It is human nature to want to help someone in their darkest hour. Yet knowing how to even detect that an individual is contemplating suicide is challenging enough. How many of us can adopt new skills to engage with that person to help save their life?
However, there are some concrete steps that an HR team can share with line managers to prevent colleagues from joining the 5,821 UK suicides the ONS registered in 2017.
What symptoms and red flags can colleagues look out for, assuming there is no recorded history of previous suicide attempts, mental health conditions or family history of suicide?
Depression is a major risk factor for suicide. The deep despair, pain and hopelessness that accompanies a major depressive disorder can make suicide feel like the only escape route. Depression varies from person to person, but red flags can include low self-esteem, sadness or feeling ‘empty’, irritability or frustration, hopelessness and pessimism. Physically, it can manifest itself in persistent unexplained headaches, digestive problems, joint and muscle pain, tiredness, loss of energy and slowed thinking and movements.
There are numerous other conditions that can be linked to a higher risk of suicidal ideation; these include social anxiety disorders, anorexia nervosa and body dysmorphic disorder, as well as risk factors like sleep deprivation, being under the influence of drugs and alcohol and a tendency to reckless or impulsive behaviours.
Life-changing personal injury can also trigger suicidal thoughts. We have handled cases where individuals are facing the pain and trauma of a very serious injury, and fear their jobs are at stake, and we have helped them realise precisely when the GP needs to be informed urgently.
Handling someone in crisis
But in reality, what can a concerned colleague do if they suspect someone is at risk? There is a massive void that can stop us from intervening, and it’s all about ethics and qualms around confidentiality, and even a fear that we can tip someone ‘over the edge’ if we talk to them about it.
Using our experience at HCML, we have created a 12-point checklist for handling someone who may be in crisis. They work for even the most buttoned-up Brit.
- Mention to the individual that they look a little quiet, down or anxious, and ask if there is anything you can do for them.
- Listen and be there for them. Empathise if you can (it’s not for everyone); sympathise if not.
- Avoid judging them or sounding condescending.
- Gently ask if they are having suicidal thoughts. Studies show it does not increase risk.
- Signpost them to call a helpline, friend, family member, their GP or mentor.
- Follow up with them after the crisis has passed.
- If you use case managers, like HCML, they will assume responsibility and contact the individual urgently to assess their risk level, support them and engage with their family.
- Escalate extreme cases by contacting the individual’s GP or community mental health team, informing them that they need to assume duty of care. You don’t need to, nor should you, keep someone’s thoughts of suicide confidential.
- Give your colleague the Samaritans’ phone number (116 123) and explain if and when it is clear that you need to breach confidentiality in a real crisis.
- Keep lists of agencies, such as the Samaritans, NHS specialists and charities, that can help.
- If someone is at risk, keep them safe by staying around and removing anything that could cause harm while seeking help. Be practical and realistic.
- Be ready to call 999 if all else is failing.
Pete Clark is head of corporate and public sector service development at HCML, in charge of occupational rehabilitation