The Suicide and Work study has created by work-related grief support provider Creative Ministries Network. The study outlines some significant insights into the factors leading to both attempted and completed suicides of people who were injured at work. The impact of suicide in Australia is socially and financially immense, yet still very little is understood about its causes - especially when work is involved.

The study, supported by law firm Holding Redlich, follows on from a previous study conducted in 2002. This was one of the first Australian studies to suggest the possibility of a link between work – especially work-related injury – and suicide.

Director John Bottomley told RTWMatters last year, “We were really interested to see whether peoples’ 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.”

The Suicide and Work report addresses a glaring hole in Australia’s understanding of the relationship between work and suicide, asserting that, “Work factors can contribute to both family relationship breakdowns and mental illness prior to the onset of suicidal thoughts, but these causal factors have largely been ignored by traditional OHS approaches, and the traditional medical model.”

On what limited general research into suicide has been done in Australia, authors note a distinct lack of recognition of the relationship between work and suicide.

“Even the recent Senate Inquiry “The Hidden Toll: Suicide in Australia” singularly fails to give due attention to the fact that what happens to people in their working lives can be relevant to Australia’s terrible suicide toll”

The Suicide and Work study supports the burgeoning opinion of RTW coordinators, treaters and advocates that there is a real link between long-term injury and mental illness – which is ultimately increasing injured workers’ risk of attempted and completed suicide.

The research

The study examined 58 Victorian WorkCover Authority records of suicide and attempted suicide related claims (submitted by the individual or their surviving families) from 1985-86 to 2006-07.

Of the 21 suicide claims for workers’ compensation, 10 had no previous WorkCover claim, while 11 had at least one WorkCover claim prior to the death claim for workers’ compensation.

The study compared this data with Victorian Coronial findings data for the 21 completed suicides, with a view to gaining insight into the role work factors played in these deaths.

The findings

Neither the Victorian WorkCover Authority’s, nor the Victorian Coroner’s databases were set up for facilitating and informing social research such as that on the factors leading to suicide.

By painstakingly comparing the two sets of data, however, researchers identified that mental injury, stress or psychological injury was the primary causes of suicide. Though they describe this finding in itself as “unsurprising”, researchers go on to state why this is central to understanding the impact workers’ compensation can have on injured workers mental health.

Of the eleven workers who committed suicide and who had at least one WorkCover claim prior to their death, almost two-thirds first appeared on the WorkCover system presenting with a physical affliction. What this means is that their physical injury was the precursor to their mental injury, which was in turn the precursor to their suicide.

Examining the factors involved in this transition, researchers concluded that the subsequent mental injury may have been caused by one or combinations of physical injury, the subsequent loss of economic security, social connection and meaning for their life, or their experience on workers’ compensation.

This last point raises some familiar questions about the detrimental impact workers’ compensation and return to work systems have on injured workers. Specific risk factors for suicide for injured workers on workers’ compensation identified by the study include:

• The length of time on compensation;
• The vulnerability of younger workers;
• The emergence of psychological symptoms of mental illness for those initially presenting with physical injury; and
• The possibility that workers from blue-collar occupations may be more at risk of suicide than other occupations.

Perhaps most significantly - especially to those actively involved in return to work - was the finding of a correlation between the length of time on compensation and an increased probability of suicide. Researchers point out that while the data cannot definitively identify what it is about the length of time on compensation that increases injured workers’ risk of suicide, it is likely that this is secondary in importance to what actually occurs to the person during this time.

Hopefully this finding alone will bolster return to work advocacy - by those who already understand the myriad factors underpinning the importance of proper treatment and prompt return to work.

Making the case

Suicide and Work concludes with an argument that improvement of data collection on work factors in suicide will contribute to suicide prevention, calling on GPs, police, WorkCover investigators and the Coronial system to oversee this process. Without this occurring, the authors warn it will be difficult to challenge conventional wisdom that tends to blame the victim by locating the problem of suicidality in the individual’s mental state.

The authors stressed the importance of recognising the potential for physical injury alone to precipitate mental illness and suicide, recommending that we “critically evaluate the tendency to psychologise and medicalise the causes of suicide.”

The study maintains that while it was able to identify some factors that could be used to help prevent work-related suicides, inconsistencies between different databases restricted research conclusions that would ultimately inform social policy to remedy the current situation.

Until such a move is made in that direction, it is likely that we will continue to struggle convincing employers, treaters and legislators of the tangible link between work-related injury and the increased risk of suicide.