Many employers are continuing to improve their mental health benefits. However, the strategies they are implementing may not focus on the unique needs of those at risk for suicide or the distinct level of support and intervention they may require at different stages of a crisis. Employers and their vendor partners have the opportunity to close potential gaps in their mental health programs specific to suicidality.
The following Q&A explores why suicide is an important issue for employers, the limitations of different components in a mental health benefit package in treating suicidality, and how employers can support their at-risk employees in a more timely and effective manner.
Why should employers be concerned about suicide?
An average of 130 suicides occur per day in the U.S., equating to about 1 every 11 minutes. Globally, over 700,000 people die by suicide every year, and over 77% of global suicides occurred in low- and middle-income countries in 2019. Suicide is a top ten leading cause of death in the U.S. for people ages 5-64, and about 80% of all people who die by suicide are of working age (18-65). For people ages 10-14 and 25-34, suicide is the second leading cause of the death in the U.S., signifying that suicide risk is not only high for relatively younger members of the workforce, but also for children and dependents of older working adults. Disparities among suicide rates are also noteworthy, as people of lower socioeconomic status, Black children and adults, LGBTQ+ youth, and Black LGBTQ+ youth have experienced substantial increases in suicide rates over the past decade.
Soon after the pandemic started in 2020, data showed that the rate of depression among U.S. adults tripled from 8.5% to 27.8%. More recent research shows that this increased rate has not only lasted into 2021, but worsened to 32.8%, now impacting one in three U.S. adults. One year into the pandemic, anxiety and depression rates increased by 25% globally. Adolescents are also experiencing a sharp decline in mental health, as the rates of suicide and depression have increased among this population. Suicide among teenage girls in the U.S. increased a shocking 51% since 2019 according to hospital admissions data from the Centers for Disease Control and Prevention (CDC). These large increases in depression and suicide raise concerns that indirect effects of the pandemic may be exacerbating mental health conditions, which may be developing into suicide ideation and resulting in an increase in suicides and suicide attempts. Indicators from a wide range of groups point to an urgent need to address suicidality for both working-age adults and their dependents, and employers are uniquely positioned to do so.
We set up an Employee Assistance Program (EAP), so that should be enough, right?
Experts note that EAPs are not enough to work as a stand-alone suicide prevention program and should not be treated as one. Treating suicidality requires suicide-specific strategies, protocols and clinical skill sets. EAPs without treatment programs specific to suicide may not effectively address suicidality, largely because programs that only focus on certain risk factors, such as depression, may not necessarily address suicidality in patients. Employers can lean on products that can be scaled up to meet the mental health needs of their employees, but they must understand the limitations of these products; they are only one component of a comprehensive mental health strategy. Scaling up effective programs that specialize in suicide prevention and connecting them to existing mental health resources may be the most efficient strategy.
If members experience a crisis, can they access skilled therapists?
Many employers have provider networks that include behavioral health care providers and vendor partnerships to allow members to access therapists. However, the average wait time to see a therapist in the U.S. is 48 days, a period far too long for someone considering suicide, as well as a potential contributor to one of the highest suicide rates among Organization for Economic Co-operation and Development (OECD) countries (14.1 people out of 100,000). Even if a patient having suicidal thoughts does get the opportunity to see a therapist, the provider may not have the expertise to treat suicidality. One in three behavioral health professionals have never had suicide training, and even among those who are trained, only 61% report confidence in their ability to use evidence-based therapy to treat suicidal thoughts and behaviors.
What can we do?
Employers can consider how to implement a comprehensive mental health benefits package that includes strategies to specifically address suicide using the following multipronged approach:
- Reassess mental health offerings to ensure that the programs and providers are equipped to identify suicide risk and qualified to assist employees and their families concerned about suicide risk or handling crisis situations.
- Maintain a workplace culture that values respect, psychological well-being and social support to reduce the incidence of predictive factors for suicidality and tackle mental health concerns among individual employees with more immediacy.
- Develop and administer trainings on crisis protocols to prepare leadership, managers and co-workers for the unfortunate occurrence of a tragedy.
Employers can play an important role within the wider public health framework by enhancing their suicide prevention and postvention efforts. Employees are members of many communities, and actionable steps employers take to prioritize the health of their employees can have downstream impacts on the broader population. These impacts can be especially substantial when it comes to changing cultural norms, destigmatizing suicide and mental health issues, and understanding risk factors and warning signs for suicidality. Employers can decrease the incidence of suicide considerably and support employees through these crises by focusing on prevention, specialized care and short- and long-term postvention strategies.
To see a more detailed look at actionable steps employers can take to address suicide, take a look at the article “The Vital Role of Employers in Suicide Prevention and Postvention" and our podcast "We Can Make Strides in Preventing Suicide".
Business Group Resources
- The Vital Role of Employers in Suicide Prevention and Postvention
- Podcast: "We Can Make Strides in Preventing Suicide"
- Suicide: An Increasing Concern for Global Employers
- Responding to Potential Risk of Self-Harm or Suicide in the Workplace Quick Survey
Recommended resources to seek help if you or someone you know is having thoughts of suicide:
- U.S. National Suicide Prevention Lifeline: 988
- U.S. Crisis text line: 741741 text HOME
- The Trevor Project: For young LGBTQ+ lives
- Trans Lifeline: 877-565-8860
- Didi Hirsch Mental Health Services
Note: All calls are free and available 24 hours a day, seven days a week. All conversations are confidential.