Of 13,232 suicides between 2011 and 2015 where occupation was recorded, low-skilled male construction workers were found to have a three times greater risk of suicide than the male UK average.
Additionally, a 2017 survey by Randstad of 3,400 UK construction workers revealed high rates of dissatisfaction with work environment, as well as perceived unsympathetic attitudes of their employers towards mental health.
There is clearly a mental health problem in the industry, but what can be done to improve this? How do we promote a mentally safe environment in construction?
What is good mental health?
The World Health Organisation defines good mental health as a state of wellbeing in which every individual realises their own potential, can cope with the normal stresses of life, work productively, and is able to make a contribution to their community.
Mental disorders such as depression, anxiety and psychotic disorders are clinical conditions characterised by abnormal thoughts, perceptions and emotions. They have evidence-based treatment pathways, and access to healthcare and support services is crucial.
Both poor mental health and mental health disorders are caused by a variety of factors, including individual attributes as well as social, cultural and political drivers, with the strength of each factor being different in each case.
A vital part of mental health is an enriching and supportive work environment, where people feel able to talk honestly about their concerns and can access support when needed.
”Moving towards a mentally safe construction industry is about putting measures in place to increase good, supportive workplaces”
Conversely, work can sometimes be harmful to mental health, such as when demands are greater than the ability to cope, or relationships with management is particularly poor.
Moving towards a mentally safe construction industry is about putting measures in place to increase good, supportive workplaces, and reduce workplace stressors where possible.
Workplace interventions to improve mental health can be categorised into primary, secondary and tertiary interventions.
|Good staff employment practices and welfare provisions||X||X|
|Staff support networks and wellbeing activities||X||X|
|Staff access to GP and community mental health service||X||X|
|Mental health first aiders on site||X||X|
|Management mental health training||X||X||X|
|Telephone counselling service (eg EAP)||X||X|
|Workplace stress policy with associated risk assessment||X||X|
|Occupational Health provision||X||X|
Primary interventions aim to prevent poor mental health or a mental health disorder from developing. Secondary interventions aim to detect poor health at an early stage and enable recovery. Tertiary interventions aim to help workers with ongoing mental health problems return to work, stay at work and live fulfilling working lives.
The table above lists examples of interventions into these categories. Not all possible interventions are listed and most impact at more than one level.
Better evidence is needed
To show commitment, all reasonably sized companies should adopt a mental health policy. This should set out aims, roles and responsibilities and provisions aimed at preventing and addressing mental health among employees.
But before spending time and resources on workplace mental health interventions, it is vital to look at individual company needs then choose interventions that will provide the biggest benefits.
“We urgently need a better evidence base so we can focus on interventions with not only good RoI but maximum gain in employee mental wellbeing”
A good evidence base for workplace interventions is therefore vital to success.
The recent Thriving at Work report into mental health commissioned by government (produced in association with Deloitte) looked at the current evidence base for interventions. Using outcome measurements including staff retention and sickness absence rates, the overall finding was a positive return on investment for wellbeing programmes.
However, studies looking specifically at the UK construction sector are lacking. We urgently need a better evidence base so we can confidently focus attention on interventions with not only good return on investment, but maximum gain in employee mental wellbeing and reduction in suicide rates.
Every death from suicide is a personal tragedy and a loss to society.
We must not be afraid to talk about mental health – including suicide – and honestly look at what can be done to give everyone the best chance to lead a happy and productive life.
There are now organisations dedicated to helping make that difference. Mates in Mind, established in September 2016 with government and construction industry support, has created interventions to raise awareness and address mental health in construction workers.
“Even in our increasingly hectic working lives, the compassion required for good mental health must not be overlooked”
The What Works Centre for Wellbeing seeks to improve the evidence base for wellbeing initiatives, helping government and industry choose ones that offer the most positive impact on employee health.
And the Department of Health and Social Care announced a 10-year research strategy on mental health in December 2017. The department’s strategy must ensure there is a workplace element, encouraging researchers to work with industry to generate evidence for construction workplace mental health programmes, so we know how to improve company mental health, happiness and productivity.
Above all, collaborating with others and sharing best practice is of vital importance.
At Barhale we have developed a training programme, Engineering Better Mental Health Management, to help our managers recognise and manage mental health in the workplace.
The workshops, delivered in collaboration with local NHS mental health teams, have received encouraging feedback, and we will share lessons learned with partners in the industry.
Even in our increasingly hectic working lives, the compassion required for good mental health must not be overlooked.
Dr Lisa Curran is a consultant in occupational medicine and a director Barhale