Understanding attitudes to suicide in FIFO workers

What's the issue?

Suicide is a leading cause of death globally, with men dying by suicide at higher rates than women. There is increasing interest in conducting suicide prevention research within workplaces that employ a high proportion of men including mining and construction. Previous research has shown higher rates of suicide in these industries, which is thought to be driven by low levels of help-seeking behaviours in men, coupled with negative stigma surrounding mental health and suicide, and exposure to unique lifestyle stresses associated with mining and construction.

Many mining and construction workers are subject to fly-in/fly-out (FIFO) schedules. FIFO work can place individuals in a state of isolation, with an absence of regular and trusted social networks, lack of autonomy and long shift hours.

It is estimated that the prevalence of suicide amongst male mining workers is likely to be 25 per 100,000.¹ Despite the high rates of suicide and exposure to known risk factors, there is limited suicide research on FIFO workers in the mining and construction industry. The authors of this paper aimed to gain an understanding of the attitudes towards suicide, help-seeking and help-offering behaviours for suicide prevention among this group

What was done?

The researchers used an online, self-reported survey to gain an understanding of the attitudes towards suicide, help-seeking and help-offering of those working in the FIFO industry. The survey questions related to the following key research questions:

1. What are FIFO workers’ attitudes towards suicide?
2. What stigmatised beliefs may hinder FIFO workers from seeking help if they had suicidal thoughts?
3. What stigmatised beliefs might hinder FIFO workers from offering help to a colleague they suspect of having suicidal thoughts?

Survey participants were recruited between 13 June and 14 July 2024. Convenience sampling was used to recruit participants who self-identified as current FIFO workers in Western Australia via a QR code and hyperlink that took them to the survey page. The survey QR code link was shared via social media (LinkedIn and Facebook), as well as news alerts from the Western Australia Department of Energy, Mines, Industry Regulation and Safety (DEMIRS).

A cross-sectional qualitative study design was used to get a snapshot of attitudes towards suicide and help-seeking. The survey questions included close-ended questions to capture participants' demographic information, coupled with seven open-ended questions about suicide and attitudes to suicide.

Researchers coded the survey data and performed a thematic analysis.

What was found?

A total of 138 (n = 138) FIFO workers participated in the study, of which 101 (73%) were males, 37 (27%) females, and none identified as non-binary, prefer not to disclose, or self-described. Participant age ranged from 23 to 76 years, with a median age of 39.

Of the 138 participants, 96 (70%) identified as having lived or is currently living with experience of suicide. There were no questions measuring if their lived experience was related to their own suicide experience, bereavement or supporting another person with suicidal behaviours.

Analysis of the survey data found four key themes related to participants attitude towards suicide. These themes were:

• Fear of negative consequences for employment
• Lack of trust in leadership and workplace culture
• Perceived inability to respond to suicidal disclosure, and
• Fear of negative reactions.

Fear of negative consequences for employment

Study participants identified that the main barrier for them to disclose suicidal thoughts or behaviours was that it would negatively impact on their employment.

Study participants expressed their concern that they would lose their job because of their suicidality, or that disclosure would lead to fewer opportunities for career progression.

Potential job loss can contribute to financial difficulties, further exacerbating stress for an individual.

Lack of trust in leadership and workplace culture

Study participants felt that industry leaders did not have the adequate skills or empathy to respond to an employee’s suicidal disclosure. Participants were concerned about a lack of confidentially about their mental health, and suicidal thoughts and behaviours by organisational leaders. Some organisations have mandatory processes requiring leaders to report and escalate employee’s risk of suicide to upper management, which can change employment conditions for workers deemed unfit for work.

Study participants felt that workplace culture prevented them from seeking help and sharing suicidal concerns with colleagues. ‘Hyper-masculinity’ was identified by several participants as a barrier to help-seeking. The feared they would be treated differently and not taken seriously by colleagues if they expressed their suicidal concerns.

Perceived inability to respond to suicidal disclosure

Participants felt they lacked the knowledge and skills to respond to someone experiencing suicidal distress. Results showed there was a fear that they would say or do something wrong, and that most participants felt like they wanted to help someone, but didn’t feel confident to know how. Participants felt guilt related to not being able to say the right things and prevent a suicide death.

Fear of negative reactions

Participants expressed hesitation to ask someone if they were experiencing suicidal thoughts and behaviours in the fear they would be dismissed and rejected. They also feared becoming responsible from someone’s recovery should they disclose suicidal thoughts and behaviours.

Some participants feared being met with violence or hostility should they ask someone about their suicidal concerns.

Overall, the results of this study showed a high level of empathy towards people experiencing suicidal thoughts and behaviours, which differs from previous research finding that masculine work culture was a barrier for empathy. The researchers note that the results from this study may be due to the high number of participants who reported a lived experience of suicide.

The themes identified in this study align with the Interpersonal Theory of Suicide, with reluctance to share suicidal concerns due to wanting to belong and be accepted by colleagues.²

Why are the findings important?

These findings highlight the reluctance of FIFO workers to disclose suicidal thoughts and behaviours to both organisational leaders and colleagues due to concerns of confidentiality, rejection from colleagues, and negative impacts on employment. Workplace initiatives such as the Employee Assistance Program (EAP) may have limited value in FIFO industries due to concerns of breaching confidentiality and consequences for employment.

Programs that increase the knowledge and skills of employees and organisational leaders to respond to suicide may help support the breakdown of stigma and encourage help-seeking behaviours.

There is an opportunity for mining and construction industries to re-define and shift organisational processes to encourage and support help-seeking behaviours without ramifications for the safety of all employees and the prevention of suicide.