Impact of Colleague Suicide on Affected Co-Workers: History
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Subjects: Behavioral Sciences
Contributor:
Hilary Causer
,
Johanna Spiers
,
Nikolaos Efstathiou
,
Stephanie Aston
,
Carolyn A. Chew-Graham
,
Anya Gopfert
,
Kathryn Grayling
,
Jill Maben
,
Maria van Hove
,
Ruth Riley

People bereaved by suicide are affected psychologically and physically and may be at greater risk of taking their own lives. 

  • suicide
  • postvention
  • impact
  • loss
  • grief
  • bereavement
  • colleague
  • co-worker

1. Introduction

Suicide is one of the leading causes of death around the world, with more than 700,000 people dying by suicide every year [1]. This means that 1% of all global deaths are due to suicide [2]. Suicide affects the physical and psychological health of the bereaved [3] and, compared to other causes of sudden death, those bereaved by suicide report higher levels of rejection, shame, stigma, and a need to conceal the method of death [4][5]. Every suicide impacts approximately 80 [6] to 135 [7] people, of which 1 in 30 may be deeply impacted and so can be considered bereaved [8]. Suicide bereavement has also been identified as a risk factor for attempted suicide [9][10][11]; approximately 7–9% of people bereaved by suicide subsequently attempt suicide [11][12]. There is also an association with occupational dropout [13].
Previous studies have measured and explored the impact of suicide on family members [14][15][16][17], friends [18], teachers [19], university staff [20][21], therapists, and other healthcare workers [22][23][24]. A recent UK-wide survey on the impact of suicide [4] found that 2% of participants reported being bereaved by a colleague’s death. However, the impact of colleague suicide has not been widely investigated, even though the suicide rate in the UK is higher for certain professions; approximately 12 deaths per 100,000 were suicides between 2011 and 2015 while the risk of suicide for female healthcare professionals was 24% higher than this national average [25].
The support offered to those impacted by suicide is known as postvention [26][27][28][29]. Effective postvention has been shown to improve mental health and grief-related outcomes [30], help bereaved people seek and share support and information, and memorialise their loved ones [31]. While there is some postvention guidance for workers impacted by colleague suicide, see e.g., [28][32][33], existing guidance is limited and is not always evidence based.

2. Workplace Cultures, Professional Contexts, and Individualised Responses

Suicide loss is shaped by perceptions of professional identity and workplace settings. However, this is unacknowledged in postvention guidance, which takes an individualised view of cause and impact. Whilst the emotional impact reported by staff following a colleague suicide reflects the wider literature [34][35][36][37], experiencing this impact within professional identities and workplace settings complicates individual responses.
For instance, perceptions of professional identity and uniqueness shape staff experiences of grief. The researchers reviewed the experiences of police officers, firefighters, military personnel, and primary care health professionals. Such professionals may be working within a culture of invulnerability [38], whereby perceptions of being impervious to work-related stresses become part of a professional identity. Staff who perceive themselves as invulnerable are less likely to find psychological safety following a colleague suicide. Researchers have concluded that talking about vulnerability and illness reduces perceptions of isolation and promotes coping mechanisms for GPs [39]. It is likely that such openness may also promote healthy coping in other professions. Furthermore, the researchers found that staff across a range of professions believed that their experience of suicide loss was more impactful due to their perceptions of the unique traits of their job role or professional identity. While several professions perceived themselves as unique for similar reasons, this indicates that these ‘unique’ attributes and their impact on professionals’ experience of a colleague suicide ought to be understood, acknowledged, and incorporated into support to meet staff needs for all groups.
Currently, workplaces do not provide the time and support required by employees to undertake the emotional work that arises following a colleague suicide. The researchers found that a ‘carry on’ narrative dominates, prioritising work tasks and productivity over emotional needs. Similarly, when exploring the experiences of bereaved staff on their return to work, Bento [40] used the phrase ‘the show must go on’ to describe employees’ perceptions of silence or pressure to catch up with work tasks. It may be that leaders working in ‘24/7′ professions such as medicine or the military are expected to keep working to prevent the fallout from a depleted workforce, meaning they must put work ahead of their wellbeing.
Hochschild [41][42] utilises the concept of ‘feeling rules’ to describe the processes of emotion management that occur in workplace settings. Similarly, Doka [43] talks about ‘grieving rules’ that describe societal norms around loss and grief behaviours. Together, these concepts may provide a framework for better understanding how staff are expected to manage grief in the workplace and how organisations operate to direct grieving processes away from the workplace. Within the social model of individualisation, we are expected to do our emotional work in the privacy of our homes [44]. However, when grief occurs at work, this expectation generates further stress and an understandable disconnect for staff. The researchers found that staff must work to navigate these complex expectations surrounding grief after a colleague’s suicide. Similarly, Grandey [45] identified that employees suppress or regulate emotions following a stressful event to deliver an appropriate emotional presentation for the workplace. Such emotional management has been conceptualised as emotional labour [41]. When expressed emotions differ from those that are felt, emotional dissonance and internal tension may result [46]. As such, emotional labour is stressful and may lead to burnout [47].
As Pitimson [48] points out, UK legislation regarding compassionate leave does not recognise the death of a colleague, meaning any leave is at the discretion of the employer. In response to this point and the findings, the researchers argue that time must be offered in workplaces to accommodate the emotional work that may follow a colleague suicide and avoid the risk of emotional burnout.
It would be beneficial for authors of postvention guidance to offer strategies for addressing these specific staff experiences and needs following a colleague suicide. Overall, the guidance the researchers reviewed did not take an organisational perspective, nor did it address professional identity and working spaces as the contexts within which loss and grief must be navigated and postvention support delivered. As previously noted, current guidance has drawn only sparsely on empirical evidence, which may explain this disconnect between need and delivery. The researchers argue that postvention guidance must draw on the lived experiences of the people it aims to support. The reviewed guidance largely misses an opportunity to support organisations and staff by meeting them at the point of their experience.

3. Unpreparedness, Abandonment, Silencing, and the Perpetuation of Stigma

It was found that organisational unpreparedness for suicide loss generates feelings of abandonment and perceptions of silencing that further complicate experiences of grief and perpetuate perceptions of stigma. Managerial or organisational failure to acknowledge colleague suicide and its impact leaves staff feeling abandoned in navigating their path to recovery. Pitimson [48] reports that a lack of workplace acknowledgement leaves bereaved staff with fears of being judged and a need to find safe places at work for privately expressing grief. As Lattanzi-Licht [49] states, the workplace requires the bereaved to be silent, hiding their feelings. Disenfranchised grief [50] refers to instances of dismissal when either the relationship with the deceased, the nature of the loss, or the griever themselves are not recognised. Doka [50] proposes that acknowledgement of grief is necessary for bereavement to be completed. The silence and silencing found here leave staff unable to talk about or process their experiences. Thus, the idea of suicide as a taboo [51] topic is perpetuated, staff are unsupported in their grief, and their trauma remains unacknowledged and unaddressed. The findings illustrate that, alongside the absence of organisational response, the event of a colleague suicide and attempts by staff to mourn and remember their colleague were actively silenced. Staff grief in the workplace is not just disenfranchised; it is actively stifled [52].
This active silencing has an impact. As the findings demonstrated, stigma both leads to and arises following inadequate postvention. When organisations do not deliver postvention, they perpetuate stigma around suicide by failing to provide forums for conversation, acknowledgement, understanding, and healing. Paradoxically, it is the stigma surrounding suicide, and associated fears, that may contribute to organisations failing in this way. There is a fear of acknowledging suicide due to misunderstandings around risk of ‘contagion’ and the likelihood of further deaths by suicide [11]. The researchers argue that it is the role of guidance to address these naïvetés. However, if guidance is not underpinned by evidence, it may be difficult to convey these messages robustly. Additionally, it could be suggested that the term 'contagion', which has negative connotations, may perpetuate stigma and so hamper discussion and healthy postvention. Perhaps non-pejorative language such as ‘further suicides’ may be more useful

4. Managers: Identities, Roles, and Complex Pressures

Colleague suicide generates complex challenges for managers. This is exacerbated by perceptions of professional identity, whereby managers are perceived as strong and knowledgeable, and further, by postvention guidance, which situates managers as supporters of other staff. Balancing the needs of their team alongside managers’ own needs, expectations that the workplace should continue to function as usual alongside staff grief, and the need to communicate clearly to staff whilst balancing the preferences of the deceased’s family and the need to protect the deceased’s privacy are all factors that generated this complexity. The wider literature also identifies the manager as a key provider of support and comfort when a staff member is bereaved [53][54][55].
Several authors highlight that, with proactive support and compassion, the workplace can facilitate healing following bereavement [53] and that bereaved staff may feel safe in the familiarity of the workplace [48]. Compassion is defined as ‘an active orientation towards the well-being of others who are in pain’ [56] (p. 168). Kanov [57] suggests that managers are well placed to offer compassion by noticing the suffering of others, feeling empathic concern, and acting to alleviate suffering. The manager must be alert, empathically in tune with others, and knowledgeable about appropriate proactive responses. It is often assumed that managers will provide this support and compassion whilst managers’ struggles are not acknowledged [48][53][57].
The agency of bereaved staff within the supportive relationship is recognised by Dutton et al. [58], who posit that compassion requires both parties to interpret and understand each other’s circumstances to make sense of the situation. Even here, however, there is no acknowledgement that the manager may be experiencing their own grief. The researchers propose that, importantly, postvention guidelines provide guidance for the support of managers whilst they, in turn, support their teams. Additionally, guidance can identify external sources of postvention support (the availability of which varies), so that the weight of being the expert and supporting staff can be lifted from the potentially grieving manager.
Considering the broader contexts that underpin the complexity faced by managers allows for insights into the competing pressures of meeting the emotional needs of staff alongside the demand for the business to function. Pitimson [48] notes that individualism and capitalism can shape the experiences of grief in the workplace. Peticca-Harris [54] highlights this in her first-person account of restaurant managers’ responses to the sudden death of a staff member. She describes how the need to keep the restaurant open blinded managers’ ability to see, or relate to, the distress staff were experiencing [54]. Granek [59] suggests that control of grief in workplaces is political in terms of the expectation that staff will continue to contribute within capitalist societies. Peticca-Harris [54] (p. 608) concludes that ‘managers did not know what to do and how to do it, and that brought about shame and embarrassment because it was at odds with the archetypes of leadership that dictate that leaders should just know [60]’.
These multiple juggling acts are addressed in part in postvention guidance, which often suggests the formation of a postvention committee or group, meaning postvention tasks are planned for and shared (see e.g., [61][62]). This may be feasible in a larger organisation. However, it is likely that one team manager would still need to provide information, identify staff who need support, and facilitate the implementation of support resources. In smaller organisations, or those that have not implemented a postvention team, individual managers are likely to have to implement postvention support to team members whilst also having to deal with their own responses to the loss. Effective, evidence-based training may help lessen managers’ load. Attendees of postvention training for clinicians who support parents following the suicide of a child reported increased knowledge, skills, and confidence following the session [9].

This entry is adapted from the peer-reviewed paper 10.3390/ijerph191811565

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