1. Workplace & Work-Related Suicide Professor Craig Jackson Prof. Occupational Health Psychology Head of Psychology Birmingham City University

2. Worldwide attitudes... Suicidal death just another outcome

3. UK Suicide over time

4. Mostly a White Male Problem

5. France Telecom Case Privatised in 1998 40,000 jobs lost since 1998 186,000 employees 45% of those outside France 4.3% fall in profits in 1Q of 2009 182 million customers in 5 continents

6. France Telecom Internationale' 45% of customers outside France 182 million customers in 5 continents

7. France Telecom Suicides 30 staff committed suicide 2008-2009 23 staff committed suicide 2010 French suicide rate: 26.4 per 100,000 male pop 9.2 per 100,000 female pop 17.8 per 100,000 all pop

8. France Telecom Staff Situation Uncertainty New working conditions Modernisation Internal job transfers - Japanese problem C ultural & organisational changes needed

9. France Telecom Cases 9 th Sept: 49 yr old male employee stabbed himself in meeting – told he would be undergoing internal job transfer 11 th Sep: 32 yr old female employee leapt to death from office window 14 th Sep: 53 yr old senior manager overdosed 1 st Oct: 51yr old male employee jumped from road bridge – note blamed work “atmosphere”

10. France Telecom's 2 Point Defence “There were 28 suicides in the company in 2000, so 23 suicides over 17 months is actually an improvement and not evidence of an epidemic” “Most suicides caused by personal problems not professional ones”

11. France Telecom "Solution" Oct 2009 Deputy CEO Louis-Pierre Wenes resigned CEO Didier Lombard – vowed to end the “Spiral of death” Phone helpline Counselling Suspending job transfers French Labour Minister, Xavier Darcos wants: 2,500 biggest companies to plan “anti-stress” strategies Planned with Unions Govt has 27% stake in FT Health & Happiness now on “National Agenda” in France

12. 82% of male jumpers were White 11% Asian, 4% Black, 3% Latino 11% Asian, 4% Black, 3% Latino 84% of female jumpers were White 4% Asian, 4% Black, 4% Latino 4% Mixed race GGB Suicide Statistics

13. Foxconn and the iPad Manufacturing giant in China Renowned for efficiency 400,000 employees Laptops, mobiles - Nokia, Apple, Dell HP 14 suicide deaths since Jan 2010

17. Foxconn and the iPad Explosion Fri 20th May 2011 2 dead 16 injured

18. Multiple Approach Required Conditions: long shifts, rigid, oppressive, poor payConditions: long shifts, rigid, oppressive, poor pay Company asked workers to sign a letter promising not to kill themselves (now withdrawn)Company asked workers to sign a letter promising not to kill themselves (now withdrawn) Legally immune agreementLegally immune agreement Intensity of labor - twelve hour shiftsIntensity of labor - twelve hour shifts Compensation for families in poverty too temptingCompensation for families in poverty too tempting Building giant safety net to prevent jumping deathsBuilding giant safety net to prevent jumping deaths Hiring counsellors and Buddhist monksHiring counsellors and Buddhist monks

19. Our own attitudes...

20. Difficult to study... Suicide multi-causalSuicide multi-causal End-stage of complex processEnd-stage of complex process Attracts emotive reporting in mediaAttracts emotive reporting in media Receives little / no academic attentionReceives little / no academic attention Workplace attribution straightforward in many casesWorkplace attribution straightforward in many cases Samaritans gets in the way on www Samaritans gets in the way on www

21. Worldwide epidemiology 1 million suicide deaths / year 10-20 million attempts / year 50% of first time attempts fail 23X more likely to die from suicide if tried previously

22. Over-simplified theories Following are all common to suicide & attempts: current mood disordercurrent mood disorder previous suicide attemptsprevious suicide attempts prior outpatient psychiatric treatment*prior outpatient psychiatric treatment* admission to psychiatric hospital within the previous yearadmission to psychiatric hospital within the previous year low incomelow income absence of educational qualificationsabsence of educational qualifications recent stressful events (legal, work-related life events)recent stressful events (legal, work-related life events) never married*never married* Beautrais (2001)

23. 55.4% of jumpers were never married of jumpers were never married 39% of jumpers were under psychiatric care GGB Suicide Statistics

24. Suicide case: WPC Paula Tomlinson Armed response officer, aged 37 One of first female snipers in UK 90-strong team (88 males) Hanged at home 2004 2003 Dismissed from firearms duties Complained: Colleagues viewing porn video on a residential courseColleagues viewing porn video on a residential course Felt victimised in macho culture of firearms unitFelt victimised in macho culture of firearms unit Fell out with a number of influential male colleaguesFell out with a number of influential male colleagues Sefton Coroner Christopher Sumner: “Paula Tomlinson killed herself at a time that she was suffering from stress, a contributory factor of which was work related.”

25. Suicide locations... Impacts Rail network Underground Car parks ForestsBridges Homes / Gardens Workplace

26. Male / Female differences 75% Suicidal deaths are male Sex-split same since 1991 Females - suicide highest among 75 yrs plus Males - suicide highest among 15-44 yrs

27. 75% of jumpers were male 25% of jumpers were female GGB Suicide Statistics

28. UK Suicides Males Females 30 suicides per 10 suicides per 100,000 in Scot 22 suicides per 6 suicides per 100,000 in Wales 18 suicides per 5.6 suicides per 100,000 in NI 17.5 suicides per 5.2 suicides per 100,000 in England 5,554 UK suicides 2006 5,377 UK suicides 2007 5,706 UK suicides 2008 5,675 UK suicides 2009

29. Suicide Space Access to lethal meansAccess to lethal means Opportunity for solitudeOpportunity for solitude Only resort available (perceived)Only resort available (perceived) Lack of support (perceived)Lack of support (perceived) Location away from assistanceLocation away from assistance

30. Methods differ by Sex Males: violent, instant, impact, gunshot Females: slower, non-visceral, pain-free HangingHanging FirearmsFirearms Co-proximalCo-proximal Other poisonOther poison Car CO poisoning reduced by catalytic converters Paramedic attendance improved

31. Hanging Most common method in UK Majority in homes / gardens Minority in prisons & psychiatric hospitals Rope / cord most common ligature 47% did not achieve full suspension Oxford study (2009)

32. Firearms Shotguns used in 75% cases Minority had contact with psychiatric services Small percentage had a history of previous self harm Sports & Work were main reasons for gun ownership Oxford study (2009)

33. Co-proxamol More than 40% of individuals were aged 55+ years Almost half had a history of self harm Alcohol used in more than half the overdoses: alcohol use = fewer tablets needed Co-proxamol was less often prescribed for younger than older cases Death occurred in most cases before the individual could reach hospital.

34. Other poisonings Pesticides, herbicides, drain cleaners, other prescription meds 25% who died from overdose reached hospital alive Paramedics assisted in nearly 75% of cases Half the cases had a history of self harm Oxford study (2009)

35. Suicide in the Midlands City. Rate. Cases. UK rank Wolves 22.1 per 100,000 146 cases#101 Birmingham 19.3 per 100,000 541 cases#172 Dudley 18.0 per 100,000 147 cases#215 Coventry 17.3 per 100,000 146 cases#245 Sandwell 16.6 per 100,000 125 cases#268 Walsall 15.9 per 100,000 105 cases#294 Solihull 13.8 per 100,000 74 cases#363

36. Cumulative Model

37. Emerging issues Copycat Suicides Norway press ban Reduced copycat suicides Over-reporting Emotive, simplistic, gender-biased Social Networking Smaller world, greater individual influences

38. Emerging issues Death of the Suicide Note Once vital evidence in suicideology Non-paper society replaced notes TweetsFacebookTextsBlogs Video diaries

39. Emerging issues Assisted Suicide Suicide tourism 120 visitors to "Dignitas" Failure to prosecute Human rights Law will change - Lord Carlisle & Baroness Finlay

40. Emerging issues Internet Suicide Forums William Melchert-Dinkel Encouraging 2 suicides Freedom of speech Law not caught up with www

44. References Etzersdorfer, E., L. Vijayakumar, W. Schöny, A. Grausgruber and G. Sonneck (1998). Attitudes towards suicide among medical students: comparison between Madras (India) and Vienna (Austria). Social Psychiatry and Psychiatric Epidemiology. 33. 3. 104-110. Gibb, B. E., M. S. Andover and S. R. Beach (2006). Suicidal ideation and attitudes toward suicide. Suicide & Life-Threatening Behavior. 36. 1. 12-8. Hawton, K and van Heeringen, K (eds). (2000). The International Handbook of Suicide and Attempted Suicide.Chichester, Wiley. Jackson CA. (2008) Work-Related Suicide. Management of Health Risks. 126: 2-8. Karasek, R. and T. Theorell (1990). Healthy work: stress, productivity, and the reconstruction of working life. New York, Basic Books.

45. References Karasek, R. A. (1979). Job demands, job decision latitude and mental strain: implications for job design. Administrative Science Quarterley. 24. 285-308. Mellanby, R. J. (2005). Incidence of suicide in the veterinary profession in England and Wales. Veterinary Record. 157. 14. 415-7. Sawyer, D. and J. Sobal (1987). Public Attitudes Toward Suicide Demographic and Ideological Correlates. The Public Opinion Quarterly. 51. 1. 92-101. Siegrist, J. (1996). Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology. 1. 27-41. Stack, S. (2001). Occupation and Suicide. Social Science Quarterly (Blackwell Publishing Limited) 82. 2. 384.

46. References Stansfeld, S., R. Fuhrer, M. Shipley and M. Marmot (2002). Psychological distress as a risk factor for coronary heart disease in the Whitehall II Study. International Journal of Epidemiology 31. 248-255. Stansfeld, S. A., R. Fuhrer, J. Head, J. Ferrie and M. Shipley (1997). Work and psychiatric disorder in the Whitehall II Study. Journal of Psychosomatic Research. 43. 1. 73-81. Vilhjalmsson, R., E. Sveinbjarnardottir and G. Kristjansdottir (1998). Factors associated with suicide ideation in adults. Social Psychiatry and Psychiatric Epidemiology. 33. 3. 97-103.