Work-related suicide is a significant yet underexamined issue, but a new WorkSafe report aims to shed light on its prevalence
In three sections, the report looks at how work factors may contribute to suicidality. It considers the questions: What is work-related suicide? What is the prevalence and nature of work-related suicide in New Zealand? And finally, What actions might help us understand and respond to work-related suicide?
Section 1: Understanding Work-Related Suicide
Section 1 of this report provides a literature review to clarify what is known about work-related suicide. The review reveals that while there is a considerable amount of research examining general suicide rates within or across particular industries, there is a clear lack of research into work-related suicide. In the suicide literature more broadly, studies that look into the relationship between work and suicide typically focus on the absence of work (that is, unemployment) as a risk factor, while failing to consider aspects of work that may increase suicide risk.
There are, however, a small number of studies examining the role that work factors may play in suicide. These studies do not appear to use an explicit definition of work-related suicide or agreed-upon criteria. Instead, each study generates its own set of criteria, based on slightly different assumptions about what work-related suicide is. As a result, findings from these studies cannot easily be compared or collated. Internationally, the lack of research is accompanied by very limited recognition of work-related suicide as a social and legal issue. Official data collection regarding such suicides is also scarce. There appear to be several reasons for this lack of recognition, including: the conceptual ambiguity of work-related suicide; the causal complexity of suicidality; and the current emphasis on mental illness in explanations of suicide.
The review then discusses work factors that have been identified in the literature as potentially elevating suicide risk. Perhaps the most widely commented on connection between work and suicide relates to situations where a person’s work facilitates their access to and/or familiarity with lethal means.
The literature also considers socioeconomic factors – such as low job status, low education levels, and low income – and how these appear to be associated with particular psychosocial stressors, such as job insecurity and low job control. Less explored, is the question of whether jobs that are considered ‘high status’ are also associated with unique psychosocial stressors that may contribute to suicidality.
Work-related psychosocial stressors are therefore seen as an important type of work factor. The review summarises the specific work stressors that appear most commonly in the literature. Presently, evidence for a causal relationship between work-related psychosocial stressors and suicide appears inconclusive. This inconclusive evidence should be viewed in the context of various methodological challenges, including: problematic research designs, issues with data quality, and the statistical rarity of suicide.
Where work factors more broadly do contribute to suicidality, the impact they have will not be uniform. The review discusses the elements that appear to contribute to variability in which factors are impactful and the extent of this impact. These elements include the different interpretations and resources of individual workers, as well as the gender and career stage of workers. Findings in some studies also suggest that different work stressors appear to be more highly correlated with different forms of suicidality (that is, certain work stressors may be correlated more with suicidal thoughts, while others may have a stronger association with suicide attempts or suicides).
Finally, the review looks at existing efforts to conceptualise the relationship between work and suicide. These efforts are currently limited, which not only impedes our understanding of work-related suicide, but may also contribute to the inconclusive findings in some empirical studies. The attempts that have been made include the application of models of work stress (demand-control model, effort-reward model, conservation of resources theory, job characteristics model, and the organisational justice model), or the application of general theories of suicide (the interpersonal theory of suicide, psychache theory, and Émile Durkheim’s sociological theory of suicide) to help explain the means by which work-related factors are thought to influence suicidality.
Section 2: Occurrence of Work-Related Suicide in New Zealand
Section 2 of this report examines the occurrence of work-related suicide in New Zealand, with findings from a study of coronial data. This study undertook a review and qualitative content analysis of all available coroners’ findings for suicides that occurred in New Zealand between 2017 and 2021.
In this study, a suicide was considered work-related if either of the following two criteria were met:
1. work-related stressors played a significant role in the person’s suicidality, and/or
2. the means of suicide were distinctly related to the deceased person’s work.
Using these criteria, the study found that of the 1678 applicable cases of suicide that were reviewed, there were 197 work-related suicides. Such suicides thus represent 11.7% of all suicides that occurred in New Zealand between 2017 and 2021 (for which a coroner’s finding was available in mid-August 2022).
For all suicides that involved at least one work factor, this study assessed the significance of these factors by contextualising them within the wider circumstance of the case. This contextualisation process enabled the further finding that of the 1,678 applicable cases, 17 (1.0%) were cases in which work factors appeared to play a predominant role and were central to explaining the suicide. In the remaining 180 work-related suicides, work factors appeared to play a notable role and were relevant to explaining the suicide. Finally, of the applicable cases, there were 49 (2.9%) in which work factors were present but appeared to play a non-significant role, such that they were not clearly relevant to explaining the suicide. These 49 cases did not meet the criteria above and were not included as work-related suicides.
Section 2 also presents basic demographic, geographic, and industry-specific data associated with these work-related suicides. Although the case numbers are too small for reliable inferences, these findings are of interest and may point to areas for future research. Of the 197 people who died by work-related suicide, 162 (82.2%) were male and 35 (17.8%) were female. Their ethnicities were: New Zealand European, 141 (71.6%); Māori, 28 (14.2%); Asian, 9 (4.6%); and all other ethnicities, 19 (9.6%). The mean age of those who died, at the time of incident, was 45.4 years old.
The agriculture, forestry, and fishing industry (and, more specifically, the occupation ‘farmer/farmworker’) was particularly prominent in these findings. This is partly due to the prevalence of work-related means among suicides by farmers. However, this industry still appears overrepresented even when only cases involving work stressors are included. The study also found that of the 197 cases of work-related suicide, 38 (19.3%) were by people who were not employed at the time of incident. This finding points to the ability of both work stressors and work-related means to continue having an effect after a person’s employment has ended.
Section 2 also offers insights regarding the three categories of work factors: the presence of work stressors, the use of work-related means, and the occurrence of a suicide in the workplace of the deceased. All three work factors are defined, with elaboration on the types of stressors, means, and locations this included. Explanations are also provided as to how the study contextualised the significance of work factors, and why the criterion of a suicide in the workplace was considered insufficient, by itself, for classifying a suicide as work-related. The most prominent work stressors, means, and location types are presented, along with broader themes in these work factors, and points of interest that warrant further research.
By way of a summary, of the 1678 suicides that were reviewed in this study, 170 (10.1%) involved significant work-related stressors; 43 (2.6%) involved work-related means; and 41 (2.4%) occurred in the workplace of the deceased.
Themes derived from the prominent work stressors included: ‘work burden’, ‘conflict and mistreatment’, and ‘undermined competence and security’. Prominent forms of work-related means included: the use of firearms by farmers, or by members of the police or armed forces; and certain instances of the use of pharmaceutical drugs by health professionals.
Finally, although the occurrence of a suicide in the workplace of the deceased was considered insufficient, by itself, for classifying a suicide as work-related, there appeared to be a high correlation between these workplace suicides and the presence of work stressors. This suggests that the occurrence of a suicide in the workplace can serve as a ‘red flag’ for a possible work-related suicide.
Section 3: Recommendations
Section 3 of this report provides recommendations that arise from the findings of Sections 1 and 2. These recommendations are intended to support consideration of responses to work-related suicide, including by a workplace health and safety regulator.
The first recommendation is to adopt an explicit definition and clear criteria for work-related suicide. Specifically, the report suggests that a work-related suicide be defined as a suicide in which work-related factors significantly contributed to the suicidality of the deceased. This definition should be accompanied by clear criteria. Section 3 points to (and recommends the retention of) the distinction between a potential work-related suicide and an actual work-related suicide. The criteria of an actual work-related suicide were presented on the previous page. In contrast, a potential work-related suicide is one that involves any of the following three criteria:
1. the suicide occurred in the deceased person’s workplace
2. the means of suicide appear to be related to the deceased person’s work, and/or
3. there is circumstantial evidence (such as a suicide note or witness statement) indicating that work-related stressors were a contributing factor.
As the criteria for a potential work-related suicide do not require a detailed assessment, they enable the immediate identification of suicides that appear to involve work factors. The criteria used to determine an actual work-related suicide then narrow this down to cases in which the role of work factors has been confirmed and appears significant in explaining the person’s suicidality.
The second recommendation is for the routine assessment of potential work-related suicides. It is suggested that several aspects of the research methodology described in Section 2 could be adopted or adapted by an assessing agency, such as WorkSafe New Zealand, to support robust findings. Finally, this recommendation includes exploring the source of notifications of potential work-related suicides, which might include government agencies as well as businesses.
Thirdly, the report discusses how the routine assessment of potential work-related suicides should be accompanied by the careful collection and dissemination of findings from these assessments. This may support improvements in data quality, and thereby support wider efforts by coroners, researchers, and policymakers to prevent work-related suicide. This could include keeping an official record of work-related suicides to enable monitoring of the ongoing prevalence of these deaths.
Finally, Section 3 of this report outlines several recommendations for future research. Improved understandings of work-related suicide – achieved through both further research and more frequent workplace investigations – would likely facilitate greater recognition of work-related suicide and allow for the development of tailored suicide prevention initiatives, to reduce the occurrence of these deaths.
