Executive Summary

QPR for Corporations: A Depression/Suicide Awareness and Prevention Pilot Project for Employers

Overview
In the recently released President’s Freedom Commission on Mental Health, suicide prevention is listed as the top priority. The Commission strongly supports the implementation of the Surgeon General’s new National Strategy for Suicide Prevention (2001). In turn, the National Strategy specifically targets employers as important players in the prevention of suicide. Goal 4, Objective 4.4 of the National Strategy states, “By 2005, increase the proportion of employers that ensure the availability of evidence-based prevention strategies for suicide.” The report further states, “It is in the interests of employers to prevent suicide and suicidal behaviors. And, “A suicide in the family of an employee may result in such grief that the employee becomes incapacitated.”

Of the nearly 30,000 suicide deaths each year in the U.S. most are working adults. The leading contributory cause of these suicides is untreated major depressive disorder, a highly remedial medical problem. Given recent developments in suicide prevention and public policy in America - and the growing knowledge that suicide is a preventable fatal outcome of brain disorders - we believe that now is the time for a leading American company to embrace suicide prevention as a corporate value. Just as schools are the venue for youth suicide prevention training, we believe the workplace can become the venue for suicide prevention training for employed adults.

To our knowledge, the QPR Institute has the only evidence-based, established systems approach to reducing suicide risk in large organizations. Our Suicide Risk Reduction Program has been successfully installed in the largest non-profit mental health system in the world. The Devereux Foundation has 5,000 staff in 27 major facilities in 14 states with a daily census of 17,000 active at-risk patients. Research and evaluation reported by Devereux staff found excellent outcomes over four years, with significant reductions in suicidal behaviors by patients and staff. The program has been featured by the American Psychiatric Association as a model for enhancing patient safety.

As a means to further public policy and advance the state of knowledge in preventing suicide we wish to focus now on a stressed segment of society: working people. Our approach to suicide prevention education and training includes efforts to prevent suicide among the employee’s family members, friends and colleagues.

Scope of the problem and the challenge
In June 2003 the University of Rochester’s Center for the Study and Prevention of Suicide held a national consensus conference in Washington DC on preventing suicide among men in their middle years (ages 25 to 54). In attendance were several major US corporations, leadership from the National Institutes of Health, the US Air Force, Employee Assistance Society of North America, National Institute for Occupational Safety and Health as well as researchers and representatives of the healthcare industry. Keynoters highlighted a stark and alarming fact: men in their middle years kill themselves at twice the baseline rate of other Americans. With few exceptions, these men are working for American institutions, companies and corporations.

With the exception of the US Air Force recent success in reducing suicide among airmen and women (from 16/100,000 to 9/100,000 lives lost to suicide – almost a 50% reduction -- over a four year period), few large organizations have viewed suicide as a preventable fatal outcome of untreated disorders of mood or substance abuse. Fewer still have viewed employee suicide as a direct, bottom line negative impact to the company’s investment in its human capital. Moreover, the link between untreated depression, substance abuse and suicide, and suicide and other forms of workplace violence have been ignored by most Employee Assistance Professionals contracted to provide educational and mental health services to their corporate clients.

The challenge now is to tackle suicide awareness and prevention education in the American workplace, and to directly and aggressively address and remediate those risk factors that lead suicide attempts and completions.

Pilot Project
The specific aim of this project is to implement the QPR Institute’s Suicide Risk Reduction program for healthcare organizations in one corporation with multiple work sites. The participating corporation will provide the venue for training. The central point of this project is to learn if the teaching of a one hour public health depression and suicide awareness message, together with a basic 3-step intervention skill set (QPR for Suicide Prevention) results in positive employee evaluations of the training, improved knowledge about suicide and its causes, and an increased likelihood of recognition, identification and referral of potentially depressed and suicidal persons to professional healthcare providers (the gatekeeper function). This will be accomplished by systematically educating and training employees with a web-enabled interactive CD-ROM that captures pre-post training survey data on knowledge and attitudes about depression and suicide, and perceived likelihood to intervene with a suicidal person (the educational component). Following training and program installation, additional brief focus group meetings with a limited number of staff will help determine:

At the end of the project, data will be analyzed to construct and publish a narrative description and cost-benefit business model for suicide prevention programming in the workplace.

Expectations of participating corporation

  1. Assist/consult in the introduction of a depression awareness and suicide prevention risk reduction program for employees.
  2. Participation in limited pilot testing of distance learning technology in advanced suicide awareness and prevention skill building for selected staff prior to full scale introduction of the program (optional).
  3. If one is available, provide access to its Employee Assistance Program vendor to allow the vendor to be trained in suicide risk assessment and management
  4. Agree to mandate for all employees, by policy, the completion of a 1-hour educational and awareness CD-ROM program on the nature of suicide, its causes and prevention, and to continue the program for a minimum of two years.

Participating research organizations
Corporation or business entity: to be named
The QPR Institute, Inc., Spokane, WA
Eastern Washington University, E. Clair Daniels Chair, College of Business and Public Administration
Washington State University, Department of Health Sciences Spokane, WA

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