[MCOH-EH] Self-Harm Statements by Employees

[David S. Cockrum]

Very recently, senior leadership at Dartmouth Hitchcock decided to eliminate our internal, in-person EAP program. We now rely fully on an EAP contracted service that is accessible by web and phone.

Previously when HR presented an employee to Employee Health/Occ Med that had made statements that suggested possible self harm, but were not overtly clear in their intent, we would ask the employee to voluntarily see our internal EAP who would perform an initial safety assessment and, if the employee was deemed to not be at immediate risk of harm, establish a safety plan and a follow-up plan. If the employee consented, EAP would also advise us of the outcome (if the employee did not consent, EAP would not advise due to confidentiality).

Now that we have lost access to this service, we are trying to figure out the best way to assess employees for self-harm. When the statements are clear and obvious, the response is not difficult. We contact Security who will call local law enforcement who will make the determination as to whether the employee can be taken involuntarily to the ED for psych eval. As the employer, we have no authority to direct the employee to the ED, we can ask/recommend, but the employee must go voluntarily.

Does your medical center have an established process/protocol for assessing employees with possible intent of self harm that you would be willing to share? We are closely engaged with HR and OGC to develop a solution that we can then communicate to all leaders and managers.

Thanks in advance for any expertise offered. Feel free to reply privately, David.s.cockrum at hitchcock.org<mailto:David.s.cockrum at hitchcock.org>, though I suspect some of our peers would appreciate the insights of some of our more experienced colleagues.

David S. Cockrum, MD, MPH, FACOEM
he/him/his
Section Chief, Occupational & Environmental Medicine
Medical Director, Employee Health
Department of Medicine

Tel (603) 653-3881 | Fax (603) 650-0930
Dartmouth-Health.org
[cid:image001.png at 01DCF76E.2EFDF210]<https://www.dartmouth-health.org/>



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