Suicide prevention and the workplace [thesis]

Leah Marie Wentworth
____________________________________________ Marizen Ramirez ii ACKNOWLEDGEMENTS I have more people to thank than I have pages. First I'd like to thank the Heartland Center, for funding me as an Occupational Injury Prevention fellow, and awarding me a pilot grant for my dissertation research. I'd also like to thank the Injury Prevention Research Center for support, and all the faculty, students, and staff associated with the IPRC for their warmth, wit, and assistance. My committee was
more » ... ittee was exceptional to work with, and I will forever be indebted to them. Marizen Ramirez introduced me to the joys of research and provided essential help with the pilot grant process. Sam Cochran served as an incredible mentor in suicide prevention work and somehow made Monday morning meetings the best part of any week. Cori Peek-Asa, my advisor and my first connection to injury prevention work at Iowa, guided me, challenged me, and supported me. Bill Field and Carri Casteel rounded out the committee with their enthusiasm and expertise. I'm eternally grateful to all my friends in Iowa, particularly the Pelicans and Defenestrators-thanks for giving me some semblance of work/life balance. My parents and sister cheered me on as I left New England for more school in a place I'd never been. A lifetime of thanks to them and the rest of my family, especially my Uncle David, for their unwavering support. iii ABSTRACT The long-term goal of this research is to reduce the number of deaths by suicide. Suicide is the leading cause of violent death in the United States, and is currently the 10th most common cause of death across all age groups. Suicide prevention efforts have historically been focused on youth/young adults, and the elderly, with less attention on programming for individuals in the working years. Our intention is to generally broaden the understanding of suicide, depression, and the workplace, with the hope of improving interventions for this underserved population. The research activities outlined below were conducted under the auspices of a larger quasi-experiment at the University of Iowa. We first sought to assess the experiences of professional, nonclinical staff identifying and responding to apparently mental health problems in the workplace. We looked at the impact of two exposures on engagement with individuals in crisis: self-reported contact (the number of students or coworkers a participant interacted with each week), and participation in any suicide prevention training/programming over the previous five years. High contact with students was generally associated with a greater capacity for recognizing and responding to depression and potential suicidality. In contrast, the association between high contact with employees and recognition and response was insignificant for four of the six recognition and response behaviors. Participation in any form of suicide prevention training or programming in the previous five years was highly associated with recognizing and responding to depressed or suicidal coworkers and students. Next, we considered the impact of a personal prior experience with suicide and prior suicide prevention training/programming on four constructs: preparedness to iv respond to someone in crisis, familiarity with appropriate resources, gatekeeper selfefficacy, and gatekeeper reluctance. Suicide prevention training/programming was significantly associated with higher perception of three constructs: preparedness, familiarity, and self-efficacy. There was no statistical difference in reluctance between previously training participants and participants who had not previously taken suicide prevention training or programming. Individuals who had a personal prior experience with suicide were less reluctant to engage, although the results were not significant. There was an association between individuals who had a personal prior experience with suicide and suicide prevention training/programming, suggesting that individuals with a personal connection to suicide might be more likely to enroll in suicide prevention programming. Finally, we examined how a suicide prevention training programming impacted the perception of safety culture in the workplace. On the 10 item safety scale, there was a significant difference between the means scores reported by the intervention and control group on 7 of the 10 questions. Individuals who participated in QPR gatekeeper training reported a higher sum safety culture score than individuals who did not participate in the training; the overall model was statistically significant. This project shows that suicide prevention training/programming of any kind in the workplace can have a persistent, positive training impact on employees by informing and empowering them to act. It suggests that individuals with a personal prior experience with suicide may be more likely to take suicide prevention training, and may be less reluctant to engage with someone in crisis. It also demonstrates that suicide prevention v training may have a positive impact on other workplace psychosocial factors, and deserves prioritization in workplace wellness programming. vi PUBLIC ABSTRACT Suicide is the 10 th leading cause of death in the United States, and is the leading cause of violent death. Recent research suggests that working-aged individuals are at increased risk for death by suicide. We looked at the impact of two exposures on engagement with individuals in crisis: self-reported contact (the number of students or coworkers a participant interacted with weekly), and participation in any suicide prevention training/programming over the previous five years. High contact with students was associated with a greater capacity for recognizing and responding to depression and potential suicidality, while high contact with employees was not generally associated with greater engagement. Participation in any form of suicide prevention programming in the previous five years was highly associated with recognizing and responding to depressed or suicidal coworkers and students. Next, we considered the impact of a personal prior experience with suicide and prior suicide prevention training on four constructs: preparedness to respond, familiarity with resources, gatekeeper self-efficacy, and gatekeeper reluctance. Suicide prevention training/programming was associated with three constructs: preparedness, familiarity, and self-efficacy. We also found an association between individuals who had a personal prior experience with suicide and suicide prevention training, suggesting this is an important target population. Finally, we examined how a suicide prevention training programming impacted the perception of safety culture in the workplace. Individuals who participated in QPR vii gatekeeper training reported a higher sum safety culture score than individuals who did not participate in the training, indicating a higher perception of safety culture. viii
doi:10.17077/etd.cwjydgn1 fatcat:hba2h64knbfkpk6nqpv2yk24cu