Latest Newsletter - December 7, 2021
Employers’ responsibilities to suicidal employees
Over the last 30 days or so, I have received a number of enquiries from employers asking such questions as:
‘What should I do when an employee tells me they are feeling suicidal?’
So, this week I thought that I would look at the Employers’ duty of care with regards to their employees’ mental health and wellbeing.
Why is suicide a workplace issue?
Employers have a legal duty to take care of employees and provide a safe working environment. This includes the moral duty on employers to take care of their employees and to support wellbeing and good mental health.
This obviously includes for them to manage the risks related to workplace stress and preventing unfair treatment, such as bullying and harassment. This should help to address some of the potential risks associated with suicide.
As such, employers have an important role in creating the kind of environment where people can seek help if they are experiencing suicidal thoughts. This is best served by having an appropriate number of trained Mental Health First Aiders. If someone knows their concerns will be listened to with empathy and understanding, this can help that person to take the first step in accessing support services and securing the help they need.
Most of us spend a large part of our waking hours at work.
This can have a major bearing on your health and wellbeing as it can give you a purpose to get up in the morning, as well as a sense of belonging.
Conversely, an unhealthy working environment that causes, or exacerbates stress can contribute to poor mental wellbeing.
There is a still a lot of stigma and silence attached to suicide in society which understandably extends into the workplace. People experiencing mental health issues and/or suicidal feelings may fear losing their job or jeopardising their career, or being seen as incapable or unstable/ unreliable. Consequently, they are reluctant to tell anyone, which compounds the stress.
Managers or employees may be worried that a work colleague is considering suicide from their behaviour or something they have said, so it’s important they know what appropriate action to take in these circumstances.
As an employer, you can do a lot to create a supportive mental health environment. You can think about the workplace and avoid, or reduce, the difficult or stressful situations. You can set up additional support by training some of your staff to be a Mental Health First Aider, and you should consider the risk of suicide and incorporate a prevention strategy.
Not everyone may view suicide as a workplace issue and yes, many of the employee’s troubles may well be personal ones. But people can’t be expected to leave their personal worries at home and of course, work also has the potential to contribute to someone’s state of mind. Feeling able to bring one’s whole self to work also means feeling able to reach out and share a serious mental health issue and/or suicidal thoughts.
If someone is struggling, knowing they can approach a colleague or a mental health first aider and be listened to with empathy and without judgement could be the first step in them accessing the help they need.
Organisations also need to ensure it provides appropriate support for any individual who listens to someone who’s having suicidal thoughts.
Employers have a legal duty of care to provide a safe working environment for employees. This duty also requires employers to support their employees’ health and wellbeing. That includes creating an environment where mental health is treated with the same importance as people’s physical health, and the culture is one where people feel able to talk about suicidal feelings and seek help.
So let us consider how best to deal with an employee who discloses suicidal thoughts or has already attempted suicide. This could be a one-off situation, but it’s also possible that someone could have a plan to attempt suicide and/or has enduring thoughts about taking their own life.
As an employer you cannot be expected to act as a counsellor, and it’s important that managers also understand this is not their role either. It’s important to have boundaries and know when/how to refer someone to more specialist sources of help where needed.
The main qualities of the Mental Health First Aider are:
Employers’ duty of care
As an employer you have a duty of care to your employees. This means that you should take all steps which are reasonably possible to ensure the physical and psychological health, safety, and wellbeing of your employees. Legally, employers must abide by relevant health and safety and employment law, as well as the common law duty of care, which is part of the law of negligence.
Previously the courts said the duty of care owed by the employer did not extend to employee suicide. So historically employers were not liable to relatives for compensation or losses arising from suicide of a member of staff. However, over the years the courts have increasingly accepted that pressure at work affects both physical and mental wellbeing.
Case law has progressively established that many aspects, including overwork, accidents, bullying, lack of supervision and pace of work, can lead to mental consequences. These effects range from stress and sleeplessness through to suicide.
In such cases, the harm suffered must be reasonably foreseeable as if the harm is part of a ‘chain’ that can be traced back to the employer. The legal position now is that, in rare cases, the courts can find that suicide was a reasonably foreseeable consequence of an employer’s breach of duty. In some cases, a direct link can be established between the workplace to many consequences, including depression and suicide.
In breach of duty (negligence) cases, one of the things that the relatives of an employee have to show is that the harm suffered was reasonably foreseeable. Previous cases had protected the employer because the suicide was seen as breaking the link between the employer’s breach of duty and the harm suffered.
The following landmark legal ruling is a good example of how employers can now be held liable for the suicide of an employee, although this remains a rare situation.
Case law: Corr v IBC Vehicles Ltd (2008) the House of Lords said that suicide was a reasonably foreseeable consequence of an employer’s breach of duty.
Facts: After a serious accident at work, a maintenance engineer for Vauxhall Motorcars suffered severe head injuries, depression and post-traumatic stress disorder (PTSD). A machine on the production line had malfunctioned, and the robotic arm used to lift the panels on the press line had struck him on the right side of his head. Most of his ear was severed, requiring several operations, and if he had not instinctively moved his head, he would almost certainly have been killed. Six years later, aged 37, he took his own life by jumping from the top of a multi-storey car park. His widow claimed under the Fatal Accidents Act 1976 based on the legal argument that her husband’s physical and psychiatric injuries (including his suicide) were reasonably foreseeable following the accident. The employer admitted that it breached the duty of care to the employee and this had caused the accident but denied liability for the later suicide.
Issue: The key legal issue was if the deceased employee’s suicide was reasonably foreseeable by the employer or if compensation for the suicide fell outside the scope of the employer’s duty of care. The employee had not had mental health problems before the accident, so how could the employer have foreseen the suicide?
Decision: On appeal, the court found the employer liable. The personal injury included psychological injury, PTSD and depression, which had been caused by his accident. The issue was not if the suicide was foreseeable but if the kind of harm, including the depression, was foreseeable. The depression could be foreseen; therefore, it was possible to see a direct link from an accident that caused depression to the suicide. There was an unbroken chain between the employer’s breach and the suicide, and the employee’s actions did not break this link.
An employer can be deemed to have breached their duty of care by failing to do everything that was reasonable in the circumstances to keep the employee safe from harm.
So, what are the main things that you, as an employer, should look out for?
Work-related stress
Being under pressure is a normal part of life indeed many people thrive under pressure and become more energised. But if that tips into stress and someone becomes overwhelmed by stress, these feelings could become a problem for their mental health.
There is no single piece of legislation covering the issue of workplace stress: a number of laws are relevant, and much of the law governing stress has evolved from case law rather than legislation.
Stress
Stress isn’t a psychiatric diagnosis, but it’s closely linked to mental health in two important ways: it can cause mental health issues or exacerbate an existing condition, and mental health issues can also cause stress. Work-related stress can affect anyone at any level, and is not confined to particular sectors, jobs or industries.
Workplace suicide prevention strategies
Workplace suicide prevention strategies should address workplace factors that contribute to suicide risk. Such factors include bullying and harassment, monotonous tasks, stressful or distressing psychological work pressures, lack of control over work, extreme effort and inadequate reward. The HSE Management Standards are designed to manage, prevent and reduce work-related stress.
Like physical health, mental health will sometimes require employers to make reasonable adjustments, such as a change to working patterns or duties. Such adjustments are required where there is an overlap between health needs and capacity to work. Where someone’s mental health has been identified as a factor in their working context, employers should work with employees to make reasonable adjustments to mitigate harm. This is additionally true for suicidal thoughts, where identified risk factors may be mitigated through access to support and appropriate signposting to additional specialist services.
Let’s try and understand suicide
It is very difficult to try and explain suicide and many people feel uncomfortable discussing it which partly explains the stigma around it.
The British Psychological Society state:
‘What lies behind the decision to end one’s life is not fully understood. Nevertheless, it is well recognised that a range of complex factors influence this behaviour. Indeed, a past history of suicidal behaviour or self-harm is one of the strongest predictors of death by suicide.’
The Samaritans say:
Mental health problems are important influences, as well as alcohol and substance misuse, feeling desperate, helpless or without hope.’
Here are some facts about suicide
- In England and Wales, there were 5,691 confirmed suicides in 2019 a rate of 11 deaths per 100,000 population and consistent with the rate in 2018.
- Around three-quarters of suicide deaths related to men, and males aged 45–49 had the highest age-specific suicide rate.
- Despite having a low number of deaths overall, the suicide rate among the under-25s has generally increased in recent years.
- There have been concerns that the COVID-19 pandemic may lead to an increase in suicide. Data published for England to explore whether or not suicide rates rose after the first national lockdown do not show a significant rise, ‘despite evidence of greater distress’. However, the researchers caution that there is likely to be an increase in the numbers if we enter more lockdowns.
- Suicide is much more common among men than women across all age groups: men from the lowest social class, living in the most deprived areas, were much more likely to end their lives by suicide compared with those in the highest social class from the most affluent areas. Middle-aged men are the age group most at risk.
- Men are less likely to seek support as early as women, are more likely to ‘bottle things up’, and if they do have suicidal intention can select a method that is more likely to result in their death.
- Job-related features such as low pay and low job security increase risk.
- Having access to, or knowledge of, a method of suicide increases risk: for example, common explanations for a higher risk of suicide among occupations such as doctors, dentists, nurses, vets and agricultural workers (such as farmers) include having easy access to lethal means. A higher risk of suicide among health professionals could also be explained by these occupations possessing relevant knowledge on methods of suicide.
- Males working in the lowest-skilled occupations had a 44% higher risk of suicide than the male national average.
- The risk of suicide among low-skilled male labourers, particularly those working in construction roles, was three times higher than the male national average.
- For females, the risk of suicide among health professionals was 24% higher than the female national average; this is largely explained by high suicide rates among female nurses.
- Male and female carers had a risk of suicide that was almost twice the national average.
- During the COVID-19 pandemic, attention has been drawn to the need for awareness and support in relation to the potential increased risk of mental ill health and suicide among health and social care workers. NHS organisations have collaborated to provide a wide range of emotional, practical and psychological support for NHS and social care workers.
So what can the employer do to prevent suicides?
An employer can raise awareness about suicide among employees and communicate the important fact that some suicides are preventable and highlight key sources of professional help including the company Mental Health First Aider if they have one. Individuals who have been experiencing suicidal thoughts will often say what a relief it was to be able to discuss what they were experiencing.
Look out for warning signs.
The symptoms that could be associated with someone having suicidal thoughts are not definitive on their own, but could still show that someone is struggling to cope and needs help
It’s about noticing that someone’s behaviour changes by comparison with what has been typically experienced. Warning signs might be different for everyone, but having a good relationship with your employee, and the ability to recognise change in behaviour, can prompt a conversation about whether they’re okay.
So, look out for, such as:
- expression of thoughts or feelings about wanting to end their life, or talking about feeling hopeless or having no reason to live
- expression of feelings of isolation, loneliness, hopelessness or loss of self-esteem, or dwelling on problems
- withdrawal from colleagues, decrease in work performance or difficulty completing tasks
- changes in behaviour, such as restlessness, irritability, impulsivity, recklessness or aggression
- speaking about arranging end-of-life personal affairs, such as making a will, or concrete plans for suicide
- abuse of alcohol or other substances
- depressed mood or mentioning of previous suicidal behaviour
Conversely, many people won’t show any warning signs and will do their best to conceal how they are feeling. Nonetheless, being alert to potential indicators could help to build up a picture of concern for that person’s welfare. Some of the warning signs and changes can include:
- physical – for example, fatigue, changes in sleep patterns, appetite and weight changes, visible tension or trembling, increased physical health symptoms (for example, pain)
- psychological – tearfulness, feeling low, mood changes, loss of motivation, increased sensitivity, lapses in memory
- behavioural – increased smoking and drinking, irritability, anger or aggression, lateness, working longer hours, absence, impaired or inconsistent performance.
- Appearance – for example dropping standards in tidiness, unkempt look and appearing not to be washing as normal.
Managing stress effectively is a crucial part of a preventative approach to supporting mental health in the workplace, and organisations need to develop an organisational framework for managing the risks to people’s health from stress.
Hopefully this article has been of help to you and should you feel that you need further advice, please contact Jon Wilkins on 01458 253682 or by email.
Mental Health Awareness – Online Course
This course may help and explains the difference between mental health and mental illness. It covers the symptoms of a number of the most common mental illnesses so you will know what to look out for or what to expect if you are working with someone with one of these conditions. As well as providing some practical advice on how you can work effectively with those affected by these conditions.
Mental Health First Aid – Online Course
Mental Health First Aid teaches participants how to notice and support individuals who may be experiencing mental health issues or exhibiting the signs of substance use in a work environment. They are also taught how to connect those people with appropriate help from fellow employees, community resources or healthcare professionals.
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If you have any queries on any health and safety matter, please contact Jon Wilkins on 01458 253682 or by email on [email protected]