Emma, a school nurse, was driving between schools when her boss rang her. Immediately, she knew something was wrong as her boss sounded different, ‘kind of urgent’ and ‘stressed’. Emma’s boss told her to pull over and then told Emma that a colleague and friend had taken her own life.
In her car alone, Emma remembers feeling sick. But there was no time to discuss it any further because her boss, ‘seemed in a hurry to end the call’ and asked Emma if she could pass on the news to another colleague at the school she was about to visit. She couldn’t bring herself to do so. She can’t remember how she got home.
The next morning, Emma described work as: ‘Business as usual. Like nothing had happened. No-one said anything at work. It was just brushed under the carpet. The saddest thing is, it wasn’t like she’d died, it was like she’d just evaporated. Gone, nothing. Just gone and forgotten.’1
Setting the scene
Regrettably, this is a real case study and it’s typical of what I encounter in my work as a critical incident responder and trauma consultant. It’s how I now spend much of my working life, working with every size of business across every kind of sector, training them in how to plan for and respond to a critical incident, and how to support their people when the worst thing happens.
Every year, around 6,000 people in the UK end their own lives – well over three times the number of people who die on our roads.2 Suicide is now the leading cause of death among young people aged from 20 to 34, with men nearly three times as likely as women to die because of suicide, although the female suicide rate in England is at its highest since 20053 – and they are predominantly of working age. The impact of a suicide on the wider community is not to be underestimated, and is relevant to employers and all practitioners with a vested interest in supporting employee mental health and wellbeing. Interestingly, a study in the US, led by clinical psychologist Julie Cerel, showed that 135 people will know and be impacted by each person who dies by suicide.4
Statistics like this only serve to demonstrate that however many preventative suicide awareness trainings and talks that employers may offer, it’s simply impossible to eliminate the risk of suicide from our personal and professional lives. Shockingly, however, there is no standard protocol for employers to manage the psychological impact when a member of staff takes their own life (or indeed any other sudden death or other critical incident occurs). Instead, workplaces and our wider society, directs its focus towards suicide prevention measures, training in awareness raising and spotting the signs of suicide, which is failing to do anything to stop the numbers of people taking their own lives.
In this article, I argue that instead of focusing solely on suicide prevention, employers need to get much better at postvention – by this, I am referring to the actions taken by the employer in the minutes, hours, days, weeks, months and years after the suicide of an employee. A good place to start is by being proactive – acknowledging that suicide doesn’t just happen to other people, putting in place clear protocols, as well as welcoming safe discussion about the potential causal factors of the suicide, even if that means that the workplace culture may come under scrutiny. Unless we can speak more openly about these psychosocial challenges, I believe that we risk ignoring our moral duty of care to employees, potentially creating further human distress and suffering in the process.
The golden hours
After a suicide, there is an optimal period of time, which I call ‘the golden hours’, in which certain things need to happen, at speed, to both manage and contain the incident. Ideally, this is when I will receive a call – it could be a construction site, manufacturing plant, a retailer, school or university – it’s just your average workplace where people turn up to work each day – except on that day, someone doesn’t.
An employer’s response tends to be inconsistent, arbitrary, and reliant on the individual discretion of the person who receives the news, rather than following a specific protocol or set of guidelines. And, even the most proficient and confident of leaders can feel completely out of their depth, lost and overwhelmed at how to respond to a suicide.
Once an employer is notified that a member of staff has taken their own life, shock and panic usually sets in. Unsure what to do next, the person who takes the call phones his manager, who phones her manager and news spreads. Next, HR managers get involved who may decide to call the Chief Exec; there is a ripple effect and a colleague puts something on social media about the suicide, raising questions about how and why it happened.
In some cases, the police and press arrive at the gates and members of the community turn up to lay bunches of flowers as rumours grow about the deceased, perhaps questioning workplace pressures, money worries or relationship issues. Accusations are made that the deceased’s managers were all aware that the employee was struggling. Colleagues are feeling devastated that they didn’t know or didn’t do something to stop it from happening. And so, it continues.
The suicide of a colleague has been described as having impact that is ‘akin to a social bomb exploding, with the extent of the devastation impossible to predict.’5 This is why I call the first few hours after a suicide or a critical incident ‘the golden hours’ – it’s a small window of opportunity to follow a plan, led by someone who is trained, skilled and resourced to help the organisation to navigate the unexpected. Having protocols in place will help the employer to prevent rumours, blame, disinformation and contain the contagion after the suicide of an employee (and other critical incidents). This is well-known to have far-reaching consequences for how people cope in the immediate aftermath through to how they recover. It can also have huge implications for how people will be left feeling towards their employer in the future.
Responding to a suicide at work
The focus of my attention is not on the person who has died but on those who are left behind. At work, this might include colleagues, friends, co-workers, managers, external suppliers and the community, among others. Given how much work takes place virtually, colleagues working elsewhere in the world also need to be considered. It is proactive, deeply practical work and my primary role is to contain the crisis, give people factual information and help them to have the best chance of retaining a sense of safety and control after the shock and trauma.
While people will want and need to speak about the deceased (‘venting’), what they did and how they died, my focus is on providing a place of safety and support, of stabilising and grounding them in the here and now – ‘How are you doing?’ and, ‘What do you need now?’ There can be a great deal of comfort in knowing you are having a normal response to an abnormal event.
A risk assessment needs to be made about the support in place for those most affected. For example, I’ve known managers who (with the best of intentions) have sent everyone home after a suicide, without checking whether there is anyone at home when they get there. This might be quite the wrong decision for an employee who had been suicidal in the past, and was currently suffering with low mood and troubling thoughts – so one size doesn’t fit all.
We know that people in a state of shock are biologically unable (because of the human trauma response) to function well – so it’s good advice to make sure that employees don’t drive and alternative travel arrangements made, such as booking taxis. Machinery at work should not be operated, and I’ll provide factual handouts about what to expect which offers advice to friends and family, and suggest that they give the info to their loved ones or leave it in a central place at home.
The most common emotions following the suicide of a colleague are psychological shock and anger. Anger may lead to further feelings such as ‘confusion, anxiety and shame’ that arise from the belief that anger is an inappropriate response (it is not – it is common to be angry at the person for taking their life). Additionally, there will be behavioural responses, including altered eating and sleeping habits, and a need to repeatedly talk about the event. Some behaviours may be visible and impactful within the workplace, such as absenteeism, presenteeism, or problem drinking. This could be because they are already going through stressful situations in their lives, their support system is dysfunctional, they have ongoing emotional or behavioural health vulnerabilities, or they have some history of family suicide, or a previous bereavement by suicide.6 Managers must be helped to understand that staff are not only experiencing the loss of a colleague by suicide but are also working through these multiple elements of that experience and, will require space, support and empathy. Workers express the intensity of their experience as being unlike other unexpected osses, since workplace suicide has the added burden of stigma, fear and secrecy.
Why does someone take their own life?
It’s human nature to want to find answers and when there aren’t any, people try to make sense of it as best they can – but this doesn’t mean that the truth is always arrived at. Suicide is not caused by a single factor. Instead, it is the end product of a complex set of biological, psychological, clinical, social and cultural determinants that come together in a perfect storm. For most, suicide is not about wanting to end one’s life but about wanting unbearable mental pain to end.
As shocking as a suicide often is, Professor Rory O'Conner who leads the Suicidal Behaviour Research Laboratory at Glasgow University describes what he calls, ‘the everydayness’ of suicide. By this, he means that, ‘what leads someone to become suicidal is very often about what happens every day: everyday failures, everyday crises and everyday losses. Too often people think that suicide is about the out-of-the-ordinary, a response to things that happen to other people and not to them, when it is not. For some, suicide is about bullying, divorce or the loss of a job. For others, it is about bereavement, bankruptcy, shame, discrimination, loss of benefits or illness. It is about how we respond to stressful events and circumstances, as well as the cards that we are dealt at birth.’5
Next in this issue
Is a suicide work-related?
But what if we believe the workplace to have contributed to the death in some way? How should we make sense of what has taken place? How are we left feeling about our employer? How can we continue to work for the same employer? How does the family of the person who took their own life respond to the employer? And, as workplace practitioners, how can we best support those colleagues left behind who may be seeking justice or accountability from their employer?
The public’s attention has been drawn to the issue of a work-related suicide following a series of recent high-profile cases attracting media attention. You may recall the horrific case of Jaysley Beck, a Royal Artillery Gunner, who at just 19 years of age took her own life, having received more than 1,000 messages and voicemails from her boss in October 2021. In November, the number of messages increased to more than 3,500 and was described as ‘a sustained campaign’ of controlling sexual harassment. In an internal armed forces inquiry, it was found that the intense period of unwelcome behaviour from her boss was almost certainly a causal factor in her death’.7
In another high-profile case, Ruth Perry, a 53-year-old Headteacher at Caversham Primary School in Reading for 13 years, took her own life after she was informed that the school would be given the lowest possible Ofsted rating, downgraded from ‘Outstanding’ to ‘Inadequate’. Last December, Heidi Connor, the Senior Coroner for Berkshire, found that Perry’s suicide was ‘contributed to by an Ofsted inspection carried out in November 2022’ at the school that she led.8,9,10
Cases such as these have contributed to a groundswell of those now calling for all work-related suicides to be investigated by the Health and Safety Executive (HSE), and have created arguably long overdue wider public discussions about this emotive topic (there is scant discussion of why work or working conditions might drive some employees to suicide). Unsurprisingly, this is something that bereaved family members and colleagues have been seeking for a very long time.
I find it inexplicable that if an employee is killed at work by a machinery accident, there will be an investigation carried out by the HSE, but not if, for example, an employee dies by suicide having hanged himself in the warehouse at work. It has the effect of silencing everyone – there is quite literally nowhere to take a suicide at work – no investigation – no questions asked – no answers provided – just a deafening silence which adds to the trauma of the suicide because it can feel as if nothing of any importance has happened.
Landscape beyond the UK
I was curious to see how other culture and nationalities deal with this difficult issue. Interestingly, the Japanese have terms both for death from overwork (‘karoshi’) and work-related suicide (‘karojisatsu’), each of which is defined in law, largely in relation to excessive hours of overtime work.11
In the US, suicide is considered a fatal occupational injury if certain criteria are met, which includes the suicide occurring both at and away from the workplace.12 And, in France, since 2000, a suicide has been presumed to be work-related and subject to further investigation where several criteria are true, including circumstantial evidence and if the person is wearing their work clothes.13
However, in the UK there is no official recognition of a ‘workplace suicide’ and in guidance offered by the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR 2013), it states that suicides are ‘not reportable’, although the same regulations require the reporting of any death which arises as a ‘result of a work-related accident’.14
Often when I arrive at a workplace, I am quickly viewed as a trusted confidant for people who want to discuss their theories about the tragedy. There are recurring themes that seem to go beyond rumour and speculation, and which fit with much of the research into work-related suicides which has featured in Hazards Magazine in recent years. In a Special Report published in 2017, it found that the top factors responsible for workers being driven to suicide seem to be bad jobs with too much work, too little control, or poor or punitive management, unfairness at work, emotional labour, trauma, work-related harm, and hazardous substances that affect mental health and access to means.15 It’s important to state that it’s not all bad practice – I’ve met some courageous people in organisations who have managed the situation to the absolute best of their ability, with humanity and empathy, improvising even when the death has occurred within the Christmas holidays, or when they themselves have been away from work. The suicide of a team member is an incredibly difficult situation, and can be particularly hard for line managers who feel the impact as profoundly as any of their colleagues, but also have to carry out the task of keeping the business going.
What is suicide postvention?
It’s why I advocate for suicide postvention. The term suicide postvention refers to the actions taken to support people affected by a suicide death in the workplace when an employee has taken their own life, regardless of where the suicide took place. A well thought out suicide postvention plan will be one of the most powerful suicide prevention activities of them all. Regardless of any workplace culpability, postvention maintains its focus on how we can support survivors, prevent contagion, address root causes, reduce stigma, build resilience and improve education and awareness, leading to policy and system change where they are needed.
Ideally, organisations will already have a psychological trauma support policy, and a suicide postvention plan can simply sit within this. It requires identifying individuals in the business who will act as the postvention committee. These individuals will be crucial to developing guidelines specific to their workplace and are responsible for implementing postvention plans in the event of a suicide – they will be widely known within the organisation as the first, and only point of contact whenever a suicide or suspected suicide death occurs. It can be helpful if someone on the committee has had personal experience of suicide or the organisation might consider involving someone externally, such as a critical incident stress management (CISM) workplace specialist.
Committee members will then undergo training in aspects related to a suicide at work, including: how to respond, protocols and procedures, how best to use any support resources eg occupational health, EAPs etc and identify any gaps or areas needing further attention. The committee will also nominate a member who will be responsible for all communications made with the family/next of kin of the deceased.
To summarise, suicide postvention is a crucial aspect of a comprehensive suicide prevention strategy. It not only provides support to those affected by a suicide but also helps address the root causes and risk factors, ultimately contributing to the prevention of future suicides.
In the absence of any postvention plan, my immediate advice is to throw out the playbook and simply be human. A suicide death is not a normal ‘death in service’, nor should it be treated as one. While we know that people’s needs may be high, we simply can’t know what we need during such times. Placing the onus on individuals to seek support assumes that those experiencing trauma symptoms can appropriately identify and articulate what those needs are. We know this is not true – and that’s why suicide postvention is so vital for business, regardless of what business it may be.
A workplace suicide has the longest tail of all – by this I mean, it has the potential to come back and touch us when we least expect it. While there has been so much messaging about the prevention of suicide, I think employers are missing an opportunity to learn the lessons that could help us to respond better when a suicide does take place. If we can lean in to the discomfort and help our organisations talk about what happens after a suicide, we may find that we can learn more about some of the common threads that can lead some people to take their own lives. In doing so, we could learn much that would help those who are left behind.
1 University of Surrey. Postvention guidance. Supporting NHS staff after the death by suicide of a colleague. [Online.] www.surrey. ac.uk/sites/default/files/2023-08/uos-suicide-postventionbrochure.pdf (accessed 9 November 2023).
2 Samaritans. Suicide kills three times more people than road traffic accidents, we urgently need to act. Samaritans 2017; 9 January. [Online.] www.samaritans.org/wales/news/suicide-kills-three-times-more-people-road-traffic-accidents-we-urgently-need-act/ (accessed 9 November 2023).
3 Office for National Statistics. Suicides in England and Wales: 2021 registrations. ONS 2022; 6 September. [Online.] www.ons.gov.uk/peoplepopulationandcommunity/birthsdeath-sandmarriages/deaths/bulletins/suicidesintheunitedkingdom/ 2021registrations (accessed 9 November 2023).
4 Cerel J, Brown MM, Maple M, Singleton M, van de Venne J, Moore M, Flaherty C. How many people are exposed to suicide? Not six. Suicide and Life-Threatening Behaviour 2019; 49(2): 529-534. https://pubmed.ncbi.nlm.nih.gov/29512876/ (accessed 9 November 2023).
5 O’Connor R. When it is darkest: why people die by suicide and what we can do to prevent it. London: Vermilion; 2021.
6 Business in the Community. Crisis management in the event of a suicide: a postvention toolkit for employers. PHE 2017. [Online.] https://www.bitc.org.uk/wp-content/uploads/2019/10/ bitc-wellbeing-toolkit-suicidepostventioncrisismanagement-mar2017.pdf (accessed 9 November 2023).
7 Abdul G. British soldier took her own life after sexual harassment from boss, says army. The Guardian 2023; 4 October. [Online.] www.theguardian.com/uk-news/2023/oct/04/soldier-jaysley-beck-took-her-own-life-sexual-harassment-army (accessed 9 November 2023).
8 Simnaz E. Headteacher killed herself after news of low Ofsted rating, family says. The Guardian 2023; 17 March. [Online.] www.theguardian.com/education/2023/mar/17/headteacherkilled-herself-after-news-of-low-ofsted-rating-family-says (accessed 9 November 2023).
9 Waters S, McKee M. Ofsted: a case of official negligence? BMJ 2023; 381: 1147.
10 Adams R. Ofsted inspection contributed to headteacher's suicide, coroner rules. The Guardian 2023; 7 December. [Online.] www.theguardian.com/education/2023/dec/07/ofsted-inspection-contributed-to-headteacher-suicide-ruth-perry-coroner-rules (accessed 11 December 2023).
11 Demetriou D. How the Japanese are putting an end to extreme work weeks. BBC Worklife. 2020; 17 January. [Online.] www.bbc. com/worklife/article/20200114-how-the-japanese-are-puttingan-end-to-death-from-overwork (accessed 9 November 2023).
12 Harris R. Suicide in the workplace. Monthly Labor Review 2016; December. www.bls.gov/opub/mlr/2016/article/pdf/ suicide-in-the-workplace.pdf (accessed 9 November 2023).
13 Venturi R. Burnout in France: focus turned to workplace health after spate of suicides. The Guardian 2014; 12 February. [Online.] https://tinyurl.com/4r52r2em (accessed 13 November 2023).
14 University of Leeds. Work-related suicides are uncounted. School of Languages, Cultures and Societies News 2021; 26 July. [Online.] https://ahc.leeds.ac.uk/languages/news/ article/1866/work-related-suicides-are-uncounted (accessed 9 November 2023).
15 Waters S. Suicidal work: work-related suicides are uncounted in the UK. Hazards Magazine 2017; March. [Online.] www.hazards. org/suicide/suicidalwork.htm (accessed 9 November 2023).