Covid19, Unemployment and Suicide – a Very Unholy Trinity

If you don’t mind, please indulge me while I kick off with an introduction – I suspect that most readers have never heard of me (@BDLDKevin) or my organisation before.

My name is Kevin Moore, and I’m one half of Big Dog Little Dog (I’m the big one in case you were wondering!) – a two-man mental health training company with a background in the employment and skills sector.

As I’m sure that you can imagine, we’ve been a bit busy over the last 6 months…….

Our 2020 has largely been spent delivering workshops and courses related to Covid19 and its mental health consequences and, back in the days when we thought that Corona was just a brand of lager, our major focus was on mental health and unemployment.

It doesn’t take a genius to understand the many interconnectivities between the virus / lockdown and being without work.

• Both drive social isolation – an act that is rarely beneficial to our mental health.
• Both have caused financial hardship, especially when combined with each other.
• Both carry the risk of developing a long-lasting pessimism about the future.
• And both are significant contributors to exacerbating an existing mental health disorder.

And the future doesn’t look too bright in either area – now that we’re officially in recession, and with the Job Retention Scheme winding down, it would take a miracle for unemployment to not reach record levels in our lifetimes.

In terms of Covid19, current estimates are that, even if a cure was found tomorrow, the associated mental ill health would last for another 2-3 years. Neither issue is going away anytime soon.

But the area of commonality that troubles us the most right now is both subjects’ links to suicide.

Now I can be stat-driven on describing the links between unemployment and suicide, but the Covid19 link is one that I’m just going to have to apply some fairly safe assumptions around.

In these unprecedented times, we won’t have any reliable data on this year’s known suicides until September 2021, when the ONS publish the annual, verified, statistics.

Firstly, what do we know about the links between unemployment and suicide?

An important point to note, and this might sound odd, is that unemployment does not, in itself, cause suicide. What it does is introduce a multitude of suicide risk factors into someone’s life, that may or may not lead to that person considering death as an option to deal with their circumstances.

If we were together in a training room right now, and I asked you what suicide risk factors unemployment can bring, I’m sure that you’d have a multitude of answers.

In fact, we asked that very question when delivering a webinar in August, and here are the answers that the audience gave (typos are theirs, not mine!):

Unemployment & Suicide – A Global Issue From a UK Perspective Webinar

https://www.youtube.com/watch?v=sJKhmAtVRGc

Unemployment sucks

It creates an environment that suicidal thoughts can feast on, developing practical, psychological and even physical stressors that can contribute to someone taking their own life. So it’s really encouraging to see Welfare-to-Work services these days focussing as much on addressing life stressors as on actually getting a job.

And that’s incredibly important – just look at some of the historical statistics around the links between unemployment and suicide:

• One in FIVE suicides worldwide is linked to unemployment (World Health Organisation)
• Almost TWO THIRDS (66.4%) of customers claiming health-related unemployment benefits have had suicidal thoughts (Adult Psychiatric Morbidity Survey 2014)
• People claiming health-related unemployment benefits are over SIX times more likely to attempt suicide than the general population (APMS 2014)

So then we consider Covid19’s impact on suicide rates and the assumptions that we have to make. Firstly, it’s again important to note that it does not directly cause suicide – and that’s a really important factor to accept, so that we can prepare ourselves for the long-term mental health impact of the virus and lockdown, whether a vaccine is found or not. But, like unemployment, Covid19 and/or lockdown have introduced a significant range of suicide risk factors into the lives of most, if not all, of us.

The list is a long one, but those that I suspect will have the biggest impact are:

• Social isolation (lockdown) and the potential impact that it’s had on relationships within and outside of the home.
• Worsening of pre-existing mental health disorders.
• Increase in destructive coping strategies during isolation, including domestic violence, substance misuse and self-harm.
• Sustained anxieties about unlocking, the virus, recession and the future overall.
• Stunted social skills and a potential resistance to reintegrating with society.
• Worsening of physical health conditions due to recent unavailability of effective treatment.
• Increased use of, and potential dependency on, the internet – which is home to some really destructive negative peer pressure.

Unfortunately, the government’s key strategy for identifying and addressing increased suicide during/post-Covid is to monitor suicide and self-harm rates and responding accordingly.

I say “unfortunately” as there are two flaws with the strategy of linking suicide and self-harm:

1. Firstly, although there’s a strong link between the two (those who harm themselves in the long term are 49 times more likely to die by suicide), it’s not an absolute, two-way link. Not all of those who self-harm attempt suicide, and by no means are all suicides prefaced with self-harming behaviour.
2. Secondly, it seems to me to be an incredibly reactive response. It requires self-harm to happen before action is taken to reduce suicide – surely the only acceptable approach is a proactive one?

As strong as the link to self-harm is, there are 3 risk factors that I would suggest are monitored – evidence suggests that one or more are present in the majority of suicides and all three are, if we take the effort to look, detectable in our staff’s and learners’ lives.

1. Mental ill health is present in most, but not all, suicides. Depression is by far the most common disorder, but any disorder can feel insufferable.
2. Substance misuse has a strong link through a) its often depressive effects and b) the lowering of inhibitions – making someone far more likely to act on suicidal thoughts.
3. Previous history/exposure: Someone who has attempted suicide before is a higher risk than someone who never has. Similarly, someone who has experienced a loss through suicide may find the subject more normalised and therefore less alien than someone who hasn’t.

Be Alert

So my key challenge to all readers as a result of this piece is to be alert. Alert to the myriad effects of unemployment that may be having a practical and/or psychological impact on your learners’ lives, and also alert to signs of any of the above in learners and colleagues alike.

It’s therefore paramount that we’re watching for signs of people struggling, observant for signs of substance misuse and asking people that we’re concerned about whether they’ve been exposed to suicide before. And don’t believe that that last circumstance is rare.

With over 6,500 known suicides in this country each year, and research suggesting that every suicide negatively impacts 115 people, we’re talking of nearly ¾ million people being affected by suicide every year.

If you want your organisation to be better equipped to deal with the issue of suicide, here’s a couple of suggestions:

1. Firstly, have a watch of the webinar above – it’s specifically on the subject of suicide and unemployment. It’s also really worth watching its sequel (see below), which is specifically around organisational readiness to combat and deal with suicide. Although it’s aimed at the Welfare to Work sector, the learning is instantly transferable to the learning and skills sector.
2. Secondly, as per the second webinar, please look into your policies, processes, staff competences and culture around the subject of suicide. Policies needn’t be complex, and there is a range of training options to equip everyone with the knowledge and skills to be able to ask people whether they’re contemplating suicide. The Ofqual-regulated qualifications that we developed with NCFE, LearnBox and AELP, and their associated courses, were launched on 10^th September this year – more details can be found here.
3. Lastly, look after yourselves please. Suicide does not discriminate, and it’s vital that we’re regularly checking in with ourselves and seeking support if necessary. If you need or want to speak to someone about how you’re feeling, the Samaritans (116 123) are a wonderful, highly available service.