Magazine article The Journal of Employee Assistance

Suicide and Male Workers: Men Commit Four of Every Five Suicides, Frequently in the Context of a Business or Work Failure. EA Professionals Are in an Ideal Position to Assess for Suicide Risk

Magazine article The Journal of Employee Assistance

Suicide and Male Workers: Men Commit Four of Every Five Suicides, Frequently in the Context of a Business or Work Failure. EA Professionals Are in an Ideal Position to Assess for Suicide Risk

Article excerpt

In May 2001, the Office of the Surgeon General of the United States launched an initiative to promote awareness of suicide as a public health problem and encourage the development of suicide prevention programs. Although the suicide rate in the United States declined in the decade leading up to the release of the initiative, suicide is still the 11th-leading cause of death in the United States. More Americans kill themselves each year than are killed by other people.

The overall suicide rate in the United States is about 11 per 100,000. But that figure obscures a startling discrepancy, which is that suicide is primarily a male problem. In women, the suicide rate is between 5 and 7 per 100,000; for men, it's between 18 and 20. Men commit four of every five suicides, although 75 percent of suicide attempts are made by women. If you look at the demographics of suicide fatalities in men, the suicide rate is about the same from age 15 up to the age of 50, rises slightly from age 50 to 60, then increases dramatically after that.

What can we make of these statistics? Unfortunately, our understanding of gender distinctions related to suicide is minimal. We do know, however, that whereas women tend to commit (or attempt) suicide in the context of an interpersonal failure, men tend to commit suicide in relation to a business or work failure. The risk of male suicide seems to be greater if there's a fall in status or position; it doesn't appear to be related to one's status within the work organization or one's income bracket.

This information has obvious implications for the workplace. Men in the workplace are primarily between the ages of 20 and 60, and at those ages the suicide rate for males is between 20 and 25 per 100,000. Employee assistance professionals who work with men who are being displaced or demoted should consider them at elevated risk of suicide, though not necessarily "at risk."

NUMBER-ONE CONTRIBUTOR

How can you determine which employees (if any) are at risk for suicide? The bottom line is that more than 90 percent of people who attempt or commit suicide will have one of three mental health disorders: depression, alcoholism, or schizophrenia. Another 5 percent will have personality disorders. More than 7 in 10 persons who commit suicide have at least two disorders, either a combination of depression and alcoholism or depression and personality disorders.

Depression is the number-one contributor to suicide; that is, if we look at 100 suicides, anywhere between 60 and 70 percent of them would have been diagnosed with depression. However, the vast majority of people who suffer a depressive episode in a given year do not attempt suicide. This points up one of the biggest problems in preventing suicide--we don't have a tool that can accurately predict whether someone is likely to try to take his or her own life. Screening awareness programs are really the state of the art in this area.

Although women are twice as likely to have depression as men, they are also twice as likely to seek treatment. Overall, people with depression tend to commit suicide early during the course of their illness--sometimes during the first or second episode--whereas people with alcoholism tend to commit suicide later in the course of their illness. What this means is that if someone in your organization has alcoholism, s/he may stay sober for 10 years, but if this person's job becomes threatened, relapse may occur and the risk of suicide can increase.

One of the things you'll notice about many people who are depressed is that they also have symptoms of anxiety. In fact, it is estimated that about 70 percent of people with depression have anxiety symptoms. This is relevant in part because one of the mainstreams of treatment today is antidepressant medications in combination with psychotherapy There's a growing belief that we tend to underuse anti-anxiety agents in the initial phase of depression treatment. …

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