workplace may not be impacted, and it is likely that the supervisor can occupy the singular role of “support person,” instead of needing to balance her/his own grief response with the wide range of impact a suicide loss will have on different members of the workplace. Figure 2 (Carson J Spencer Foundation, 2015) illustrates the priorities that must be balanced to maintain a healthy workplace.

Suicide postvention in the workplace focuses on mitigating negative outcomes for individuals and the workplace, and supporting the work community in a healing process (Carson J Spencer Foundation et al, 2013).  The goals of suicide postvention in the workplace is really not that different that other crisis responses (Carson J Spencer Foundation et al, 2013), i.e., to support people through the trauma and help restore functioning to a disrupted system (Suicide Prevention Resource Center, 2010). The process is about managing the inherent balance of needs and safety components that can sometimes be at odd with one another. On one hand workplaces acknowledge something really significant happened, while on the other hand leaders are pressured to get back to business as usual. On one hand grieving employees need to share stories to grief and honor a life that was lived, while on the other hand workplaces practice safe messaging seek to minimize glorification of the deceased and the divulgence of too many details about the death. On one hand, employees need information that is quick and accurate, while on the other hand, privacy and investigation concerns can slow and complicate the process.

A complicating issue for workplace suicide postvention is that getting fired, laid off, humiliated or disciplined at work can be a triggering event for some suicidal employees. When this occurs residual bitterness, anger and mistrust for leadership can have a profound effect on the intensity and duration of the employee’s response. 

One interviewee shared this story,
“My husband, an employee for 18 years, and supervisor for the last 15 and was let go from his position the day before he died by suicide. While this was the third suicide with the company, there was no crisis plan in place. Employees were notified when his death was posted on the lunchroom TV. Management chose not to attend the visitations or funeral in order to ‘keep the peace,’ but quite frankly I would have preferred to see them there. There was a lot of hostility because he was let go from his position as a supervisor, and when word of his death got out, there was more hostility from the people who worked with him in the plant.  Management let the dust settle over time with no comments.”
Few workplaces plan for a suicide by having access to a postvention guide like the one listed below, because too often the daunting nature of suicide throws people into reactive or avoidance mode. As a first step, we have managers reflect on the question, “What do you usually do when there has been a trauma or death in this workplace?” Usually there are already cultural norms and policies in place to address grief and trauma, and any deviation from this cultural standard is likely to cause confusion and additional hardship.

Case example: When an employee loses a family member to suicide
I am a pharmacist at a grocery store and had been there 8 years when my teenage son died by suicide. I knew all my customers by name and many of them knew my son. When word reached the store my store manager called everyone together to break the news. With tears streaming down his face he explained that my son was dead. Work was suspended, people were allowed to go home or take the time they needed to pull themselves together. For a grocery store this is huge as we are all about customer service in a community where the competition is fierce. By the afternoon I had cards, a gift basket and messages from so many of my workplace family. Many of the staff were able to take the day off to attend my son’s memorial and the store was generous in their contributions. Since my return to work, I have been given free rein to cry when I need to, hug when I need to and talk with others when I need to. My store management and fellow staff continue to be a source of support and comfort.
Conclusion: Be Prepared to Respond Instead of React

Like many workplace crises, managers are most effective when they are prepared to respond. In “A Manager’s Guide to Suicide Postvention in the Workplace: 10 Action Steps for Dealing with the Aftermath of Suicide” (Carson J Spencer Foundation et al, 2013) co-authors from the Carson J Spencer Foundation, Crisis Care Network, the National Action Alliance for Suicide Prevention, and the American Association of Suicidology highlight the strategies that will assist workplaces navigating this particular form of crisis response. The guide helps managers with crisis checklists, flowcharts and templates and is currently available as a free download PDF available to the public at www.WorkingMinds.org.

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