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7 dos and don’ts when an employee is at risk for self-harm

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This article discusses suicide. If you are thinking about suicide, contact the National Suicide Prevention Lifeline (800-273-8255) for help.

The construction space has focused increasingly on mental health in the past several months, and for good reason: The consequences of the pandemic have caused many workers to struggle with issues of grief, financial strain, anxiety and isolation. One mental healthcare provider reported a 2,000% increase in workers accessing telehealth care between late 2020 and early 2021. 

Companies have recently introduced a raft of programs intended to improve employee mental health, from free counseling to a companywide week off to gamification. But what about those unfortunate times when an employee hasn’t gotten the help they need in time and is in the midst of a crisis?

On June 9, Terri Solomon, co-founder of Littler Mendelson’s New York office and co-chair of the Workplace Safety and Health Practice Group, and Marc McElhaney, CEO and director of professional services of Critical Response Associates, weighed in during an XpertHR webinar on how employers can best handle mental health crises in the office. 

1. Do treat suicide risk as a potential safety threat for others — not just the employee.

While suicidal individuals are rarely violent, the opposite is not necessarily true. “Very simply, if you look at the mass killings [at work], the active shooter incidents that have happened in this country … every single one of them involved a suicidal individual,” McElhaney said. “In fact, from my perspective as a psychologist, I would say that those were primarily suicidal acts.”

Employers have a duty to maintain a safe work environment for all employees. Threats or warning signs of suicide do not only threaten the safety of the individual in question, but could create an office-wide safety risk. Make sure your emergency action plan is up to date and intervene early if you detect warning signs. 

2. Do follow your gut.

Contrary to common belief, Solomon and McElhaney said, people at risk of suicide rarely “just snap.” Significant behavioral changes and warning signs nearly always accompany the possibility of self-harm. Pay attention to indications like increased alcohol use, lack of motivation, lack of communication, attendance issues, increased aggression or agitation, changes in performance, a disheveled appearance and inability to concentrate. Keep an eye on significant emotional shifts as well, especially depression, tearfulness and mood swings. 

Overall, trust your gut, Solomon and McElhaney said. If you sense a major change, ask the employee what’s wrong. If you have a strong suspicion, it’s even OK to ask the employee if they are contemplating suicide. “[For] most people, it feels very embarrassing, it feels very awkward, and there’s a lot of resistance to that,” McElhaney said. “But I will say that many people who are contemplating suicide would like to be asked. That gives them an opportunity to open up.”

3. Don’t just send the employee home.

For employers who are hesitant to get involved with their employees’ personal lives, it might be tempting to simply send a troubled employee home for the day — or a longer period of time — and hope for the best. This can be a big mistake, according to the panelists.

“The first thing you need to do is to make sure that person is safe,” Solomon said. Look up the employee’s emergency contact and let that person know the employee is thinking about or has threatened suicide. Wait until that person can come and pick up the individual. If the employee is working remotely, employers can involve the emergency contact, or in an emergency, call the police and ask for a welfare check. 

But if you know the emergency contact to be outdated and no longer on good terms with the employee — an ex-wife in a bitter divorce, for example — don’t release the at-risk employee into this person’s care, if possible. Try to find an alternative contact.

4. Do call for help, if the employee appears ready to take immediate action.

In the most serious cases — when a threat of self-harm is not only known, but imminent — call 911, an emergency contact, or if known, a treating therapist. Ask to have the employee taken directly to the hospital for evaluation and treatment. 

5. Don’t drive the employee to the hospital in your own car. 

A caring employer may want to drive the employee to the hospital themselves, but this could put both the employer and employee at risk, Solomon and McElhaney said. “You don’t want to put the manager in that kind of risk … that the employee en route to the hospital [is] going to, for example, swing open the car door in the middle of a busy highway,” Solomon said. 

6. Do follow up.

Maintaining mental health is a continuous journey; if you’re concerned about an employee, or if an employee has already had a crisis and is back at work, do more than check in once and move on. “It’s not enough just to send them to the [employee assistance program] or to say, ‘How’re you doing?’ and you have a nice conversation,” McElhaney said. “Follow up with them. See how they’re doing.” 

But “ask a genuine question that’s going to get a genuine answer,” McElhaney said. A perfunctory “How’re you doing?” may feel like it’s an adequate check-in, but it’s likely to get just as perfunctory a response. “You have to do a little bit more in terms of communication,” he said. “Ask something more specific. ‘COVID-19 has been really hard on everybody, working from home. How has it impacted you?’ And then actively listen.” 

7. Do create a workplace emergency plan that includes suicide risk. 

Employers can take plenty of actions right now to reduce the risk of suicide scenario. Hold all-staff meetings that destigmatize talking about mental health. Provide workers with work-sponsored “wellness” time off and look into expanding mental health benefits. Talk to employees about what to do if they’re concerned about a co-worker. Ensure employees know about everything their existing benefits can provide, from EAPs and free counseling to telehealth. Share the contact information for the National Suicide Prevention Lifeline (800-273-8255) alongside benefits information in the employee handbook. 

Finally, build suicide awareness and prevention into your workplace emergency response plan. In a crisis, it’s common to freeze or make the wrong call. Ensure managers and other employees are prepared and understand what to do if they recognize an imminent suicide risk at work. 

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