Dealing with suicidal colleagues.  A 12-point checklist for buttoned-up-Brits.

Pete Clark, HCML’s head of corporate and public sector service development, explains what HR people can do to help staff who may be exploring suicide.

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 then engage with that person to help save their life?

However, there are some very concrete steps that an HR team can share with line managers, to prevent any colleagues from joining the 5,821 UK suicides that official statisticians registered in 2017.

Red flags

So 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, or joint and muscle pain, tiredness, loss of energy and slowed thinking and movements.

Of course there are numerous conditions that can be linked to a higher risk of suicidal ideation, to give it the clinical term.  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, fear their jobs are at stake, and we have helped clients realise precisely when the GP needs to be informed urgently.

But in reality, what can the concerned colleague do, if they suspect a colleague is at risk?  There is a massive void than 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 own 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.

  1. You can simply mention to the individual that they look a little quiet, down or anxious, and ask if there is anything that you can do for them.
  2. Listen and be there for them. Empathise if you can (it’s not for everyone), sympathise if not.
  3. Avoid judging them or sounding condescending.
  4. You can gently ask if they are having suicidal thought. Studies show it does not increase risk.
  5. Signpost them to call a helpline, friend, family member, their GP or mentor.
  6. Follow up with them after the crisis has passed.
  7. 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.
  8. Escalate extreme cases by contacting the individual’s GP or community mental health team, informing that clinician that they need to assume duty of care. You don’t need to, nor should you keep someone thoughts of suicide confidential
  9. 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.
  10. Keep lists of agencies from the Samaritans, to NHS specialists and charities who can help.
  11. If someone is at risk, keep them safe by staying around and removing anything that could cause harm whilst seeking help. Be practical and realistic.
  12. Be ready to call 999 if all else is failing.

According to the Office of National Statistics in 2017 there were 5,821 suicides registered in the UK, an age-standardised rate of 10.1 deaths per 100,000 population.  This was dominated by men with the UK male suicide rate being 15.5 deaths per 100,000.  The peak age for male suicides was 45-49 years, and for women it was 50-54 years.