Starting the conversation

Can reps play a part in supporting work colleagues who may be thinking of suicide? New guidance suggests they can

A TUC resource published earlier this year makes it clear that workplace reps are not expected to be counsellors or experts in suicide prevention. But, the resource says, they are often the point of contact for staff members in crisis, and they can both support the person and steer them towards sources of help. “You do not need any special training to be able to listen,” the TUC advises.

Up to 6,000 people in Britain end their own lives each year and government figures show there is a greater risk of suicide among female nurses than in other occupations.

Male health professionals are at relatively low risk compared to men working in other industries like construction. But in the four years to 2015, the risk of suicide among female health professionals, nurses especially, was 24% higher than the national average. 

This elevated risk may be linked to a high incidence of psychiatric illness, as well as access to, and knowledge of, suicide methods, including lethal drugs.

Employers have a legal duty to provide a safe working environment and this includes addressing issues such as stress or bullying that may cause a worker to have suicidal ideas. Reps can play a part in ensuring employers have processes in place to identify those at risk.

Public Health England and Business in the Community have joined forces to produce a suicide prevention toolkit (scroll down for more information).

In an introduction to the toolkit, Samaritans CEO Ruth Sutherland writes: “With a third of our lives spent at work, it is highly likely that there will be people struggling to cope in the workplace and possibly trying to hide it. There are lots of things we can all do to make a difference.”

Don’t be afraid to engage in a conversation. My experience is that people will generally appreciate that you care

It's OK to talk about suicide

So how can reps initiate a conversation with people they suspect are struggling with suicidal thoughts?

Tanja Koch, RCN Counselling Service Co-ordinator, and a counsellor herself, says: “It’s OK to talk about suicide – don’t be afraid to engage in a conversation. My experience is that people will generally appreciate that you care.”

Choose an appropriate setting to initiate a conversation, Tanja suggests. Then start by expressing general concern – something like: “You don’t seem yourself lately.” She adds: “If the member then expresses suicidal feelings, reps should take every indication of self-harm seriously.” 

If the member is at immediate risk, emergency services must be contacted, without the person’s consent if necessary, although it should be explained that confidentiality will have to be broken in order to safeguard them.

“If the member is not at immediate risk but has suicidal feelings, then gain consent to refer them to the RCN Counselling Service,” Tanja says. “And advise the member to make an emergency appointment with their GP and provide the Samaritans freephone number – 116 123.”

Such interactions with members may be distressing and Tanja advises that afterwards reps should take time out to care for themselves and, if necessary, tap into their support networks. But although difficult, a rep’s intervention in such circumstances can help change the course of a member’s life.

‘I felt listened to’

Ricky*, an RCN rep, recently supported member Belinda* after she was dismissed from her job due to ill health. Ricky was very concerned as Belinda had said that “life isn’t worth living now” and that she may never work as a nurse again. After Ricky addressed this directly with Belinda, they agreed that counselling may support her. 

As well as making a referral to the RCN Counselling Service, he signposted her to emergency services, her GP and the Samaritans if more urgent support was needed. 

Ricky wrote to the counselling service requesting an urgent referral. The referral included Belinda’s consent to be contacted directly. 

The counselling service contacted her within 48 working hours and carried out an in-depth risk assessment. The counsellor also discussed safeguarding measures and set-up a therapeutic approach known as brief therapy. 

Belinda expressed to the counsellor that she felt listened to and relieved to talk openly about how she really felt. She thought people did care about her. 

Six counselling sessions, additional advice and support from the RCN’s debt advice and peer support services helped Belinda get through this difficult time and consider her options for the future.

*Names have been changed to protect confidentiality.

Designing a workplace suicide prevention programme

Key elements include:

  • a work environment that values its employees
  • education and training on mental health
  • internal communications and induction to raise awareness of resources and available support
  • clear policies, procedures and guidance for those who need support
  • a plan for responding to a suicide attempt or death.

The above is taken from Reducing the Risk of Suicide: A Toolkit for Employers.

More information

With the addition of suicide and self-harm to the new NMC education standards, the RCN wants to see improvements across all nursing disciplines in suicide awareness, including the confidence to share information in a timely way.

For information about the work the RCN is undertaking on this, including guidance for health care professionals on how to understand and spot early warning signs, visit our website page on suicide awareness.

To find out more about the TUC's guidance for activists, read Work and Suicide: A TUC Guide to Prevention for Trade Union Activists

Words by Daniel Allen

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