How Mental Health Affects Workplace Safety

How Mental Health Affects WorkplaceSafety Joel D. Mowrey, Ph.D. Mental Health & Recovery Board of Portage County

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What Would You Do? You overhear one of your colleagues talking on his/her cell phone that they are thinking of killing him or herself. OR You overhear one of your colleagues talking on his/her cell phone that they are thinking of killing another person.

What Would You Do? • Pretend you never heard the conversation? • Go tell someone else what you heard? • Go ask the person if you can help them?

It’s Not My Job!! • Why me – this is a job for either a mental health professional or police or both!! • These are really personal issues and I should mind my own business and not be a snitch. • I would probably make things worse if I did something. I could get sued! • But, if we do nothing, we cannot solve the problem.

What Stops Us From Seeking Help? • Stigma about having mental health problems – fear we will be labeled as weak and “crazy.” • Feel ashamed and even “sinful” – I am a bad person and do not deserve help. • Afraid of being locked up in jail or hospital. • Tried treatment before but it did not help.

Are you an Honest Person??? • How many of you have ever had a physical illness, such as a cold, flu, headache, sprain, etc?? • How many of you have ever been stressed?? • How many of you have ever had a mental health problem?

ANSWER ALL OF YOU HAVE MENTAL HEALTH PROBLEMS!!!

Dimensional Approach Mental MentalMental Health Health Illness Problem

We Are All Gatekeepers! • Gatekeepers are not mental health professionals or doctors • Gatekeepers are any responsible people (adults & children) who spend time with people (family & colleagues) • Co-workers often have more face time than family or friends

Workplace Statistics • U.S. Bureau of Labor Statistics 1992-2008: • 3867 Suicides in the Workplace or 215 per year • Suicide accounts for 4-5% of all workplace deaths • 94% Men • 36% ages 45-54 (highest age group) • 78% Caucasian • 14% Management positions (largest category) • Guns primary means followed by hanging

Workplace Statistics • OSHA reports over two million acts of workplace violence per year • 2000-2010: an average of 558 work-related homicides occurred annually in the U.S. • Homicides account for 11% of all fatal workplace deaths • Transportation 38.3%, Contact with objects/equipment 17.4 % , Falls 14.8%

Workplace Statistics • 2010 – 518 homicides and 270 suicides • 2011 – 458 homicides and 242 suicides. Guns were used for 78% of homicides and 45% suicides • 2011: 40% of women’s deaths were due to spouse/significant other/domestic partner while only 2% for men. 36% of men’s deaths were due to robbery. • 2011: 102 deaths were to sales staff, 105 to police/security/correction officers, and 60 to managerial staff

Workplace Statistics • About 70% of workplace homicides were committed by robbers and other assailants while about 21% were committed by work associates between 2005 and 2009. • Between 2005 and 2009, while firearms were used in 5% of nonfatal workplace violence, shootings accounted for 80% of workplace homicides. About 14% of workplace homicides resulted from stabbings and beatings (hit, kick).

Workplace Statistics • Majority of all assaults are committed by healthcare patients at nursing homes and residential care facilities (61% of all assaults) • Most homicides -- gas/service stations, bartenders, taxi drivers, security guards. Working alone and at night increases likelihood of assaults/deaths.

Why Learn About Suicide? • Considered to be the 2nd leading cause of death among college students and people ages 24-34 • Considered to be the 3rd leading cause of death among people ages 15-24 • Overall, it is considered the 4th leading cause of death for people ages 18-65

Why Learn About Suicide? • No one is safe from the risk of suicide – wealth, education, intact family, popularity cannot protect us from this risk • It can be our colleagues, friends, neighbors and loved ones • A suicide attempt is a desperate cry for help to end excruciating, unending, overwhelming emotional pain and suffering • “I am not afraid of dying. It is living that I am afraid of.”

Why Learn About Suicide? Occupations most affected by Suicide: • Physicians • Occupations performed in isolation: farmers, miners, writers, artists, etc. • Veterans and active duty military • Temporary workers

Is Suicide Really a Problem? • Over 100 people complete suicide daily • In 2010 there were 33,687 deaths from motor vehicle crashes and 38,364 suicides. • This data refers to completed suicides that are documented by medical examiners – it is estimated that 2-3 times as many actually complete suicide

The Unnoticed Death • For every 2 homicides, 3 people complete suicide yearly– data that has been constant for 100 years • During the Viet Nam War from 1964-1972, we lost 55,000 troops, and 220,000 people to suicide

Gender Issue • Women make attempts 4 x as often as men • But - Men complete suicide 3-4 x as often as women • Women’s risk rises until midlife, then decreases • Men’s risk, always higher than women’s, continues to rise until end of life

Risk Factors for Violence • There is no accurate or useful "profile" of individuals who engage in targeted school/work violence. • Incidents of targeted violence at school or work are rarely sudden, impulsive acts. • Prior to most incidents, other people knew about the attacker’s idea and/or plan to attack. Most attackers engaged in some behavior, prior to the incident, that caused concern or indicated a need for help.

Risk Factors for Violence • Most attackers were known to have difficulty coping with significant losses or personal failures. Many had considered or attempted suicide. • Substance abuse, especially use of drugs/alcohol, including at work. • Most attackers had access to and had used weapons prior to the attack and often made inappropriate references to guns and use of violence at work.

Homicide Myth Only “crazy” people or those with serious mental illness kill other people. Fact: Only about 4-5% of homicides have been attributed to individuals with serious mental illness, such as schizophrenia. Actually eleven times more likely than general population to be a victim of violent crime.

Risk Factors for Violence • One of the strongest predictors of future violent behavior is a past history of violence. • Substance use problems increase the risk of violence in any individual far more than the effects of a major mental disorder. • Main Problem as mental health professionals is that we have no good tools to predict dangerousness.

Risk Factors For Suicide? • A family history of suicide increases risk by 6 times • A significant loss by death, separation, divorce, moving, or breaking up with a significant other • Financial problems/losses, e.g., job loss, debt • Chronic physical illness

Risk Factors For Suicide? • History of Abuse/Neglect • Social Isolation • Access to firearms – people who use firearms in their suicide attempt are more likely to die • The 2nd biggest risk factor - having an alcohol or drug problem

Risk Factors For Suicide? • Biggest Risk Factor -- Depression • 90% of person who complete suicide have a diagnosed depressive illness • Most people with Depression feel powerless to solve his or her problems, feel helpless and alone, and feel hopeless – do not see any hope of change

What is Depression? It is more than just a sad mood and one cannot just “snap out of it.” • Weight gain/loss • Sleep problems • Sad mood • Anger and Irritability!!

What is Depression? • Confusion, loss of concentration, poor memory • Fatigue, exhaustion, physical complaints • Withdrawal from friends, family, work associates • Loss of interest in fun things, no motivation • Negative thinking, including suicidal thoughts

Permanent Solution- Temporary Problem • A depressed person has a Health problem, and cannot think clearly or logically about how to solve the problem of stopping their pain (“psychache”) other than suicide. • Feel like a burden on others so see suicide as actually helping loved ones. • They have lost the fear of death. • They cannot see any reason for living.

Suicide Myths – What Is True? Talking about suicide might cause a person to act. False – It is helpful to show the person you take them seriously and you care. Most feel relieved at the chance to talk.

Suicide Myths – What Is True? No one I know would do that. False - Suicide is an equal opportunity killer – rich, poor, successful, unsuccessful, beautiful, ugly, young, old, popular and unpopular people all complete suicide.

Suicide Myths – What Is True? Once a person decides to die, nothing can stop them. They really want to die. NO - Most people want to be stopped – if we don’t try to stop them they will certainly die. BUT – Some people in spite of help do complete suicide.

Suicidal Warning Signs • Direct statements: • “I wish I were dead” • “I am going to kill myself” • “I don’t want to live anymore” • Indirect statements : • “No one cares if I live or die” • “Life is just too hard – it isn’t worth it” • “You’d be better off without me” • “It is hopeless, things will never get better – I give up”

Suicidal Warning Signs • Previous suicide attempts • Increased substance abuse • Sudden happiness after a long period of depression • Cleaning up “loose ends”: Giving away prized possessions; Quitting a job

Tips to Avoid Workplace Violence • Organizations that demonstrate care for their workplace community by developing physical/emotional wellness programs to improve employee morale and retention while keeping costs down. • Examples of wellness programs are trainings in stress reduction, conflict resolution and information that supports daily routines of proper nutrition, exercise & adequate sleep

Tips to Avoid Workplace Violence • Creating a Positive work environment that: • Values its employees and promotes respect • Models open communication • Creates a sense of belonging to a team • Encourages people to seek help when they need it and to support each other

What Should I do? • If you are concerned about someone becoming violent or even homicidal, safety is the rule – always tell someone else, e.g., at work tell a supervisor/manager. • For someone who may be suicidal or appears to be depressed and in distress, talk to the person directly. Or at least tell someone else.

Ask Questions! • “I’ve noticed that you seem upset – would you like to talk?” • “It seems like things have really been bothering you recently. – can I help?” • “I am concerned about you - Are you thinking of killing yourself?”

Ask Questions! • Remember, you cannot make someone suicidal by talking about it. If they are already thinking of it they will probably be relieved that the secret is out. • If you get a “yes” answer, don’t panic.

Reassurance • Talk openly- reassure them that they can be helped - try to instill hope • Encourage expression of feelings • Listen without passing judgment

Some Don’ts • Do NOT promise confidentiality – “I cannot keep a secret as I need to keep you safe.” • Do NOT minimize the problem - “It’s not that bad.” Rather “I know you are in pain and are serious about killing yourself.” • Do NOT make judgments or use guilt, e.g., “It is selfish to kill yourself.” • Do NOT Leave the person alone

HELP -- Never Go It Alone! • Collaborate with others • The person him/herself • Family and friends • Co-workers • Emergency room • Police/sheriff • Family doctor • Crisis hotline • Community agencies

REFER • Townhall II Hotline 24 hours a day, 7 days a week 330-678-HELP (4357) or 866-449-8518 • Access at Coleman Professional Services 24 hours a day, 7 days a week: 330-296-3555 or 1-877-796-3555 Access is located in the Sue Hetrick Building, Lovers Lane, Ravenna behind Robinson Memorial Hospital and conducts hospital pre-screening assessments 46

REFER • Employee Assistance Plans for mental health and substance abuse services • Mental Health & Recovery Board of Portage County Suicide Survivors Support Group 330-673-1756 x 203 Joel Mowrey, Ph.D. • Crisis Intervention Team (CIT) – Trained police officers who can help in a crisis 47

Websites • Ohio Department of Mental Health www.mh.state.oh.us • American Foundation for Suicide Prevention www.afsp.org • Suicide Prevention Resource Center www.sprc.org • American Association of Suicidology www.suicidology.org 48

“Never forget that a handful of committed people can change the world. Indeed, it is the only thing that ever has.” Margaret Mead

How Mental Health Affects Workplace Safety