Editor’s note: This story focuses on the topic of mental health and suicide. If you or someone you know is having suicidal thoughts, call the National Suicide Prevention Lifeline at 988.
In September 2021, John Gaal Sr. received an unexpected phone call from a colleague late on a Saturday evening. The colleague’s son had died by suicide, and he didn’t know what to do next.
Gaal, who’d lost his own son, John Gaal Jr., to suicide about four years earlier, knew the feeling. In the immediate hours following the tragedy, there was no guidance, no roadmap.
After speaking with his colleague, Gaal became a regular resource for people in those circumstances and made himself available for those whose loved ones had died by suicide. He fielded eight more of those calls in a 12-week stretch, and dozens more in the time since.
In fact, Gaal took one of those calls the night before he spoke to Construction Dive for this piece.
The director of worker wellness at the nonprofit Missouri Works Initiative, Gaal has studied suicide “postvention,” or the need to intervene for friends and family immediately following a death by suicide. He’s published his research on the topic in the International Journal of Vocational Education and Training.
Here, Gaal talks with Construction Dive about the notion of postvention, why the first hours are so important and what builders can do to make a difference.
Editor’s note: The following has been edited for brevity and clarity.
CONSTRUCTION DIVE: What is suicide postvention?
JOHN GAAL SR.: I often put out the concept of a triangle. One leg is prevention, one leg is intervention and one leg is postvention. When I show it, I show the sides overlapping at the apex of every one of those corners. Intervention impacts prevention as well as impacts postvention and so on.
In simple terms, prevention is awareness. Intervention is where someone has gone through a prevention course and asks, “Now that I know that, when I see something and hear something or I observe something, how do I intervene?”
We see a lot of work in the areas of prevention and intervention, but not as much in postvention, which is the third leg of the triangle.
We also call it aftercare. What do you do with the people left after someone dies by suicide, possibly a loved one, a coworker, a dear friend or family member?
Not a lot of work has been done in that area. In fact, the ratio is about 40 to one for peer-reviewed research articles on prevention compared to postvention.
What are those phone calls like?
None of those calls ever asked me, "John, what do I do three weeks, three months, three years from now?" Every one of those calls said, "John, I'm in the eye of the storm. What the hell do I do right now?"
People are thirsting for this. They need a protocol.
So what can people do?
In a workplace setting, there are four key things that we want to look at in that acute phase.
Coordination's the first one. We’ve got to be really good in our communication and offering support.
Ideally, we task a team of three or four people with running point. You need one person that knows how to engage with the media because there's journalistic protocol on suicide in the press. We can't have four or five people sending mixed messages to the local press.
Then comes the notification: we have to make sure that we've contacted the family, that they’ve given permission to share information and confirm how much information they want us to share.
This is such a taboo topic in our society. Our approach is, we don't share any details about the “how” involved in the death. We also use proper language. We don't say “committed suicide.” We use the phrase “died by suicide.”
The reason we do that is because so much of the language is steeped in history, tradition and religion. For example, people “commit a sin,” they “commit a crime.” We need to move away from that judgmental type of language when talking about suicide.
We have to meet with the employees, to stop the rumor mill, to encourage them to stay away from social media until we have more information that's ready to be properly shared.
The third phase is communication. We have to be there in the first few hours in an attempt to stop contagion, which is the concept that people exposed to suicide have increased risk of dying by suicide themselves.
Work done by the University of Kentucky back in 2018, suggests that one suicide impacts 135 people. That means in a company of 150 people between the office and field workers, we're going to need 150 different strategies. Because how you process grief and how you knew John Jr. is different from how I process grief and how I knew John Jr.
The final phase is support. How do we offer assistance to those workers? To the family members? It's really important that we address people in a group and then we start addressing people as individuals.
How can companies and leaders be more prepared?
If you haven't already undertaken steps towards suicide prevention and intervention, do so now. And then follow that up with a training in postvention, which is so important but so often overlooked.
