John Bottomley, director of work-related grief support provider Creative Ministries Network, is leading a study to determine the effect of workers’ compensation on suicide rates among workers. It’s a follow up to a study his organisation conducted in 2002, instigated after a union official’s letter in the Age newspaper about work-related suicides.

“She had been concerned about the number of suicides that she felt had occurred in the finance sector as a result of restructuring in the mid- to late 1990s. Because [Creative Ministries Network] supports people who are bereaved after work-related deaths, I followed her up and we started working together to try to document the extent of that concern that she had.”

Their research into the public suicide records of the Victorian coronial database soon expanded to include the Victorian WorkCover authorities’ data on suicide deaths.

Collecting the data to analyse has proved anything but simple. “The WorkCover data didn’t seem to match what we were seeing in the coronial databases,” said Mr Bottomley, who hopes better suicide data collection will be one of the changes to emerge from the study.

“We were really interested to see whether people’s experience on WorkCover was in any way associated with their suicide and there’s just not enough reliable data in the material we’ve got from WorkCover to determine that one way or the other.”

“There does seem to be an association between long-term injury and increased stress and mental health issues,” said Mr Bottomley, who believes not enough is being done with such information.

There is no standardised way of collating information regarding work factors in suicides.

“The coroner’s information essentially depends on the investigation by the police, while WorkCover’s information comes from workers’ compensation claims – so we’re looking in this second study to clarify the data collection approaches used by WorkCover and the coroner, and then have a discussion with both agencies about whether we can get improved data collection in place to have better analysis of these sorts of deaths.”

Anyone involved in vocational rehabilitation, said Mr Bottomley, should be concerned about the lack of reliable data on the relationship between work injury and the potential for suicide. “It’s something that has significant social policy implications, and practice implications as well,” he said.

Mr Bottomley described the practical elements that may impact upon an ill or injured person’s suicide in three areas, based on the cases observed in research.

“One risk factor is personal disfigurement, where the person’s injury may have caused them the loss of a limb, facial disfigurement or burns.

“Secondly, severe and prolonged pain. There’s one case that we document in which the injury was eight years previous to the person’s suicide. Prolonged or chronic pain over a period of time can be a risk factor.

“The third is probably harder to quantify: stress associated with loss of feelings of self worth. That’s getting into the area of depression and feelings that life’s not worth living,” said Mr Bottomley.

Attitudes in the workplace can play a part in reducing these risk factors, he said.

“[Return to work coordinators] ought to be saying, this person’s mental health is at risk, and looking at whether they’ve got appropriate help – whether they’ve been to counselling, addressed pain management, and things that might relate to attitudes in the workplace,” for example, in relation to disfigurement.

The case manager should also be made aware of the employee’s concerns. Practical support will make the employee feel acceptable, and accepted, said Mr Bottomley. “One of the common things in work injury and mental health is that workmates often pull away from the ill or injured person, and their difficulties are compounded because they become isolated.

“The employer and the insurer should work to make sure that the person’s support network is sustained as much as possible, by finding ways to encourage them to be connected to activities that give them some sense of purpose; and if it’s not able to be in their old job then support through those transitions are really critical.”

Mr Bottomley gave an example of a woman who wasn’t given transitional support after a work injury left her unable to perform her previous role. “There’s a comment we have here from the husband of the woman who committed suicide, which is ‘her work was her life’. So the loss of her job was shattering, and it’s fairly sad I think that we don’t have systems to help people make these transitions.”

Mr Bottomley is receiving strong cooperation from the Victorian Coroner and from WorkCover in the study, and hopes the results will lead to improvements data collection shortcomings.

He believes improved data collection will drive policy surrounding work-related suicides. “At the moment, because the data is unreliable there’s not been enough serious policy attention given to the prevention of suicide for people with a work injury.”

“There’s some work around depression but I think that’s more generic. I’m not sure that it’s been linked in enough to work injury as a factor that can start the disintegration of a person’s sense of self,” he said.

Creative Ministries Network: (03) 9827 8322
www.cmn.unitingcare.org.au

National Helplines:
Lifeline (24 hours) 13 11 14
Kids Helpline (under 18 years of age) 1800 55 1800
Just Ask (rural mental health information) 1300 13 11 14
Mensline Australia (24 hours) 1300 78 99 78
SANE Helpline (mental illness information, support and referral) 1800 18 7263