Identifying Predictors of Suicide Ideation Among Human Service Workers: An Exploratory Analysis

Annually, around 45,000 individuals die by suicide and rates continue to rise in the US. Notably, about 70% of deaths by suicide occur among the working-age (age 15-64) population. Research has examined individual and workplace predictors of suicidality among the working-age population. Evidence has found poor working conditions, such as occupational climate or job demands, across various occupations can contribute to suicidality. Furthermore, high-risk helping occupations such as EMTs, have an increased rate of death by suicide. However, limited literature specifically examines suicidality among human service providers. The current study examines several predictors of suicide ideation among human service workers.

Methods

The current study analyzed cross-sectional data from an ongoing longitudinal study, the Florida Study of Professionals for Safe Families (n=1500), which follows newly-hired child welfare workers to examine multiple dimensions of their job. Data were taken from wave 1 (baseline) and wave 4 (18-months) to assess several measures of workers’ experiences and their impact on suicide ideation. The sample is a cohort of 915 respondents, including child welfare workers and those who left child welfare but were still employed in a human service field. Wave 4 included a depression screening tool - the PHQ-9.  The final question assesses the extent of suicide ideation in the past two weeks (“thoughts that you would be better off dead or hurting yourself”; none, some days, about half the days, and nearly every day). Suicide ideation was dichotomized (none/all others). Continuous protective factors included three types of coping strategies (avoidance, task, and emotional), and three types of social support (co-worker, family/friends, and supervisor).  Continuous risk factors included psychological distress, entrapment (the feeling of negative situations being inescapable), burnout, and secondary traumatic stress. Having a family history of maltreatment (yes/no) was also included. Binary logistic regression was used for this analysis.

Results

The majority of the sample identified as female (86%), non-Hispanic White (45%) or non-Hispanic Black (34%) and fell within the age range of 20-67 (M=31.6). About 10% responded positively to suicide ideation, a higher rate than the national average. Expected findings included a positive relationship between suicide ideation and entrapment (OR=1.11, p <.01), psychological distress (OR=1.11, p=.01), and task-oriented coping (OR=.0.90, p=.04). Unexpectedly, while work-related burnout was significant (OR=.086, p=0.04), the relationship was negative, and more research is needed to understand this finding further.

Implications

Suicide ideation among human service workers is an important issue given responsibilities workers have to assist vulnerable populations.  This study found that human service workers are experiencing more than double the rates of suicide ideation compared to the national average (about 4%). Workers experiencing significant workplace distress reported a higher risk of suicidality, indicating more services are needed to assist workers and attention to attenuating work stress is essential. Workplace supports such as Employee Assistance Programs, must provide education on self-care, well-being, and risk and protective factors of suicide/suicide ideation to frontline workers and their supervisors. Future research should explore additional strategies organizations can implement to create a culture of self-care and enhance worker mental health well-being.