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Levelling Up Safety by Embracing Total Wellness at Denver Fire Department with Manuel Almaguer

Levelling up safety by embracing total wellness at Denver fire department



“At that time, we had focused so much on line of duty deaths, but what we did not know is that suicides were starting to outpace line of duty deaths in the fire service.” Manuel Almaguer remembers back to 2013 when the Denver Fire Department began to roll out training with an intentional focus on discussing stressors, risk factors, and ways to take care of themselves and each other in public safety. Tune in as Manuel discusses steps the Denver Fire Department has implemented through the years to beat the stigma, build trust through vulnerability, and prioritize peer support to embrace total wellness throughout the fire department.


Real leaders leave a legacy. They capture the hearts and minds of their teams. Their origin story puts the safety and wellbeing of their people first. Great companies ubiquitously have safe yet productive operations. For those companies, safety is an investment, not a cost. For the C-Suite, it’s a real topic of daily focus. This is The Safety Guru with your host, Eric Michrowski, a globally recognized ops and safety guru, public speaker and author. Are you ready to leave a safety legacy? Your legacy success story begins now.

Hi, and welcome to the Safety Guru. Today I’m very excited to have with me Manuel Almaguer. He’s the assistant Chief with the Denver Fire, 20-year veteran champion of mental health and we’re here to talk about some incredibly powerful actions that he’s taken. He’s driven within Denver Fire to bring the topic of mental health to the forefront. So many really excited to have you with me today.

Hey. Good morning, Eric. It’s my pleasure and looking forward to this conversation for quite some time. Thank you.

Excellent. So many your story has been shared in many different forms that I’ve heard. In terms of the work you’ve done in Denver Fire, maybe let’s start a little bit about what got you inspired to do some very powerful things which we’ll get to very soon around mental health within Denver Fire.

That’s great. It’s a great intro. And my background before I came into Denver Fire Department was in psychiatric settings. So, I was a psychiatric registered nurse and I worked in institutional settings with the developmentally disabled as well as those with some severe mental illness concerns that would require the institutional setting. So, I’d worked in that setting for eleven years and then I went into the career change with Denver Fire and really thought, okay, I pretty much have seen what I’m going to see in life and there’s really nothing that’s going to be shocking to me or something that’s going to as I thought would be traumatic. So, this was in the year 2000 and then I started to see trends and people that I had worked with and people who had retired from the fire service and taking their own lives. But where it really impacted me, and a few others was in 2013 when there was a suicide of one of our respected captains in the Democratic Department and just a man that many of us kind of looked up to as a mentor. And you have to keep this perspective when you come into public safety and specifically the fire service and you always think of somebody who’s stoic, somebody who doesn’t have any issues personally, somebody who’s just kind of that man’s, man, firefighter, firefighter.

He just never really looked deep into the layer of anything that could be preoccupying them in any way. So, this individual took their life in 2013 and it crippled a handful of us. And at the time it was with an employee group called Firefighters Incorporated for Racial Equality and maybe on the executive board worked with this individual in the firehouse. So, what was so interesting about this is that at that time, we had just started to get at the forefront of suicide in the fire service. And at that time, Denver fire collaborated with the National Pawn Firefighters Foundation. We were focusing on the Life Safety Initiative, which is mental health. So, we started to roll out some training. It was very basic training. It was called stress first aid. So, at that time was the very first introduction that I could recall in the fire service, where we started talking about stressors risk factors and ways to take care of yourself and each other. But we were influenced in all of this. We were just trying to get the message out. Well, while we were doing this, right under our nose is when the suicide of the captain occurred.

So, at that time, we knew we had to do something that had a little bit more teeth to it, that was more sustainable, and actually would capture the attention of the importance of this pattern that was starting to go on in the fire service. Because at that time, we had focused so much online of duty deaths, but what we did not know is that suicides were starting to outpace line of duty deaths in the fire service, but we never even so at the time, a task force was formed with FRE. There’s about three to five of us that says, okay, let’s go out and see what we can do. We’ve had enough and we were broken. Eric we really did not know what we were going to get into, but we knew we needed to do something. And so, what we did is the firefighter mentality. We picked up our bootstraps, we marched forward and said you were not going to take no for an answer. But we really didn’t have an idea. We started to look at resources in the state of Colorado, city of Denver, and at that time, we were knocked on many doors.

We’re here, we’re men. We lost somebody very close to us. We have a lot of the same DNA running through our bodies. We’re high-risk factors. We’re at a high stress job. And people are like, yeah, that’s great. That’s a tough culture, tough stigma. Let us know if you have somebody that’d be willing to work with you. It was to us as like, boy, we were just kind of like, whoa, I guess we are kind of in our own little category of high-risk occupations. Well, then what happened at the time is I just happened to be looking on YouTube and I saw there was a local department of the region down to the south of Denver that had put together this video called Dealing with the Aftermath of Suicide. So, I watched it very captivated, like, wow, this is what we’re trying to get into.


I looked at the credits, and in the credits was Dr. Sally Spencer Thomas. And I looked at, wait a minute here. She’s down the street from us. So, we made contact with her. About three of us went in there to talk to her, and immediately we knew we were in the right hand. She almost was, like, waiting for us. And at that time, she was recognizing this pattern and trend that was going on amongst working agents, specifically in the public safety industry as well as the construction industry. So, what we did at that time was we collaborated with Sally, and we started at a very, very we had a strategy to go and get some focus groups. And so, what we did is we got members from all ranks, probably about ten to 15 members of the Denver fire department of all ranks. We just went into a room, and we just started talking about what we were all going through and what was so glaring and all that. And I knew everybody in this room, and I thought I had a pretty good idea of who they were as men and as women and as firefighters.

The out is I really had no idea what they were going through. And they were raw. They were tough conversations and very real and eye-opening dialogue. And we had felt that the common thread we had all had been we were all stressed. We take home our work, and we knew we had a system that needed more resources. Keep in mind, at the time when I came on the Denver fire department in the year 2000, we had a city policy that had kind of made its way into our department policies. And it basically was, if you’re experiencing a crisis or if you need mental health resources, call this number.


And it was office of employee assistance as a paragraph, probably that big, and every city employee, this was the avenue for resources. So, at the time I thought, well, I don’t want to minimize what anybody in a city employee is going through, but I felt pretty confident that somebody in the library or somebody in parks and rec wasn’t dealing with the same stressors. And that’s me.

I think that’s probably a fair assumption.

And so those are the types of things we knew we had to start having in place in order to have options for our members. Because, you know, the more options you have, the better choices you’re going to make, and there are resources that are better suited for you and your own individual needs. But at that time, our most used resource was our care support team, and that is members of the Democratic department through specialized training. And that is what we had. It was most widely used. We had a department of psychologist. But if you did not feel comfortable with those two resources, then all you had was just the city OOE EAP employee assistance program. So, what we did with that focus group is we looked at a strength and needs assessment. What are the strengths of the fire service? What are the strengths of the Denver fire department? We knew the strengths are we’re a family, we take care of each other. We all have the risk factors that we all can pretty much unspoken language know that, okay, this person, he or she is going through probably the same challenges that I’m going through.

We knew that the strengths are with the firefighter mentality. Give us a task, we’ll take care of it. And the weaknesses we have were lack of resources, lack of trust. Lack of trust meaning that we didn’t feel confident that we could come forward with vulnerability. It was a weakness at the time, and we felt that we didn’t have trust and there would be no labeling the stigma attached. And I want to promote in the fire service well if I come forward and I start talking about the course I’ve taken in my career with dealing with my mental health challenges or concerns, does this impact me where I go on my future? He felt very, very leery about crossing the boundaries of being leaders in the fire service and conveying vulnerability to our peers. And then our peers felt I don’t trust leadership because they’re going to go and use this against me in my career. All these obstacles, we just kind of hashed them all out. And so, we also had done a survey and got to keep in mind a survey in public safety. We probably have 2% to 5% Ops participation. We put this survey and we asked what do I think about mental illness?

What do I think my peer thinks about mental illness? What do I think leadership thinks about mental illness? Can I name five risk factors, somebody who may be experiencing a crisis? Can I list five resources that are available to me and to my peers? We had about a 20% participation rate in the fire service and to many in a company organization, I might not see my calaba. To us it was huge. And we knew at the time that people want to be heard and people are struggling. So, we found out some very alarming data from that. People couldn’t even name resources other than the EAP. And so, with that, we put together a training and said, okay, we’re going to go through this model called the working minds model. We’re going to train the trainer because we knew in the fire service public safety, you bring in an outside speaker to tell you, you know, this is what you’re going through. You automatically get suspicion. You’re going to get the fear of conspiracy. So, we knew in order for it to be effective, it had to be biased for us and we had to put people who’ve actually walked this path.

We’re in positions of leadership and basically say, okay, this is what we’re dealing with. That was the first challenge. The second challenge is we knew we could not go in there and just say, we’re going to talk about mental health and resiliency. Sure, you’re probably going to get callings that day. You’re probably going to get people who have some other thing they want, training they got to take care of. But we knew we couldn’t do that. So right at that time in the fire service, we always are championing physical health. Cancer is high amongst firefighters, heart attacks amongst firefighters and first responders. So, we knew we had to capitalize on that and morph it together, what we call the total wellness. So, let’s talk about what we’re going to take care of our physical health, checkups physicals body composition analysis, propensity for injury, and then let’s start talking about our minds, what’s going on here? As below, as above, so below, that’s kind of our approach. So, we coupled it all together. We called it total wellness and we got great buying. And it was something that we felt that became a model that continued to be used in corporate America.

But it was something, like I said, if I look back on it and it was probably the best thing that we could have done, but there’s was something missing. We had just started to capture data and at that time the data was alarming because like I mentioned before, you think of firefighters, you think of the worst possible thing that could happen is a line of duty death. But when we start talking about working age, men, fire service, the risk factors we all bring in, we’re risktakers by nature. We’re around death all the time. We know if we are in a crisis. We know the mechanisms to take our own life. And we had captured the attention of the data of the people we were presenting to on the organization. But we knew in order to get that knockout punch to really deliver the message. At the time, Dr. Sally says, let’s get about five people in leadership positions. Let’s put together a video. And I want you to talk about moments in your career when you are vulnerable, maybe going through a difficult time, have soft treatment, and you are now triumphant, if you mind.

The ten of us that are going through this, we’re like, we’re very passionate. We know what needs to be done. But all ten of us are like, I don’t know anybody like that, do you? We’re kind of looking around the room. In reality, we were part of our own story. This is part of our own healing. And those of us who were deeply impacted by the suicide of the captain, I look back on it and going through this was part of the best thing we could have done for ourselves because we were able to lay our hearts on the table, be open be vulnerable. So, once we got together, a group of us that basically talked about seeking help, advocating for mental health and resilience building, which is what captured the attention of the members of the department of everything we did. And it was all great. People said, you know what, I never knew that you were going through this, and I admire you so much for your courage and vulnerability and coming forward and that we were able to build on. And I firmly believed, unfortunately, we had a line of duty death about a year and a half later, and this was a firefighter who had fallen through a roof and had lost his life two weeks later.

Well, because we had already started to build those skills of resiliency, crisis intervention, suicide prevention, we were able to teach the entire department on grief and loss. And I firmly would never have been able to broach that topic if we hadn’t already built that trust. And so that is kind of the story in a nutshell on how Denver Fire Department began to morph into championing mental health, coming up with more programs, recognize the value of resource building internally through peer support. Department psychologists were able to come up with a chaplain service for people who are more inclined to have spiritual intervention for mental health. And we were able to collaborate with many, many agencies and suicide prevention organizations and champions. But that’s how it all began.

I think the story is incredibly powerful. A couple of things that really hit home for me was the importance of peer support. And I think the message you shared around without trying to minimize the challenges that other groups may go through. EAP and many organizations that actually remember having the conversation earlier this week is the EP group that you’ve got prepared to address themes. Do they understand what you’re going through saying in the fire department or whether it’s law enforcement without its construction, whatever industry that you’re in because it seems maybe different construction, sometimes you could be away for six weeks or you might be flying to see your family for a day, which could create new stressors and differences. So, I think the peer support piece is something I’m hugely in favor of. I think it’s incredibly important. I love how you adapted things; you made it for the fire department, you adjusted terminology, the total wellness. I think these things are powerful because if it feels like it’s something that’s corporate that’s being pushed, people won’t use. And I think that’s incredibly powerful. And your message around vulnerability, I’ve seen it time and time again when people are comfortable, and leaders are comfortable being vulnerable.

It’s so powerful in terms of getting people to understand.

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That’s a great point, Eric. And this is a story I want to share with you recently. About two weeks ago, I was at a call downtown on an actual suicide of an individual who had taken their life by jumping off of a structure. And so, if that would have happened 1520 years ago, those who were part of that incident had witnessed what had happened, we would lose them because we would never address what they’re feeling now or what they may be feeling next day down the road. So, after everything was mitigated and during that time when I’m getting the company back in service, the first call I made was our purpose support director. And I said, this is what happened. These are the individuals that were on the scene. Please give them a call by the end of the day or tomorrow morning. So, to see that transition and now it’s part of our call process. First incident, I would never have even thought of that 1520 years ago. It was just something that you went home, you took it home with. If you were able to talk with members of your family or of your own internal support network, fantastic.

But if you didn’t have those, then this is carried with you, and it be accumulated through your career.

Right. And I think one of the reasons why I think your story’s powerful and obviously we’re talking mostly about safety. You’re in the public safety space, you do incredibly dangerous workday in and day out. What’s the impact of mental health and not addressing on physical safety of a team member? That because I think the two things are intertwined. We know from a physical safety standpoint, distractions, all sorts of things that can be exacerbated by mental health can have an impact in terms of my choices, my decisions, and how I stay physically safe as well.

Yeah, that’s a great question. So, as I mentioned earlier, we started to recognize the trend and pattern in line of duty death being surpassed by suicides, not just in the fire service, but in public safety. And this has continued to be the trend for almost ten years. I think the only time we had line of duty deaths that were outpacing suicide was during COVID, but we don’t see a drop off in these trends. So, the cumulative effect, if these stressors and risk factors aren’t addressed, obviously the worst-case scenario is the suicide of a member. But you can also attach it to the things that maybe we don’t consider taking it home to your loved ones. Anger, substance use. And that data we had done back in 2014, we started to see the prevalence of substance use. We started to see the prevalence of domestic issues that were going on in the home. We started to see a trend in the number of divorces in the fire service. We started to see the number of disciplines in the fire service. We started to see a number in injuries. So, all the things you can easily attribute to not taking care of yourself.

And when you look at the number of calls that the peer support receives on an annual basis, of course they’re all confidential. But we do look at the types of calls and they all are on family, substance use, anger management, feeling loss of value and a sense of purpose because of injuries. And you have to keep in mind we’re all kind of have our bread to be on the frontline, to be out there riding on the rig, to be a part of a crew. And when you have issues where you’re taking time off of work, whether for recovery, whether it’s mentally or physically, you lose that sense of value being a part of something bigger than yourself, part of a team. So those are all the things that you can attribute to not taking care of yourself. And then we were also seeing trends, and this is something that may be surprising to a few, is our retirees were taking their lives in the past two years. I probably have a handful of retirees who once they were off the department, had taken their lives. It’s a sense of possibly not having a support network of the brothers and sisters of the fire department to bounce things off and maybe not having the support network that they once had.

And I’ve seen this in other industries as well, where there’s a very strong bond connection to the mission, even in the aviation space, pilots as well, risk factors after they retire. All of that also changes the context that you’re operating within. So, is this something you’ve also extended to people that have left the fire department in terms of the peer support or not yet?

No. Well, we’ve brought it to the attention of administration. We brought it to the attention of the union. Of the union. And yes, I believe it’s part of the message that this is what we’ve seen, these are the resources available to you. But we don’t really have to touch points like we would have members who are currently in the department. But I will tell you what we did that I really felt that was a game changer for us is that I really didn’t start talking about mental health until my 15th year on the department. When I came on in the year 2000, if there was anything going on with me internally, I’d dare not say anything. And even if I was to say, hey, I’m having a bad day, I’ll be quiet kid, just move on, get on the rig. So, part of the academy process, when the new recruits come in, they are automatically just within that first 17 weeks of their training are instructed on the importance of self care, are instructed on being able to have the courage to intervene if a member or a colleague. And I use this story, and I’ve used it with the recruits.

So, in the fire service, we’re safety oriented. Everything’s about safety, of course. And when you’re on a call, all of us are responsible and have an obligation to safety. It doesn’t matter if you’re the chief. It doesn’t matter if you are the brand-new firefighter in the city. You come up on a house fire and you see a roof sagging, I ask the most junior person, the least seniority on the department, what would you do? You roll up on this. What would you do? Oh, Chief, you know what? I immediately talked to the incident commander, but there’s a safety issue right there. The roof is saying, we need to pull people off the roof without hesitation, with confidence. I said, okay, you go back to the firehouse, and you happen to walk past your officer’s room, and you see your officer with his head in his hands and he saw me. What are you going to do? They look around, I don’t know. I said, the mindset is we’re safety officers on the fire ground and in the firehouse, if somebody is in danger or there’s a concern or somebody is not themselves, just like reading smoke, we can tell when there’s turbulence.

We should be able to read each other when there’s inner turbulence, have the courage to intervene and have that dialogue. So that’s the mindset that we’re trying to have. Our entry level recruits have those skills and at least the awareness of themselves and their peers that they can start having that conversation and start moving things in that direction early in their career.

Thank you, Manny. That’s very powerful. So, Manny, thank you for sharing all these great ideas and your experience through this. If somebody wants to get in touch with you to explore your journey within Denver Fire, to explore how to leverage some of the insights you’ve had there in the organization, how can they get in touch with you?

Eric, they can contact me through my personal email. And that is Manny322003@yahoo.

Perfect. And I also want to thank you for coming, sharing your story, for the work that you’ve done within Denver Fire and how you brought all the teams together behind this. I think it’s a very encouraging story and a story I wish a lot of others started thinking about. How do I embark on a similar journey and ultimately as well, thank you for your service within Denver Fire and keeping people safe day in and day out. Really appreciate everything you’ve done. Thank you.

Yeah, thanks, sir.

It’s been a pleasure.

Thank you for listening to the safety guru on C-suite Radio. Leave a legacy. Distinguish yourself from the pack. Grow your success. Capture the hearts and minds of your teams elevate your safety. Like every successful athlete, top leaders continuously invest in their safety. Leadership with an expert coach to boost safety performance. Begin your journey at Come back in two weeks for the next episode with your host, Eric Michrowski. This podcast is powered by Propulo consulting.

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Assistant Chief, Manuel Almaguer, has been a Denver Firefighter for 22 years. Chief Almaguer has served in many roles in the Denver Fire Department. This includes Division Chief of Fire Prevention, Assistant Chief in both Training and Operations. Hazardous Materials Captain, and Lieutenant in Administration. He is a national champion of mental health and resiliency. He has spoken at The White House and Pentagon on Suicide Prevention and Men’s Health.

For more information: [email protected]




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Suicide Prevention: A Call to Action for Safety Leaders with Dr. Sally Spencer-Thomas

Suicide prevention a call to action for safety leaders



In observance of World Suicide Prevention Day and National Suicide Prevention Week in the United States, we are privileged to have Dr. Sally Spencer-Thomas join the podcast. In this episode, Dr. Sally shares how the loss of her brother to suicide in 2004 left her with a calling to help prevent this from happening to others by engaging the workplace in crucial conversations about suicide prevention. Tune in to learn the depths of correlation between mental health and workplace safety and how organizations and leaders can help prevent and mitigate death by suicide.


Real leaders leave a legacy. They capture the hearts and minds of their teams. Their origin story puts the safety and well-being of their people first. Great companies, ubiquitously have safe yet productive operations. For those companies, safety is an investment, not a cost. For the C suite, it’s a real topic of daily focus. This is The Safety Guru with your host Eric Michrowski, a globally recognized ops and safety guru, public speaker, and author. Are you ready to leave a safety legacy? Your legacy success story begins now.

Hi, and welcome to The Safety Guru. Today I’m really excited to have with me Dr. Sally Spencer Thomas who is a psychologist and impact entrepreneur. We’re going to have to talk about what that really means. And entails a passion for suicide prevention. She’s also the President of the United Suicide Survivors International. We have a really important topic to discuss today and it’s really as we’re talking about Suicide Prevention Week and International Suicide Prevention Day is really the connection between safety and mental health well-being and suicide. So, incredibly important topic, and very happy to have you with me, Sally.

Grateful to be here, Eric. I’m so glad to be making the connections here. 

Excellent. So, before we jump into your story and some of the themes around it, tell me a little bit about what it is to be an impact entrepreneur.

So, an impact entrepreneur brings kind of the heart of a non-profit, a mission-oriented perspective, but kind of the business mind and the efficiencies of a business model. So social entrepreneurship is another term for it but it’s basically a business that measures its profit by impact.

Excellent. Well, excellent. Thank you for the work that you’re doing in this space. So maybe let’s start with a bit of your story, your background, and how you got passionate about this critically important topic. 

Yeah, so I’m a psychologist by training and I’ve been in the field of mental health for upwards of 16 years if you count my undergraduate years when I lost my brother to suicide. This happened in 2004. My brother was a business leader himself, an executive in the insurance industry. He had launched a company in his mid-20s by his early thirty s that had gone national. And so, in all the ways that we tend to measure success in our country, my brother had those opportunities and so he was beloved. But what people didn’t know is that he fought depression and a mental health condition that ultimately proved to be fatal. And so many people have these before and after moments in their life and his death was most definitely mine. Within a couple of months. I definitely felt a calling to try to figure out some bold, gap-filling things that could prevent what happened to Carson from happening to other people. And that led us on a path to trying to engage the workplace. It was eye-opening to me. After all, this year in mental health that no one shared. The majority of people who die by suicide are working-aged men.

Most of them have one attempt, and most of them have never stepped foot in any type of mental health resource. So, we’re not going to catch them through education, we’re not going to catch them through the health care system. They’re working, or they were just working. It’s the workplace that’s the most cross-cutting system. And so eventually, that is what leads me to you. 

Wow. First, really sorry to hear about your loss, but I think it’s really impactful, you said in terms of the role that workplaces have around us, and it’s a common theme, and people don’t necessarily talk about it. We’re talking about it more these days, but there needs to be a lot more openness around talking about these teams. As you said, he was a successful executive. Most people would think he’s in a good spot and may not ask questions.

Yeah. And when we first started to try to engage workplaces in 2007, like, hey, how about some suicide prevention in the workplace? They were like, no, that’s a medical issue. People need to take that stuff up with their doctors. And I was like, but they’re not, and they’re here, they’re working, so how about you do something? But there was just so much fear and resistance in the early days. A much different story today.

Let’s touch a little bit on the link to safety, because in many cases as you said, a lot of workplaces are starting to talk about the topic, but not necessarily linking it to safety. So, can you bring some of the connections between these two areas? 

Sure. So, we didn’t have great data. So, I’m in the US. And everybody here kind of benchmarks their mortality and morbidity data off the bureau of labour statistics, and that’s where everyone was focused. And relatively speaking, suicide deaths as measured there were relatively low. They were only looking at that, however, where suicide deaths on a job site well, most suicide deaths don’t happen on a job site. That happens somewhere else. But they were missing the fact that thousands of people were dying by suicide in various male-dominated industries construction, extraction, transportation, including aviation, all kinds of industries. And once those data became public in the United States in 2016, that’s when everything changed. Because when we were looking just at what we’re focusing on is the fatal four slips and falls and electrocution and copying, we’re talking about hundreds of deaths, and every single one of those deaths matter, or maybe upwards of 1000 deaths. When we come to suicide just in the construction industry, we’re talking about 5432 deaths somewhere in that range every year. So, no one knew that. So that was the AHA moment. And then when you kind of dig deeper, there are many connections that people were not drawing the dots through between psychological safety, mental health promotion, suicide prevention, and job C-suite safety or workplace safety.

So, one is a distraction. Everybody knows that when workers are distracted, they make errors and they put themselves in hazardous situations. But no one has been talking about the fact that when you are in the throes of a pretty intense mental health condition or a mental health moment or suicide intensity, as we like to call it, your brain is off doing other stuff. And I’ll speak from personal experience. I went through my own experience with major depression in the spring of 2012. For whatever reason, that perfect storm of stressors hit me, and I had this meta-awareness that my mental health was going down the toilet. And it was one of those things like every single one of my usual coping strategies where it was meditation, trying to eat right, trying to sleep, nothing was touching it. I couldn’t sleep. Food tasted like paste, so I stopped eating. And I remember very distinctly, I like others, I could zip myself up for little periods of time to go do the thing. And for me, doing the thing is getting on a stage and talking to a whole bunch of people. And so, I knew I was really unwell, but I also had to make a living. 

So, I went to this conference, and it was actually a sorority convention in Atlanta, and I had to drive from the venue, from my hotel to the venue. And I remember driving on the highway and having a very clear thought I should not be driving. My mind was racing a million miles an hour. I had an overwhelming sense of panic that I was going to get in a car crash or get lost like there was no way I should have been driving. And that’s true for hundreds of thousands of people every day that are in safety-critical workplaces and their brain is working on something else that is not focused on the job at hand. So that’s one. Number two is fatigue. Again, everybody is connecting the dots between fatigue and job site safety, but they’re almost always only concerned with hours worked. And yes, we have lots of clear data that over certain thresholds, probably about 60 hours a week, we start to get too tired, and we make mistakes that lead to safety problems. But that’s not the only thing that causes fatigue. Most mental health conditions have some kind of sleep dysregulation as part of the criteria.

And it is either I can’t fall asleep, I can’t stay asleep, I try to sleep, and I have tons of nightmares. I’m trying to sleep with a substance use disorder. So, I’m not getting quality restorative sleep, or I sleep and sleep and sleep and sleep and I never feel rested. I always say that sleep, sleep disruption is the canary in the coal mine for some kind of mental health condition. It’s the thing that comes first. And yeah, we all have rough nights of sleep and we’ve got a lot on our minds, but if it’s night after night after night, you’re going to feel tired. And so that’s another piece. The other piece is that some mental health conditions, you can see this on brain scans, cause the brain to not properly function. And in the cases like depression, our synapses are just not firing in the way that they do when we’re well, you can see the brain is really shut down. And the experience I remember this too, the experience is kind of like you’re in this dark tunnel or this dark fog, everything is negative. You’re seeing the world through rust-coloured glasses. 

It’s very hard to generate solutions to problems or to see things from a different perspective. So, again, in safety-critical workplaces, you need that kind of decisiveness problem-solving piece that’s happening so that we can shift gears quickly and come up with an alternative plan that’s hard to do with an impaired brain. And then lastly, ongoing high levels of distress, whether that’s internally caused by a predisposed mental health condition or externally caused from trauma or overwhelmed or whatever, eventually something has got to give, and things will start to fall apart in your body. So, our immune system gets compromised. So, we’re much more likely to get things like, I don’t know, viruses much more susceptible to heart disease and even some cancers and so on and so forth. Pain issues get exacerbated. And so again, we start to see this cycle happening, our mental unwellness contributing to our physical unwellness, contributing to work sites, stresses and pressures, and then here we go round and round. So, there’s many ways that these things are connected.

Yeah, and I think you touched on we talk all the time about distraction, fatigue, all these pieces that you can’t have focused on the task at hand. If you’re thinking about other things, you’re tired. So very strong connection. So, what are some of the tactics that businesses can take to make a meaningful difference?

Well, the good news is the silver lining of the pandemic woke a lot of people up, a lot of workplace leaders, whether that’s employers, professional associations, labor unions, whatever because there was hardly a person on the planet that was impacted in one way or another. We all had this shared experience of like, oh my gosh, and workplaces got really concerned about mental health disruption of their workforce. And then add to that, we’ve got a new generation coming in, the gen Xers who are fluent in mental health awareness from birth. They have those psychosocial education things in preschool. They get it and it’s a huge priority for them. So, when it comes to recruitment, retention, and engagement of young talent, workplaces have got to get this right or we’re going to continue to see that great resignation and the turn that is so disruptive for so many employers. So that’s where suddenly, in the last couple of years, people have learned in ways that they haven’t learned in before. And because we also had data in many of the safety-critical industries that suicide was an issue, we have workplaces leaning in, not just on well-being.

A lot of people like to do the light stuff, well-being, stress management, conflict management, okay, all that stuff matters. And also, we’ve got to talk about the hard stuff. We’ve got to talk about addiction. We’ve got to talk about overdose. We’ve got to talk about suicidal despair, suicide, death, and mental health emergencies. We’ve got to prep workplaces for the whole continuum of experiences, not just the lighter stuff that’s easier to talk about. 


So, what I love about a lot of the safety-critical industries is that they tend to be very problem-solving and pragmatic people. And so, for the most part, people leaned in quickly and said, okay, we got a problem. How do we solve the problem? Give us some tools. We’ll try stuff out. And they did. So, there’s a bunch of us that have also around the same time we published it on October 19, 2019. So right before the pandemic in the United States, the national guidelines for workplace suicide prevention. Canada has something similar with its psychological safety standards for the workplace. Australia has a couple of things around a position statement for workplace suicide prevention. We were late to the party, but we got it done in 2019. And all these documents, standards, guidelines, whatever you want to call them, give workplaces a roadmap to tackle the hard stuff. And in the United States, we frame it as upstream, midstream, and downstream. So, there are a lot of things workplaces can do in the upstream part of the equation, which is promoting what we call protective factors and decreasing psychosocial hazards. Protective factors are things like belonging.

That’s why the die was concerned to play it’s about psychological safety, where people feel okay about bringing their whole selves to work. And how do we create a trustworthy work environment, a culture of care? How do we position our leadership to authentically communicate that this is a health and safety priority for their workplace? How do we have lived experience stories come through and lived experience realized as a form of expertise that can help code design all these programs? So, all of those things that are in the upstream and then with psychosocial hazards, it’s a really important paradigm shift for a lot of workplaces that it’s not good enough just to get a whole bunch of quote-unquote troubled people to counsellors. That’s usually where everybody goes, let’s get these troubled people to the counsellors for a whole bunch of reasons that are fraught we’ll get into that I’m sure that is helpful, for sure if it’s accessible, culturally responsive, all of those things. And also, there’s a whole bunch of stuff workplaces are doing every single day that is driving overwhelming despair, and mental unwellness every single day. So, they also need to take responsibility for mitigating or eliminating psychosocial hazards. 

And one of the AHA moments that we had when we were looking at this again, the United States has an inverted pyramid of the hierarchy of controls when it comes to job site safety. Sure, every single work trail I go to, every single training room on safety-critical workplaces, I see this thing hanging up. It’s like the Bible. Very important. And so, we all know that we’re going to be far more successful if we eliminate or mitigate job site safety hazards in the environment. Then only the thing we do is promote our individual responsibility for wearing our PPE like a hard hat, professional vest, whatever it is. We’re going to be far more successful if we figure out what the hazards are. Same thing here, but nobody is paying attention to this yet, at least not. 

In the United States.

The UK is doing some really cool stuff. They’re actually starting to legislate this, which is very interesting. We’re not there nowhere near there yet. But when we look at the psychosocial hazards like problems in job design, so low autonomy, low job variety, poor effort rewarded balance, those kinds of things, when we look at toxic relationships within a job C suite or within a workplace, especially a supervisor, if that’s a very toxic relationship, the chances are good the worker is going to have high levels of distress. Another piece very common is work and life getting disrupted. So, life spilling into work, work spilling into life, and having no way to navigate that in a healthy way. Another really important piece that doesn’t get talked about enough but is very clearly connected to suicidal despair is if workers feel like they’re a cog in the wheel, they really don’t have a purpose, they don’t connect to the mission, and they really feel like their contribution doesn’t really matter in the big scheme of life and really actually helping someone else have success or profit or whatever. So that disconnect. Like the thing I do 60 hours a week just doesn’t matter, leads to that sense of purposeless.

And then lastly, there are also a lot of hazards that the workplace does just by the nature of the work. So, in our first responder communities, they’re exposed to a lot of traumas. The same with a lot of our healthcare communities. There’s just a lot of sleep disruption by the nature of the job shift, work or long hours or early hours or not enough time off, all of those kinds of things can also contribute. And then the last thing I’ll say is that workplace culture also contributes to mental unwellness. If your main source of relieving stress culturally contributes to really poor coping strategies like high levels of substance abuse. I mean, I work a lot with first responder communities, and I know they get off a long shift. It doesn’t matter if it’s 08:00 in the morning they’re hitting the bars and that just sets up people for addictive patterns that lead to a whole bunch of dominoes falling over. So, lots of things and so that’s the upstream in the midstream. We’re trying to catch things early, trying to help with what we call early detection. This works for all healthcare issues. We want to catch those cancer lumps and bumps when they’re small.

We want to make sure we’ve got the blood pressure under control when the problems are coming on early. All of those things. Same thing here. We want people to be able to identify emerging issues in their mental health and not wait until things are catastrophic to reach out for help. So, the best way that we can do that is really helps the workforce own this part of their health like they own other parts of their health like we own our fitness and our nutrition. We know largely it’s up to us and the choices that we make every day. It’s not entirely but we have a lot of agencies over the decisions that we make in that space. Same thing here. Our wellbeing is largely a part of our decisions and our own self-awareness and so how can we provide a self-care orientation that matters for our overall happiness and well-being in life. And one of the things that we can empower workplaces to do in this area is advocate for anonymous confidential and voluntary self-screening. There are programs out there where workers can just host a screening day for depression and really emphasize this is anonymous and confidential.

It’s not coming back to the employer. This is just a check-up from the neck up. We’re going to do this like we do your fitness tests or other kinds of things. The other piece that I know we’re going to get into in a little bit is peer support. We have found in safety-critical environments there’s often great reluctance for a whole bucket of reasons for workers to reach out to formal mental health supports. There are layers and layers and layers of reasons why there’s a lot of reluctance we’ll get into that. And so, peer support, formally trained peer support programs, not necessarily peer support groups per se but a formal peer support program where people are recruited and trained, and they self-identify. They’ve got outward-facing cues that you’re a safe person to talk to. Most of them have significant lived experience so they can come and meet people where they are, offer empathy because of their own shared meaningful experiences, and so on. That seems to be the major missing link in many workplaces they just land so hard on. We’ve got an EAP, why is our utilization rate 2%? Because people don’t trust it, but they trust appear super.

Peer support is another piece.

There’s also an accessibility and relatability piece because I saw that in the aviation space where there was peer support and it was almost the onboarding to EAP, so they could triage. People felt comfortable they related to the person. It was hugely powerful. Versus EAP, I’ve seldom seen people other than a manager saying, oh, don’t forget to call EAP. 

Which by the way, most managers have never called. So why would I trust you? This is the same thing when you yourself have never used it. Exactly right, yeah. Let’s dive into peer support a little bit more because, for many workplaces, this is a daunting step because they have HR folks, they have employment lawyers who are like, oh no, the liability. And they get up all in a frenzy about fears of being sued. And what we’re learning again from our European colleagues is actually the opposite is true. If you don’t start doing some best practices around providing mental health support for your workforce in areas, we know that work, you’re going to be seen as negligence. You’re going to be seen as not doing what you need to do to protect your workforce. So, this is one of those areas. And we have some proven examples. Like you said, in aviation, I’m familiar with Project Wingman out of American Airlines. They became a really great gold standard for the world. And all of a sudden now most major airlines have a very viable peer support program for the pilots and then many other roles within aviation. 

And when we think about it, yeah, nobody wants a suicidal pilot, nobody wants. 

No, not a good idea. 

And at the same time, or a drunk one, right? And we were preventing our pilots from raising their hands and saying, I need help. Well, that’s a conundrum. So, peer support became, again, that safe pathway for people to get support. We’ve got a lot of really great examples from our first responder communities, especially law enforcement, fire service, and big municipal departments. They’ve had things operating for decades. So, we’ve got models that we can then translate and Trans Culture to other types of industries. And my joy at the moment I spend probably 80% of my time or more in the construction space is to watch the construction industry start to embrace this. The unions have stepped forward most boldly first, and they’re having some really good experiences. They were already set up for that in many ways because of the culture of I’ve got your back. But now we’ve got professional associations coming in and many large companies starting to look at this with seriousness. So, it’s great. And not only is peer support good for the person who’s in distress, but it’s also good for the peer supporter. We have this again, this huge body of data that shows helping others helps us. 

So, it helps that peer support person stay in recovery, and be accountable for their own wellness. It’s a great gap-filling thing that I see is absolutely the future. Oh, and to all the employers out there, cost savings, let me just say that it’s not been replicated in any peer-reviewed journal. But when I ask aviation, when I ask my fire service folks, how much of the distress and despair do you feel is resolved at the peer level? The consistent number I get from these different industries is about 80%. 75% to 80% they say are resolved at the peer level, which means people are not having to take formal medical leave or accommodations. They’re not having to go into any costly treatment for themselves or the company. They’re resolving things at the peer level so people can stay at work and do what they need to do to support their work and their families. Cost savings is another awesome reason to do peer support.

Very compelling argument on this one. And this is something I think a lot of organizations need to really seriously look at, because I’ve seen some cases where, as you mentioned, often union gets involved partners on that front. But how powerful it is, and how many more people can use it, I think it’s a huge game changer in space.

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Yeah, and the last thing I’ll mention in the Midstream space, again, midstream is about identifying problems as they’re emerging. That way things are catastrophic is training. So again, in a lot of safety-critical industries, training is the first go-to. We got a problem, let’s have training. And so, this is again a very quick cultural fit. We can just bake into stuff that’s already happening. I’ve seen some very innovative people, again for the US. Bake it into their Ocean 30 requirements as an elective that some quasi-required, and there are lots of ways we can do it. So, there is what we call gatekeeper training out there. It’s kind of an unfortunate name, but it’s stuck over the decade. Basically, gatekeeper means it’s like CPR. We’re training everyday people to know enough to recognize when somebody might be in a situation that’s driving despair at pretty high levels, and to have the confidence and confidence to go in just like a CPR person, to do what’s needed to sustain that person until we can link them to the next level of care. And so, this is Saturation training. Just like CPR. We want to train as many people as possible in the hopes that when something’s going down, somebody’s going to have the confidence to step in and know what the next level of care needs to be. 

Maybe it’s to the formal peer support person, maybe it’s to the EAP, maybe it’s to a very well-vetted substance use recovery centre in the community. Whatever they’re going to be helpful in kind of connecting those dots, and if not, they’re going to know who knows? And that’s what it does. And so, some of these that are well known are QPR stands for Question, Persuade. Referendum One is safe to talk coming out of Canada, but globally implemented. And then I’m involved with one that’s specifically addressing the workplace. It was called working minds. We’re going through a branding change this year to Vital Cog, and we can put this in the show notes.


If that’s of interest.


Where, again, we’re just in an hour or two, we are training everyday people to be able to intervene with best practice skills and conversations and referral and support. Will everybody does it? No. Does that mean it’s a failure? No. We train millions and millions of people in CPR every year. Most, like myself, never used it, and probably never will, but I’m glad I have it. I’m certainly glad I have it. And then lastly, downstream. And again, that training thing gets some of the HR folks and the employee employers like, oh no, are we now responsible for the things I’m like? Are you responsible for CPR if it didn’t work out, if they broke a rib, are you responsible? No, because we all believe in the Good Samaritan. Who is the layperson coming in to help with that Good Samaritan perspective? Here’s the kicker in the law piece, they don’t have the duty. It’s not like this is their job like it would be if you were a licensed psychologist. No, they’re Good Samaritans doing what they’ve been told is helpful at the moment. So that’s how we get through that quandary. And then finally downstream.

So downstream is getting prepared for the worst-case scenario. You are prepared for worst-case scenario around cyber-attacks. You are prepared for worst-case scenario around some kind of job site disaster. You need to also be prepared for the worst-case scenario of a mental health emergency because it’s going to happen. It’s inevitable. Most people will have one in five having them now, so you’re going to need to get prepared. And so, what does that look like? Well, number one, it looks like, go in and check out the mental health resources you have because chances are you have no idea what they do. Most companies went to the lowest bidder for their EAP, and guess what? You get what you pay for. So, if you go in, I say kick the tires, go and do some secret shopper work, make some calls, maybe have a session or two yourself, see what it’s all about. You’re going to realize either that it’s amazing and people are really responsive and understand your industry, or you’re going to realize there are a lot of problems. And then you think through, what if you’re a person on their worst day trying to navigate the system and not having people call you back and not feeling like people?

Understand the culture of the work that you do, I’m going to say you’re probably going to need to often in many cases find a better EAP. That’s been my experience with pretty much every employer I’ve worked with. And then also you probably need more than just an in-person traditional kind of mental health service provider model. A lot of safety-critical industries work around the clock. They don’t have time or accessibility to drive somewhere and have an in-person thing. So, there’s been a lot of innovation in the mental health space during Covet. It forced us to get through some pretty previously challenging barriers. So again, you need to vet it though because oh my goodness, the marketplace just proliferated with all kinds of apps and telemetry health and digital health and most of them are credible. So, find the good ones and find the ones that will fit your industry. So that’s number one. Number two, you need a crisis response plan. It’s not good enough just to have the resources there. You need to equip your managers, supervisors, the people who are in those decision-making spaces, and even your communications folks. What are we going to do? 

What are we going to do if we have an overdose? What are we going to do if we have a suicide on a job site where it’s public-facing, we’ve had witnesses, the media is coming down, we’ve got all kinds of people traumatized, we’ve got many, many people significantly bereaved by the situation. We need a plan in place and you put that plan in place before the thing happens because if you’re trying to put that do the thing on the fly, the chances are good you’re going to make a whole host of pretty bad mistakes that are not only going to not support the people left behind but can also increase the risk for future suicide death. So, you want to have a plan in place. We have a guide. It’s called Manager’s Guide to Suicide. Postvention is what we call that at work and just other things that people are going to need to be equipped. We are putting out, as I mentioned to you earlier, a white paper and again we’ll put that in the show notes also for HR and employment law because they have so many fears about how to manage this if they get stuck.

And we want to help address some of those fears to help them move forward to do the right thing for people who are experiencing their darkest day. And so, in that white paper, we talk about the kinds of accommodations that can be helpful for people experiencing mental health emergencies not only in themselves but also in their families. And so that we can come up with a really good collaborative plan that upholds the dignity of people who are suffering. That’s a very important point that we don’t respond out of fear, but we respond out of compassion to help people through because we’re all going to take our turns and we would like to be treated in that same way with dignity, partnership, respect, all of that. And then finally, again, if there should be some kind of death of a co-worker or a client or a vendor, something that’s going to impact the workplace in a significant way, we need to create safe spaces for people to grieve, to come together. Not everybody is going to need it in long teams, but we need to be on point with the communication, with the support that we’re providing. 

And what we know about suicide is in particular, it’s complicated, especially if you’ve lost a first-degree loved one, a child, say, or a partner or a parent or a best friend. It’s not the thing you’re going to get over in the three days we often give people to grieve. It’s going to take years. And in many cases, if you’re a parent that’s lost a child, it can take decades before any kind of new normal comes around. You’re just suffering very deeply for a long time. So how can workers work with people who are in that space to make sure they don’t lose an otherwise incredible worker?


But support them. Because I’ll tell you what, I had a workplace that did that for me. When my brother died, I was working at a Jesuit university, a Catholic school. And I’m not Catholic, but I’ll tell you what, the Jesuits, understand grief and they came alongside me at the moment. Here I am, almost 18 years out from the loss. Every year they still send me a note thinking of your precious brother Carson. Today I get chills just thinking about it magnified the number of employees, the number of years they are handwriting those for thousands and thousands and thousands of people every year. That matters, right? And when I was going through it, in the acute sense, they gave me time off. They gave me flex time. They allowed me to go to the support groups and the grief counsellors. They gave me a lot of grace and a lot of space. And because of that, I was a super loyal, gracious, and grateful employee for a long time. So, it makes a big difference.

Yeah, you shared a lot of incredible resources. And I think the two things that really struck me is in terms of the training that can become available because people need to recognize whether it’s peer, even leaders in the safety language. You talk a lot of actively caring. That’s a component of actively caring for your team members. The other theme that came up is really the evolution of EAP towards peer support. And I think these are two areas as well that you’ve helped, and you can help organizations in terms of taking that step forward. Is that correct?

That is, I’m excited to say that I also think what’s on the next phase of the frontier here of how we’re going to move this forward. We’re piloting a certification program right now. It’s not ready for prime time, but it will be in 2023 when we are working with the state of New York. So, they have underwritten this to walk a cohort of organizations, all of them in safety-critical organizations, through those nine best practices that I just shared with you and provide them technical assistance and coaching. It’s a deep dive. It’s not a flyby two-hour workshop, it’s six-month. We would prefer that it was a twelve-month, but it’s a six-month implementation of regular training modules. And then they got deliverables and got third-party verification, just like a lead certification. There’s a high level of accountability that they’re demonstrating. They’re doing best practice, they have to pass quizzes, all these kinds of things. So far, so good. So hopefully that’ll be ready for primetime in 2023 and then we can really move it forward. I already have some owners for construction that are saying, can you speed that up a little bit? 

Because we need some kind of benchmark to know like, are you really doing the thing? Are you just checking boxes here? So that’s also pretty exciting.

And given the safety implications, do you normally see safety organizations reaching out, or is it that safety organizations partnering with HR and NHR reaching out? What do you normally see? Because what I’ve normally seen is it becomes the HR dialogue as opposed to the safety dollars, whereas I think it needs to also be owned in the safety arena.

So, in the early days, again, 20 07 20 11 my inclination was to go to HR. It made sense, right? They’re the ones who are people. They are the ones who are in charge of the benefits. And I got because I’m talking suicide, which is scary to them, but they were like, oh no, I got frustrated and I’m like, why are you not running with this? When the safety data or when the deaf data came out, the safety people came right up to the front. And like I said, the problem-solving people, understand the connections, they have, the mechanism around that training piece. I would say in my world, the safety people have made far more advancements than the HR folks. The HR folks have been more of a roadblock historically. And that’s not universal, but historically more of a put the brakes on this, let’s back it up and play it down. Where the safety people are like, nobody dies. That’s our goal. Nobody dies and nobody suffers, whether it’s from a mental health injury or a physical injury, because they’re connected, they get it. So, we’re really driving what we hope is more of a partnership between the two because obviously, we’ve got to get the HR and employment law people on board championing this, not just putting the brakes on it. 

Yeah, they need to do the due diligence with the laws. Absolutely. And we want them to feel confident, which is why we published the white paper. But don’t put the brakes on it just because you’re afraid. If it’s just you, because we’re dealing with life and death, I get it. But we don’t respond well when we’re so afraid. We go into self-protection mode and then we can’t see the options. There are many, so I love the partnership when things come together. So, for example, we have a team do that implementation and the Hope certification. And I say absolutely, we need someone from HR, we need someone from safety. We absolutely need people with lived experience. I need someone with decision-making power, someone up at the top who knows what’s going on here, and someone from communications that’s a really strong team to help do this implementation really well.

Perfect. Well, thank you very much, Sally, for sharing all of this. I know you also have a white paper that’s coming out on near misses and instead of reporting and the link to mental well-being, do you want to give it maybe a quick highlight on some of the links there?

Yeah, well, I’ll just give the punchline, which is psychological safety. Psychological safety. So, if it means that I have psychological safety telling you I’ve made a mistake, then I feel like you’re going to have my back and not punish me for that information. And that’s how we learn about near misses or even incidents. If I have psychological safety to say I don’t feel right, there’s something wrong, and I trust that you’re going to support me and have my back, I’m much more likely to disclose that when the problems are small. If I feel like you’re going to fire me or punish me or discriminate against me, I’m going to white-knuckle it. And that can end up being a fatal overdose in the porta potty, which happens all too often. And then the last piece that ties in with electrical safety is if I feel that I don’t belong here because I’m different in some way, which of course has been such a hot topic, then I won’t ever come up with my whole self. I won’t tell you what it’s really like for life for me, or the experiences of being bullied or discriminated against, or how that impacts me and my well-being.

I won’t share that with you. And again, that leads people to overwhelming levels of despair. So, this whole idea of psychological safety is way more than I don’t feel safe in admitting a mistake or maybe suggesting an innovative way to solve a problem. It really goes to the heart of people’s well-being. And so, I’m a big fan of the movement. I just think we need to expand the definition a little more and that’s how things are tied very closely to the near miss and job site safety literature. So, I’ll send that to you I’ll put those in the show notes.

Perfect. Well, thank you very much, Sally, for sharing all these great insights. If somebody wants to reach out to you, what’s the easiest way to reach out? 

Probably the Web stop shop pieces are websites, so sally Spencer My name is sally Spencer Thomas.

Excellent. Thank you so much, Sally. 

Thank you. 

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Sally Spencer-Thomas, Psy.D.

Keynote Speaker & Impact Entrepreneur

Co-Founder & President, United Suicide Survivors International

Dr. Sally Spencer-Thomas is a clinical psychologist and award-winning mental health advocate with her own personal experience of losing her beloved brother to suicide. Her mission of giving voice to people who’ve lived through suicide thoughts, attempts, and loss and to help those in despair rekindle a passion for living.

In addition to helping leaders and communities implement innovative approaches to suicide prevention, Sally is the lead author on the National Guidelines for Workplace Suicide Prevention, President of United Suicide Survivors International, and co-founder of “Man Therapy” ( She also co-edits the Guts, Grit & the Grind book series that provides men and the people who love them with tools to help them better understand and cope with life’s challenges.

Sally has a TEDx talk and gave an invited address at the White House in 2016. Her impressive list of partners includes the National Fallen Firefighters Foundation, the FBI, Chubb Insurance, and Southwest Airlines. She has also spoken and consulted internationally including Australia, Ireland, Singapore, Taiwan, Denmark and Belgium.

For more information: 

National Guidelines for Workplace Suicide Prevention where they can “take the pledge”:

A White Paper for HR Professionals and Employment Lawyers – Mental Health Promotion and Suicide Prevention in the Workplace Policy and Response Recommendations to Help Employers Positively Impact Workers and the Work Environment:

A Manager’s Guide to Suicide Postvention in the Workplace: 10 Action Steps for Dealing with the Aftermath of Suicide 

Workplace Suicide Response; from Workplace Strategies for Mental Health of Canada

How to Move from Awareness to Action in Suicide Prevention and Mental Health Promotion: Guidebook on Training Programs: 23 Characteristics that Make Trainings Great

VitalCog: Suicide Prevention in the Workplace 




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Mental Health & Suicide Prevention in Construction with Kathleen Dobson



In recognition of World Mental Health Day, we are in conversation with Kathleen Dobson, Safety Director at Alberici. She shares some critical insights on Mental Health Awareness and Suicide Prevention in Construction. The learnings relate to so many industries. Gather some insights, reflect on how you can apply these to improve the safety of your workplace and make a difference!

Read about Mental Health: 


Real leaders leave a legacy. They capture the hearts and minds of their teams; their origin story puts the safety and well-being of their people first. Great companies ubiquitously have safe, yet productive operations. For those companies, safety is an investment, not a cost for the C-Suite. It’s a real topic of daily focus. This is The Safety Guru with your host Eric Michrowski, a globally recognized Ops and The Safety Guru public speaker and author. Are you ready to leave a safety legacy? Your legacy success story begins now. Hi and welcome to The Safety Guru. My name is Eric Michrowski and today I’m very excited to have with me Kathleen Dobson, who’s the safety director with Alberich. She’s here to talk to us a little bit about suicide prevention and awareness in the construction industry. Kathleen, welcome to the show. Really happy to have you part of the conversations. Oh, thank you so much, Eric. It’s my pleasure to be here. Kathleen, to start out, if you can share a little bit about your journey and how you got into safety and really, you’re passionate about the topic we’re going to talk about today on suicide prevention. Absolutely. Thanks. I started out as a hospital based registered nurse, and after about 15 years in the hospital, I ended up working for a manufacturer as their occupational health and safety nurse. And some of the roles that the nurse had were not very traditional. For example, I was responsible for managing confined spaces and I was responsible for conducting aerial lift training and for truck training, things that I really didn’t have experience in. And so, I. Educated myself, got some training, and as I was is that was developing my training programs, I was asked to participate in safety audits again, something that I wasn’t really familiar with, but I really enjoyed. And when that position ended, because, you know, the company downsized and so on, I found myself with several different experiences, hospital-based nursing, manufacturing, a little bit of safety, a little bit of training. And I was fortunate enough to find a job with Albury’s constructors who recognized that I understood behavior-based safety and some components of construction. So that’s kind of how we got to where I’m at now, you know, back 20 years ago and really my passion for suicide prevention. I’ve had several friends and relatives who have committed suicide. One was a registered nurse, colleague of mine. She was probably one of the first people that I knew that had taken her own life. My husband’s cousin, my own cousin. And so, there’s I think it’s it shows that almost anybody can be affected by suicide. And about five years ago, I heard a presentation from a group called the Construction Industry Alliance for Suicide Prevention. And I said, wow, that sounds great. And I and I found that one of the organizations that I belong to, network, which is the National Association of Women in Construction, as well as Tom, as well as talk, the Association of Women and Constructors were both involved pretty heavily in this in this process. And when I went to network to ask them how active and how involved we were, they said not very they were lending their name more than anything else. And I said, well, we need to do more because this is a real crisis in the industry. People are dying every single day, much more so much more so than falls in electrocution and being struck by vehicles on the highway. But we never we don’t talk about it and we don’t recognize it. So, both talk and network have put together position statements. And since they’ve been doing that, I’ve been advocating for mental health awareness and suicide prevention. That’s phenomenal. Can you share maybe a little bit about why it’s so important in the construction industry, some of the elements that make it perhaps more prone to suicide and the risk associated with it? Oh, sure. Well, in construction for many, many years is really an institution with a pretty narrow view of who belongs. So, gender, race, religion and ethnicity are all concerns. And if you were in the building, trades in your family were not part of the generations of workers. You’re really an outsider until it’s proven otherwise and. So, people who are outsiders, obviously are not included in in the day-to-day companionship, relationship, the camaraderie, the community that the construction industry offers, and if they have issues and honestly, there’s probably 40 or 50 percent of people in the United States who at one time or another have some sort of a diagnosable mental illness, whether it’s, you know, I mean, it could be depression that that’s temporary or could be depression. That’s long term and overwhelming. But the construction industry has been having been made up of very stoic men mostly. And the industry is recognized for high hazards and taking risks and being the tough guys. If you’re injured, you just kind of suck it up and you go on with your business and. So those are just some of the reasons why construction gets impacted, because we don’t, we don’t share our feelings. We are we are taught really to not. Suffer, you suffer in silence and that and that just the overall attitude, nothing can happen to me and. We’ve got this this real sort of macho image, right, about the about the industry, these are traits that are that are in quite a few other industries as well. There’s no doubt that. But all of this also has an impact in terms of overall health and safety, because if I’m not well, in some way, shape or form, I’m not going to show up with potential on the job. And other things can also happen, which can impact myself and also my peers. Can you could you show me maybe a little bit more about why businesses need to do more? I often have heard in the past, which I think is completely wrong, that business shouldn’t start dealing with mental health themes and issues. Tell me more about how you remove the stigma and why it’s so critical for businesses to drive change around suicide and suicide prevention. Well, I think I think you use you mentioned a word that I don’t like using, and that is stigma because stigma places the places a negative impact on the individual. If you’re stigmatized, you are often negatively looked at in you with your group. And we really should not we really shouldn’t put blame on people because they are depressed or they’re in pain or are there or they may have another issue that that has caused them to suffer with their mental health. Right. And I think it’s and I think it’s important that we talk about it. You know, another situation that has happened in the industry is that we’ve brought on board and recruited many, many, many people who have transitioned out of the armed services. And a lot of those individuals, especially if they have seen action in in a war zone or some sort of a conflict, they suffer from post-traumatic stress. And so, the triggers on the job site, loud noises, shouting, can trigger a stress reaction. If we talk about it, if we talk about it, it becomes very commonplace. And I can’t I can’t take credit for this. But one of my colleagues said if we can talk about prostate problems and psoriasis. We can talk about mental health and suicide prevention. And I think that I think that, you know, as we see from years ago, no one ever said the word cancer. And because there was that that that view that, oh, you know, there was something bad about that. And so. Once we started to recognize there’s nothing bad about it, we can help people who have cancer, we can we can help them transition through the different phases of the illness, even if it is deadly to them. They need they need our support. They don’t need to be isolated and ostracized. And I think that our ethic, our individuals who are having mental health crises should also be treated the same way. They should not be isolated; they should not be ostracized. And it takes an individual who has a keen eye and ear for listening to their fellow workers and cheering, hearing them talk about situations, their families, what’s going on in their lives, and as well as, you know, that sort of inflection that they’re hearing, how they’re doing their work. And if we can educate our first line or front-line supervisors to make them more aware of what to look for, patterns to look for, if people are kind of going down that that path towards suicide, I think we’re going to save a lot of lives. I think that’s so important. It’s part of the work environment is a huge part of each person’s life. And the more people are aware of signs, the more they’re prepared to address these issues, have conversations, the more positive impact we can have overall. So, I think this is incredibly important what you’re doing in that space and really trying to create more awareness around it for businesses. So, on that topic, what can businesses do to drive real impact around this? Well, you know, we talk about having employee assistance programs, and I think that they’re great. However, most employee assistance programs are designed to assist people in a in a traditional work setting, in an office setting, I believe. I don’t think they’re often equipped to manage field workers because they don’t understand what the field workers going through. They don’t understand the aches and pains that they have at the end of every single day. And how those aches and pains then can transition into another trigger, which is overuse of prescription medications and an addiction to those prescription medications. So, I think that having an employee assistance program is great. I think that the people involved with employee assistance programs need to get out onto job sites to see how workers are and how the work is done, because nobody’s going to call in employee assistance program if they don’t trust that that their conversations are kept confidential and that and that there’s no way for it to get back to the human resource department. Because are they going to put a little checkmark beside my name or a little asterisk when it says Kathy made a phone call to the AP and she’s known she’s concerned with her finances or she’s concerned with her marital status or she’s concerned about the addiction that she has. So having an AP program, I think getting families involved just by sending home material, it doesn’t have to be really focused. It can just say something like, are you OK? And if you have if you have a problem, here’s a number to call or here’s a person to talk to. Right. I’ve seen I’ve seen job fairs or, you know, where people bring in their families to celebrate a project. And there’s some vendors there, you know, they have some gateway is they have some games for children. And occasionally you’ll see a table set up, nobody behind the table, just pamphlets and information about substance abuse and alcohol abuse and mental health awareness and suicide prevention. Those tables get cleared out all the all the information gets taken and it can be a family member or it gets taken by the individuals themselves because they don’t have to directly say anything to anybody. Again, having a supervisor trained and aware so that they can. Be what we call a gatekeeper from the field to from the field to a to a helping environment to that to the suicide lifeline. No, to just say, hey, how are you doing? And can and continue to probe. Because when somebody when somebody typically ask you how you’re doing. Oh, yeah, I’m OK. But if that person says, you know what, you just don’t seem like yourself, you seem as though you’ve got something weighing on your shoulders. Do you want to talk about it? And sometimes that it gives people the opportunity to open up at that point. That’s really important. And I know when we’ve talked about on the up side before, there’s some organizations I’ve seen where the EP has gone to the next level, where they also have peers that are part of the organization that that were previously front-line workers are still front-line workers who take part in this. So that that seems to address your point around people that understand the work environment. So, with some skills around it, I think the theme of the supervisor awareness and understanding is so critical because that’s a person that’s going to interact the most with a team member that and they have a chance to check in. And on Australia, they had an annual campaign that’s are you OK? And it’s really around helping broach the topic, the conversation and speaking about it in all organizations on a regular basis around the importance of mental health, mental wellbeing, but also in terms of suicide prevention. We agree. And I think that by asking somebody, do you feel suicidal? They’re not going to go out and commit suicide. They’re going to recognize that as a as is a helpline that they could utilize. One thing I wanted was the one thing that I wanted to point out about having front line supervisors, being those individuals who can really make a difference. I read I read an article over the weekend, a gentleman by the name of Calvin Byers. He is he’s really a thought leader. He’s really been on the forefront of addressing suicide prevention in the construction industry and mental health awareness. He said, you know, nowadays we have to focus in on people’s eyes because we can’t see we can’t see expression any other way. And sometimes you can see in people’s eyes the sadness that’s there when they when they are suffering with an issue. Wow. That’s really, really important point. And I think in terms of really connecting with that, that means you’ve got to be comfortable making that eye contact, having a conversation, be looking for potentially signs of challenges that may be happening. Exactly, and, you know, as I said, our supervisors are not always they’re not always the most. People, persons on the job site, you know, a lot of times they are right there, the people there to get things done, they’re not the people that are on site to kind of. Coach and guy, you know, give the old hugs and tell them that people are doing you’re doing OK. Exactly. And I know just a couple of days ago, there was World Mental Health Awareness Day, and there was it was looking into it just before our conversation. And I found a staggering statistic from the CDC that just talks about the relevance, importance of this. They said that this was done just over the summer and said one in 10 Americans had considered suicide the previous month, about twice as many as in twenty eighteen. So, the problem, obviously, was with social distancing and the pandemic likely pointing to this increase. But the other element is young adults, eight to twenty-four. The proportionate proportion was astonishing. It was one in four. So just really such a critical theme now and in construction, but in so many other industries are really in the space of health and safety. Yeah, and, you know, you talk about the one in 10 and how that number is really increased, I think that, you know, because we have been so isolated and in in our own homes and away from our community and our and in our people that have always given us comfort. You know, if you if you had problems at home before, they’re probably not going to be any better because you’re there all the time. Exactly. And, you know, when you when you address the children that No. One in four. That’s really that’s frightening. And it I think that that really looks at the issues that surround the culture that the children are in, the intimidation, the harassment, the bullying that that that child get. That’s really that really becomes a psychological that really has a psychological impact on them. You know, as an adult, sometimes we can deal with that. But when you’re a child, you have no idea how to how to deal with somebody who is always putting you down because of your height, your weight, your inability to do sports because you’re a nerd, whatever the case may be. I mean, there are there are hundreds of different reasons why children are ostracized or picked upon and children don’t know how to deal with it. That be really well, to the next mix theme I’d love to explore with you is really what can you do about this? So, you’ve talked about what organizations can do, but what can an individual who listens to this, who has awareness, has what is it that you can do to make a difference in ultimately people’s lives? One of the first things that I would that I would recommend is for people to download the Lifelines for suicide prevention on their phones and in and in there, and then they’re messaging. You know, so that if you come across somebody, you can readily say, hey, do we need to call this number or do you need some assistance with just finding some support? And if we advocate and if we can advocate for people. I think that’s really, really important, you know, the suicide lifeline number, by the way, is 800. Two, seven, three. Eight to five, five. And the and the lifeline number is seven four one seven four one phenomenal resources to have it at your fingertips. If ever you come in, come into a situation where you’ve got to have a conversation, do something about it. So, thank you for sharing that. And any other suggestions for people in terms of a difference they can make, either in terms of if you know somebody that that might be contemplating or you’re not sure how to approach the conversation or even if you want your organization that your part of this are really embracing that something needs to happen. I think I think really just opening up the conversation is the first real key step in all of that. And just being able to ask that first question, are you OK? All right. There’s many, many, many ways that an individual can help and support. But, you know, just by being an advocate, if you’re on the job site, find, find and download some posters, some suicide prevention, some suicide prevention posters. Ask your company to offer workplace mental health screenings. Get the AP involved or community mental health professionals in so that they understand and know the workplace and the culture of the company, and I think it’s important also for us to recognize that if somebody has a mental health issue when they come back to work. Neither they nor their problems should be ignored. You should be able to talk to them and say, hey, welcome back, we’re glad to have you back. But if you if you continue to have an issue, I’m here to help you. You know, thanks for trusting in me. I’m on your side. That’s really important. And I thank you for everything you’ve done in terms of creating awareness around this, in terms of helping organizations start embracing in terms of the role and how they can make a difference. I really appreciate you coming on the show to speak more about this critical topic around suicide awareness and prevention. So, thank you so much, Kathleen. Oh, sure thing. And just one more reminder, everybody takes that checkup from the neck up. Thank you for listening to The Safety Guru on C-Suite radio. Leave a legacy, distinguish yourself from the pack, grow your success, capture the hearts and minds of your team’s. Fuel your future. come back in two weeks for the next episode or listen to our sister show with the Ops guru Eric Michrowski.

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Kathleen Dobson is a 21+ year veteran of the construction industry. As Safety Director for Alberici Constructors, she has responsibility for and supports their automotive, heavy civil, mining and industrial processes divisions. Kathi is engaged in project start up and provides sites with ongoing evaluations, audits and training when needed. Kathi is zealous regarding safety of workers and believes that everyone should be able to say they have the right PPE, the right training and the right environment in which to work. She is active on several national committees where she focuses on standards, advocacy and influencing the construction industry.