Suicide is a global crisis. According to the World Health Organization, someone dies of suicide every 40 seconds. A study by the Centers for Disease Control and Prevention (CDC) found that between 1999 and 2016, suicide rates increased in every state in the US; in more than half the states, suicide rates rose more than 30 percent. A Montreal Children’s Hospital study found emergency room visits for suicide attempts or suicidal thoughts among US children ages 5-18 doubled to 1.12 million between 2007 and 2015. The CDC says suicide is the second leading cause of death for those age 10-34.

The likelihood that one or more of your employees has been or will be impacted by this epidemic is all but certain. It could be your employee, or it could be that person’s spouse or child. A Prudential Group Insurance study found that while overall suicide rates remained relatively flat among its life insurance policyholders from 2008 to 2017, dependent suicide increased, with a significant spike in 2012.

Suicide is overwhelmingly tragic for those combating mental illness and suicidal thoughts, as well as for those left behind, who struggle to understand how they may have missed a sign or failed to get help before it was too late. This is especially true in the workplace, where the signs of pre-suicidal behavior or trying to cope with a loved one’s suicide are not obvious, and managers may not know where to turn to get an employee help.

Prudential’s latest research report, “Our Global Suicide Crisis: What Might Be Causing It, and How the Workplace Can Respond,” explains how creating an environment of open communication and transparency can dramatically help those currently suffering in silence.

Spotting Mental Illness in the Workplace

A major problem is the stigma associated with suicide. Socially speaking, taking one’s own life is often viewed as a selfish act, which can lead to survivors, including your employees, not wanting to talk about it. In reality, many commit suicide as a way to end the pain of depression or anxiety or to rid their families of the burden they perceive themselves to be.

It is a sad fact that 54 percent of the people who died from suicide between 1999 and 2016 did not have a known mental health condition. According to the CDC, some of the warning signs of suicidal risk include isolation, a sense of being trapped, anger or aggression, feelings of hopelessness, changes in sleep patterns, and talking or posting on social media about suicide.

Many of these symptoms overlap with those of anxiety and depression, which the National Institute of Mental Health reports as significant precursors to suicide. While these are classic warning signs, suicide can still prove to be complicated and elusive for those trying to prevent it, and it can often take loved ones by surprise. It’s not uncommon for suicidal behavior to be missed, considering that 19 percent of all US adults experience anxiety in a given year, and 7 percent experience major depression.

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How can HR experts and managers help someone struggling with mental illness if that person doesn’t feel comfortable talking about it or has gone undiagnosed? It starts with knowing the signs and how they vary in the workplace.

Symptoms of anxiety and depression in the workplace can often be mistaken for performance issues; they include difficulty concentrating, procrastination, indecisiveness, poor judgment calls, impulsive behavior, tardiness and absenteeism, and declining relationships with colleagues. Consider the employee’s history: Is the behavior new or unexpected? It’s important to check in with the employee before jumping to conclusions.

Changing the Conversation

By 2030, the World Health Organization projects depression will be the leading cause of global disease burden. It is already the single largest contributor to ill health and disability globally. Taking a proactive role in addressing the challenges of suicide and mental health issues isn’t just morally sound — it’s in the best interests of your company.

One of the most important ways employers can help is by reducing the stigma through open communication and transparency about mental health issues. Employers can encourage workers to ask for help as needed and make it clear that no one will be penalized for asking for help. If your company promotes things like American Heart Month or Breast Cancer Awareness Month, consider promoting National Suicide Prevention Month in September and Mental Health Awareness Month in May as well. Throughout the year, share facts about mental health, the National Suicide Prevention Lifeline, and employee assistance programs (EAPs), along with your usual promotions of healthy habits like exercise and proper nutrition.

Employers can also improve and promote various services that employees can use on their own time. EAPs that are part of company benefit plans provide immediate access to care, but it is important for EAP providers to be in network with company health plans to ensure continuity of care once EAP sessions are exhausted. Continuing therapy is vital, because statistics show that only 29 percent of the US population diagnosed with depression seeks treatment, and even fewer follow through. Employers can also consider more innovative tools like tele-mental health and on-site mental health clinicians.

Company managers should also be properly trained on the various resources to recommend to employees in need, including an EAP or health and wellness partner. In addition, if an employee needs to be out of work for treatment and recovery, the manager should remain in contact with that person. This may not only help the employee through depression, but it can also help reduce the fear of returning to work, a common cognitive barrier experienced by those who are out of work due to an unexpected injury or illness. Reaching out by sending a card or asking how the employee is doing can be an important factor in the employee’s recovery.

Lastly, because work can provide a sense of purpose that directly impacts mental health, establishing a company return-to-work (RTW) program is crucial in paving the way for those returning from a mental health leave of absence. Transitional RTW programs, where employees are allowed to resume their duties incrementally, may help people feel safe, supported, and more likely to return to full productivity than if they were expected to perform in their original capacity before being ready.

Mental health issues should no longer be a taboo topic, especially in the workplace. By understanding common warning signs and adjusting workplace culture, employers, managers, and HR staff can be the powerful allies their employees never knew they needed.

Dr. Kristin Tugman is vice president of the Health and Productivity Analytics and Consulting Practice at Prudential and author of “Our Global Suicide Crisis.”

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