Postvention is psychological first aid, crisis intervention, and other support offered after a suicide to affected individuals or the workplace as a whole to alleviate possible negative effects of the event.
1 These guidelines are not meant to represent standards of care, nor are they intended to be considered as advice, consultation or to replace appropriate medical or mental health care.
2 Adapted from Smith, Rivero, & Cimini. (2010, June 8). Postvention as a Prevention Tool: Developing a Comprehensive Postvention Response for Your Campus. A webinar of the Suicide Prevention Resource Center. http://www.sprc.org/news-events/events/postvention-prevention-tool-developing-comprehensive-postvention-response-your-ca
The box below highlights the 10 Action Steps that will assist with the above-mentioned roles and goals of the manager.
One of the highest priorities for managers in a suicide postvention response, like any critical incident, is to contain the crisis. The initial response of any organization often sets the tone for what is to follow. Upon discovery of the body of a suspected suicide on worksite property, law enforcement should be contacted immediately. As happens in all cases of non-natural deaths, the scene is first treated by police as a crime scene, thus all unauthorized people should be kept away from the body and site. Do not disturb the scene until you have received permission from the appropriate law enforcement authorities. Comply with all requests from law enforcement as they conduct their investigation. In many cases, law enforcement personnel work with victim advocates to notify next of kin in the event of a suicide. Depending on the circumstances, a representative from the workplace might consider accompanying the victim advocate when contacting the family. When notifying the next of kin, dignity and professionalism are essential, but this does not mean you need to restrain yourself from expressing appropriate emotions. Use the person’s name and work with the victim advocate to answer questions for the family while avoiding unnecessary traumatizing details if possible. If the death by suicide of an employee occurs outside of the workplace setting, management may be notified by a relative, friend, or public safety officer. The relative or friend may not have all the facts about the death, may not know for sure the cause of death, or may ask that it not be revealed that it was a death by suicide. Leadership is advised to carefully coordinate employee communication in consultation with their HR management and policies and procedures, and not make any official statements until
The death has been confirmed by law enforcement, medical examiner, or immediate family member.
When the deceased employee’s loved ones ask that the death not be disclosed as a suicide, leadership may not be able to assure complete secrecy for a couple of reasons. If information has already spread though informal communications, leadership runs the risk of appearing disingenuous, out-of-touch, and untrustworthy if there is no acknowledgement of the manner3 of death. Also, in many states the manner of death, even when it is worded as “cause of death is being withheld by family” is public information, as it may appear on the death certificate as such. Therefore, leaders can promise they will do what they
In the aftermath of a suicide, some vulnerable individuals in the workplace may be at risk for responding to the suicide by attempting their own suicide. This is also known as a contagion effect. In other words, the death by suicide of a co-worker may trigger suicidal thoughts and feelings in some already vulnerable individuals, and may increase their risk for copy-cat behavior. The reasons for contagion are many. For example, the death, particularly of an executive or perceived leader, may instill a loss of hope (e.g. “If he could not deal with his problems, given all he had going for him, what chance do I have?”); or, corporate and media attention to the death may offer just what the vulnerable person lacks and desires (e.g. a sense of importance and value, even though that attention could not be appreciated by a deceased person).Given how prevalent suicidal thoughts are at any given time, a larger workplace might find that at the time of a suicide death several other people might simultaneously experience suicidal distress and may be at risk for an attempt. This domino effect of suicide can be very disruptive to a workplace. Management can minimize the potential for contagion by setting an appropriately respectful tone when acknowledging and communicating about the employee death. Alternatively, when a culture acknowledges or memorializes a suicide death in a dramatic or sensational manner or focuses too much on the detailed means of death, there is an increased risk that some vulnerable individuals will imitate the behavior. For some suggestions on how to honor a person who died by suicide and minimize contagion, please refer to: http://www.sprc.org/sites/sprc.org/files/library/aftersuicide.pdf
One of the most challenging elements in an effective suicide postvention response in the workplace is for leadership to accurately, respectfully, and carefully communicate the information regarding the death of an employee. Occasionally, the death by suicide in the workplace setting involves other employees as witnesses. In these cases, information about the suicide death may spread quickly, especially in an era of rapid information exchange that occurs via texting, social media, and the like. Leaders should be aware that even before any official company announcement, there may already be a great deal of inaccurate information circulating within the workplace. Timely and accurate information briefs can help dispel rumors.
Review safe messaging guidelines for external and internal communication strategies and media recommendations for reporting on suicide for help developing public communications plans: http://reportingonsuicide.org/Recommendations2012.pdf or http://www.sprc.org/sites/sprc.org/files/library/SafeMessagingrevised.pdf
Usually, in the immediate aftermath of a suicide, people affected by the suicide often do not need counseling, but rather practical assistance to help them get through their day. While family members
As they plan their postvention response, managers need to be aware that for a smaller subset of people, a more profound emotional reaction might result in response to the suicide: complicated grief, trauma reaction, and even suicidal ideation. As such, managers will need to make crisis counseling and Employee Assistance Program (EAP) services readily available and easy to access, while they also create a culture that promotes and supports help-seeking behavior and allows employees to disclose their needs and seek services confidentially. Be mindful that there may be certain individual employees the managers will want to connect with intentionally and encourage to participate in the available support resources. Participation in these support services in the workplace must always be voluntary; yet, it is reasonable to believe that most employees will respond positively when managers express their care and offer tangible and meaningful support. Many organizations have
as an operating policy that leadership consults with their EAP in the immediate aftermath of a suicide or another critical incident, to determine the most appropriate response. There is no “one–size-fits-all” approach, and every response needs to be tailored to the specifics of that work group situation and culture, as well as to each individual affected.
If your organization does not have an EAP, you should contact your local mental health center to see if they have mental health service providers that can assist you in the aftermath of a crisis.
To find a mental health treatment facility near to you visit: http://findtreatment.samhsa.gov/MHTreatmentLocator/faces/quickSearch.jspx
To find a therapist in your area visit: www.helppro.com
When designing a customized response, many factors should be considered. For example, managers should consider: circles of impact (e.g., work teammates, close work friends, direct reports), nature of the work (e.g., school setting or healthcare setting), demographics of impacted employees (e.g., younger and/or new employees versus senior and/or tenured employees; differences in faith perspectives/spiritual practices), workplace schedules, productivity demands, and proximity to other critical incidents.The response plan will often include arranging for a specifically trained, behavioral health professional to be available in the workplace for some period of time to:
There are, however, some individuals who may be especially vulnerable to complications in their healing and recovery process. This could be because they are already going through major stressors in their lives, their support system is dysfunctional, they have ongoing emotional or behavioral health vulnerabilities, or they have some suicide history. These issues may be largely unknown or invisible to those in the workplace, or may have been only rumored, but these individuals especially could benefit from connecting with a behavioral health professional to help guide their recovery. Another important consideration in a death by suicide is the ever-present but unanswerable “Why (did this happen)?” question that may linger on in some minds. Managers and even crisis support counselors are unlikely to be able to to answer this question satisfactorily, nor should they try. This question is quite often linked to one’s spiritual beliefs, worldview or faith tradition, and it is usually better to acknowledge that this is a normal question and encourage the person to talk it through with their religious mentor, supportive family/friends or a mental health professional.
4 Mancini, A. & Bonanno, G. (2009). Predictors and Parameters of Resilience to Loss
Typically, a behavioral health professional who is part of the crisis response team in the workplace will be watchful for more affected or vulnerable employees and will then encourage them to follow through with their EAP services. In some cases, the behavioral health professional can even support the employee in making that initial call for help, which for some individuals can be very difficult, possibly even an obstacle.
Comfort: Support and Promote Healthy Grieving
Grief is a highly complex but normal and natural human response to the death of a loved one. When the death is sudden, unexpected, and potentially traumatic, as in a death by suicide, the grief process can become complicated by blame, guilt, shame, and anger. Sometimes managers may feel uncertain about how best to support their team in the aftermath of suicide, and either over- or underreact.
The best strategy is to consider what are the common practices and policies for dealing with other forms of bereavement, trauma, or health issues and start there in figuring out how best to proceed.
Any deviation from these practices could be seen as stigmatizing by staff (e.g. “Why is this death being treated differently than any other?”).Managers do not need to be experts on grief, but it is helpful to know that grieving is a process that varies from individual to individual. During the initial acute phase, it may be very difficult for some people to maintain focus and be productive. However, after the first couple of days, most people will long for things to get “back to normal” and will find a way to continue grieving while simultaneously taking care of their other responsibilities. This process may be different if the deceased was an immediate family member, as moving through the initial acute phase may be more painful and complicated, and may require some lifestyle changes as well.
Managers can help support this natural grieving and healing process by:
Restore: Re-establish Workplace Equilibrium and Optimal Functioning
As managers and leaders in the workplace, it’s important never to lose sight of the fact that it is part of a manager’s responsibility to stabilize the workplace and restore functioning. Ultimately, things need to get back to normal, even if that means a new normal. Managers have the very challenging task of balancing the need to care for and support affected employees, making sure that important work gets done and customers are served. Furthermore Managers need to hold to a critical balance of feeling the impact of the trauma themselves and taking care of their own healing and recovery needs – a challenging, if not daunting, task. Managers should not isolate or be the “lone ranger” at these times. Rather, they would be wise to consult with HR and their own supervisor to clarify the policies and boundaries of flexibility regarding accommodating employee needs and any changes in workloads or deadlines.
Lead: Reinforce and Build Trust in Organizational Leadership
Leadership in times of crisis is always an opportunity to reinforce and build trust, confidence, and workplace cohesiveness. When done well, employees will feel cared about, supported, and secure in the knowledge that leadership is both compassionate and competent. Feeling cared about and supported in the immediate aftermath of a traumatic event is hugely important =in the healing and recovery process. The positive outcomes of this response can contribute to an overall stronger, more cohesive, engaged and productive workplace culture.As we know, the converse is also true. If leadership fails to respond wisely and sensitively to a suicide death impacting the workplace, there will inevitably be at least some loss of trust and confidence. Ensuring fear from employees might result – either management did not care or did not know what to do, so they did nothing – and the overall impact of the traumatic event is magnified. One way to establish trust is for leaders to acknowledge how they have been personally affected by the loss.
Sustain: Transition from Postvention to Prevention
After a workplace has been affected by a suicide, managers sometimes think that their work is finished once the crisis has past. Instead, one of the most important things managers can do is transition the team from suicide postvention to suicide prevention strategies. Suicide prevention strategies are usually employed before suicidal behavior emerges and are often offered to all employees (for example, promotion of the National Suicide Prevention Lifeline 1-800-273-8255) or to a group of employees that might be at higher risk (for example, a group that might be facing relocation or downsizing). Suicide intervention usually occurs when suicidal thoughts or behavior have emerged and someone is linking an individual to care. A comprehensive approach looks beyond one or two strategies, and uses a multi-pronged, and coordinated system of strategies that addresses suicide risk from proactive prevention to intervention to postvention.
Comprehensive suicide prevention for workplaces exist (http://www.WorkingMinds.org) and comprehensive prevention planning that can be tailored for workplaces and other settings is also
In addition, several low-cost, high-impact tactics are accessible to managers. For example, training employees in suicide prevention gatekeeper models that teach employees how to recognize and
respond to signs of suicide risk in their coworkers (for more information on gatekeeper training, see “Choosing and Implementing a Suicide Prevention Gatekeeper Training Program” available at
In addition, employing an annual depression screening as part of ongoing health and wellness initiatives (see http://www.mentalhealthscreening.org/programs/workplace). Still, other employees
might be motivated to make meaning out of their loss by volunteering for suicide prevention efforts or participating in suicide awareness community events.
[WHEN CAUSE OF DEATH REVEALED]
From: [Name of CEO]
Re: Death of [name of employee]
[Our workplace] is saddened to learn of the reported suicide of [employee]. The tragic and sudden circumstances of [employee’s] death may cause a range of reactions among our workplace, so with the family’s permission we are sharing the facts as we know them and are offering support for those who might need it.[Employee] worked for [workplace] for the last [number] years. On [Saturday night] [s/he] died around [11:00PM] [DO NOT MENTION PLACE OR METHOD USED FOR SUICIDE]. We may never know all the factors leading to this tragedy; however, experts agree that in nearly all suicides there is no single cause or simple explanation.[Employee’s] memorial service will be held on [January 7 at 11:00AM], and all employees who wish to attend may be excused. The family would like to welcome all of [his/her] friends and colleagues who wish to share in the celebration of [his/her] life. Some of you may be having difficulty coping with the sudden loss of one of our workplace family. We have arranged for the Employee Assistance Program (EAP) professionals to facilitate a debriefing on [January 8th at 5:00PM]. During this group meeting, counselors will be on hand to support us and answer any questions we may have. Others may prefer individual support at this time. If so, please contact our EAP program by calling [1-800-123-4567].
The family has requested that instead of flowers, those who wish to do so may donate to [a local suicide prevention center or other charity as shared by the family] in [employee’s] memory.
For those who would like to talk about what has happened, our HR team is available to you.
[WHEN CAUSE OF DEATH WITHHELD BY FAMILY]
From: [Name of CEO]
Re: Death of [name of employee]
[Our workplace] is saddened to learn of the death of [employee]; the family has requested that the cause of death be withheld. The tragic and sudden circumstances of [employee’s] death may cause a range of reactions among our colleagues, so with the family’s permission we are sharing the following information and are offering support for those who might need it.[Employee] worked for [workplace] for the last [number] years. On [Saturday night] [s/he] died around [11:00PM] [DO NOT MENTION PLACE OR METHOD USED FOR SUICIDE]. [Employee’s] memorial service will be held on [January 7 at 11:00AM], and all employees who wish to attend may be excused. The family would like to welcome all of [his/her] friends and colleague who wish to share in the celebration of [his/her] life.
Some of you may be having difficulty coping with the sudden loss of one of our workplace family. We have arranged for the Employee Assistance Program (EAP) professionals to facilitate a crisis counseling session on [January 8 at 5:00PM]. During this group meeting, counselors will be on hand to support us and answer any questions we may have. Others may prefer individual support at this time. If so, please contact our EAP program by calling [1-800-123-4567].
The family has requested that instead of flowers, those who wish to do so may donate to [a local suicide prevention center or other charity as shared by the family] in the [employee’s] memory.
For those who would like to talk about what has happened, our HR team is available to you.
[WHEN HIGH PROFILE SUICIDE AFFECTS WORKPLACE]
[Our workplace] is saddened to learn of the reported suicide of [employee, title]. Our hearts and condolences go out the family and friends. With the family’s permission we are sharing the facts as appropriate and are offering support for those who might need it. Suicide is a complex, multifaceted and tragic event, and thus we will not speculate on the causal factors of this death. Rather our efforts will be focused on pulling together and helping our workplace find supportive resources as necessary. For those outside of our work family who might be affected by this tragic loss, we suggest you contact the National Suicide Prevention Lifeline (1-800-273-TALK ) to get referrals to support groups and other resources in your area.
RESOURCES FOR WORKPLACES
COMPREHENSIVE APPROACH TO WORKPLACE SUICIDE PREVENTION
Resource Directory (National Action Alliance for Suicide Prevention)
CRISIS RESPONSE SERVICES
Crisis Care Network
National Suicide Prevention Lifeline – 1-800-273-TALK (8255)
Veterans’ Crisis Services
Veterans’ Crisis Line and Chat: http://www.veteranscrisisline.net/
After a Suicide (Suicide Prevention Resource Center)
SUICIDE GRIEF RESOURCES
WORKPLACE SUICIDE PREVENTION TRAINING
Working Minds: Suicide Prevention in the Workplace
Toolkit listing on the SPRC/AFSP Best Practices Registry for Suicide Prevention
(train-the-trainer workshops available)
Toolkit website: www.WorkingMinds.org
Toolkit contact: 720-244-6535
ADDITIONAL GATEKEEPER TRAINING MODELS
Choosing and Implementing a Suicide Prevention Gatekeeper Training Program
The Gatekeeper Training Implementation Support System
http://gatekeeperaction.org/A Manager’s Guide to Suicide P
For downloadable PDF and complete copies of this document please visit http://www.suicidology.org/c/document_library/get_file?folderId=272&name=DLFE-822.pdf
Reposted with permission with our thanks.