The relationship between work disability and subsequent suicide or self-harm: A scoping review

Area of Science:

• Occupational Health
• Public Health
• Mental Health Research

Background:

• Work disability, defined as limitations in employment due to injury or illness, is increasingly recognized as a potential risk factor for adverse mental health outcomes.
• Existing evidence suggests a correlation between work disability and increased rates of suicide and intentional self-harm, yet a comprehensive synthesis of this research is lacking.

Purpose of the Study:

• To systematically review and summarize the existing research literature on the relationship between work disability and subsequent suicide or intentional self-harm.
• To identify factors that may modify this relationship and to highlight gaps in the current evidence base.

Main Methods:

• A scoping review was conducted following PRISMA-ScR guidelines, with the protocol registered on the Open Science Foundation.
• Systematic searches of Medline, Scopus, and PubMed databases were performed, supplemented by expert recommendations and citation searching.
• Peer-reviewed studies published from January 1, 2000, focusing on individuals aged 15 and older with work disability and reporting suicide or self-harm outcomes were included.

Main Results:

• The review identified 47 eligible studies, encompassing workers' compensation, sickness absence, and disability pension systems.
• A significant majority of quantitative studies (41 out of 44) reported a positive association between work disability and suicidal behavior.
• This association was consistent across different nations, income support systems, and health conditions, with mental health conditions and longer disability duration identified as risk-elevating factors.

Conclusions:

• The research consistently demonstrates an elevated risk of suicide and self-harm among individuals experiencing work disability.
• Further observational research is needed to address identified evidence gaps, particularly concerning specific populations and the efficacy of interventions.
• There is a critical need for governments, employers, and healthcare providers to prioritize the identification, monitoring, and prevention of suicidal behavior in this vulnerable population.