Office Hours Recap: How to use SafeSide Framework if you don't have direct access to the person at risk

A colleague working in an EAP (Employee Assistance Program) posed this situation: a supervisor is providing performance feedback to an employee. They become distressed and suicide concerns arise - so they call EAP. How can the SafeSide Framework guide an EAP clinician in this situation?

This led to a great discussion - though worded specific to this situation, these suggestions could also be helpful in phone triage or intake situations.

We started by acknowledging that in this situation there are two people needing help and support:

1. the person at risk
2. the supervisor

To achieve a good outcome, you’ll need to support both. We discussed these strategies in first connecting with the supervisor:

• Be the coach. “I am in this with you.” Establish that you will walk them through this process.
• Instil confidence. You can assure the manager that you have a framework for how to approach these situations.
• Walk them through the plan first. Highlights include:
  • (Connect) We’re going to need to ask directly about suicide - ideally, I can talk to the person and do it, but if not I’ll help you do it.
  • (Assess) Then we’ll find out a bit more about their supports - this is what we’ll need to make a plan with them.
  • (Respond) Next, we’ll work with the person to make a plan next steps and connect to resources that can provide support.
  • (Extend) Last, we’ll explore follow-up options - ways to extend our support beyond today.

Then we walked through the framework:

Connect

• Ask: You might say something like this to the supervisor: “ We cannot have this concern about suicide without knowing if they are thinking about it, so we need to ask if they are thinking about suicide.  Let’s figure out how we’re going to do that.”

If the person at-risk will talk with you directly, then you can ask them over the phone. Otherwise, you’ll need to support the supervisor in asking. 
Remind the supervisor that no matter who does the asking, you’re working together from a framework to guide the next steps - that can help reduce the anxiety common when asking about suicide.

• Collaborate: Consider what the person’s goal is and how you and the supervisor could collaborate with them around that goal. You or the supervisor might say something like:  “Thank you for your courage in sharing with me how you are feeling. We can work together to get you feeling better and figure out the next steps from here.”
• Commit: Convey a commitment to this individual, extending beyond their employment with the organisation - to their feeling better as a person.
  • “We are committed to working with you and supporting you to feeling better and getting through this.”
  • Encourage the manager to commit as well - can they say that they will check in, follow up and provide support.
  • Commit to support the supervisor: follow up and provide support. For the manager/HR representative making the concerned call, this is an incredibly high-stress situation; they are in tremendous emotional distress themselves, and so there is almost a dual-path in connecting with both the person of concern and the person intervening. Making sure that the person intervening is also okay is important when addressing potentially triggering situations like these when working to create a safe workplace.

Assess

Tony Pisani suggested in this circumstance if he could only know two things, this is what he would choose:

1. Are they actively thinking about suicide?
2. Who do you have that you can trust outside of work? “The support of family and friends can be really helpful in these situations. Who would you typically talk to in these situations? Would you be willing to contact them now to get some support?”

Respond

The goal here is to transition from talking with the supervisor to engaging directly with the person at risk to create a plan. In this situation, we imagined the person was not willing to talk directly to the EAP counsellor to this point so we honed in on widening the options.

• You might say to the supervisor, “Let’s share with the person different ways I can be involved in supporting them.”
• Would the individual be willing to speak to you individually?
• Would they be willing to schedule a crisis EAP appointment? If so, how about at X time and date?
• Offer one-way communication – would the individual be willing to listen to the counsellor speak without feeling pressured to respond until they are ready?
• Would they be open to receiving a non-demand caring contact, like a written note or email?
• Can the individual receive an email or text with a crisis line that you can use tonight if needed?
•  Can the individual who is with you call a supportive person, family member, or friend to stay with you?

Extend

Consider how to extend the connection with the person at risk and the supervisor by 1) following up with the person at risk in whatever way they were willing to engage and 2) inviting follow-up with the supervisor to provide support to them as well.

Note: This is one of the recaps from our monthly Office Hours sessions where SafeSide members can ask questions and share their experiences. Members also have access to Community of Practice with the full library of recaps, newsletters and resources.