Job Strain, Long Work Hours, and Suicidal Thoughts

September 13, 2018 by Sarah Mitchell, MPH, and BongKyoo Choi, ScD, MPH

September 9-15^th, 2018 is National Suicide Prevention week. Workplace suicide and mental health in general are often underrepresented in workplace health and safety discussions. However, globally, more than 300 million people suffer from depression, the leading cause of disability (WHO, 2017). In the US, the suicide mortality rate increased by 24% from 1999 to 2014, particularly among middle-age adults. The suicide mortality rate in US working populations has been also on the rise.

A recent study by Dr. BongKyoo Choi at University of California Irvine, Job Strain, Long Work Hours, and Suicidal Ideation in US Workers: A Longitudinal Study, addresses aspects of work that can impact suicidal ideation, or suicidal thoughts, in workers.

Currently, there are only a few longitudinal studies that examine chronic psychosocial work stressors related to attempted suicide or mortality in working populations (Milner et al 2018), and few control for family history. The purpose of the study was to investigate whether chronic psychosocial work stressors (job strain, supervisor and coworker support, job insecurity, job control, and work hours) are longitudinally associated with suicidal ideation in a middle-aged US working population, particularly after controlling for a family history of suicide. It is necessary to identify the work-related risk factors for suicidal thoughts to help prevent suicide among working populations.

The study used data from the National Survey of Midlife Development in the United States (MIDUS) II study (2004-2009), which examines the “roles of behavioral, psychological, and social factors in understanding age-related differences in physical and mental health.” Of the 582 study subjects, those who identified as experiencing some kind of suicidal thoughts answered the following question positively, “During the past week, how much you have felt or experienced thought about death or suicide? (Not at all, A little bit, Moderately, Quite a bit, or Extremely)” during the follow-up.

About 11% of the workers reported suicidal ideation at follow-up, while 3% of them reported moderate/severe suicidal ideation at follow-up. Results show that there are significantly positive associations of job strain (a combination of low job control and high job demands) and long work hours (> 40 hours per week) with moderate to severe suicidal ideation in a working population, controlling for age, marital status, other chronic work stressors, family history of suicide, and suicidal ideation at baseline. The odds for moderate to severe suicidal ideation were about four times greater in those with job strain or those who reported long work hours. This means that job strain and long work hours may be categorized as occupational risk factors for suicidal thoughts in working populations. These results indicate that job design interventions to improve working conditions may be an important strategy to prevent suicide in working populations.

Suicide prevention programs at the workplace are often focused on training and education for detecting those at high risk of suicide and connecting them with mental health services. This helps to address those already considering suicide but does not address the source of suicide ideation. This study suggests that creating and maintaining a healthy work organization should be an important strategy for the prevention of suicide in working populations.

While work is good for mental health, negative working conditions can cause harm to one’s physical and mental health (WHO 2018). There are many effective strategies that organizations can implement to promote better mental health in the workplace. The NORA Healthy Work Design and Well-being Cross-sector Council works with partners to improve the design of work, work environments, and management practices in order to advance worker safety, health, and well-being. For more information, check out resources below.

We would like to hear from you. How has your company taken steps to promote better mental health or implement suicide prevention programs? What challenges does your organization face in implementing programs that promote better mental health in the workplace? Please share them in the comment sections below.

Sarah Mitchell, MPH, is an ORISE Fellow working in Research Translation and Communication in the NIOSH Office for Total Worker Health^®.

BongKyoo Choi, ScD MPH, is an Assistant Professor, at the University of California, Irvine, School of Medicine, Center for Occupational and Environmental Health, and Environmental Health Sciences Graduate Program and Program in Public Health. He is also a member of the NORA Healthy Work Design and Well-being Cross-Sector Council.

This research was presented at the 2^nd International Symposium to Advance Total Worker Health® in May, 2018. For more information on the symposium and the other research presented click here: www.twhsymposium.org.

References:

Choi B. Job strain, long work hours, and suicidal ideation in US workers: a longitudinal study. Int Arch Occup Environ Health.2018; 91 (7): 865-875. https://doi.org/10.1007/s00420-018-1330-7

McIntosh WL, Spies E, Stone DM, Lokey CN, Trudeau AT, Bartholow B. Suicide Rates by Occupational Group — 17 States, 2012. MMWR Morb Mortal Wkly Rep 2016;65:641–645. DOI: http://dx.doi.org/10.15585/mmwr.mm6525a1.

Milner A, Witt K, LaMontagne AD, Niedhammer I. Psychosocial job stressors and suicidality: a meta-analysis and systematic review. Occup Environ Med. 2018;75(4):245-253 https ://doi.org/10.1136/oemed -2017-104531

WHO 2018 <http://www.who.int/mental_health/in_the_workplace/en/>