The issue of mental health is at last being recognised by society as being on a par with physical health, rather than being hidden and stigmatised.
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The construction sector is also beginning to shine a light on this long unacknowledged issue, and is raising awareness of its impact on the workforce.
In September, the charity Mates in Mind announced that it would be rolling out its awareness programme to the entire UK construction industry following a successful year-long pilot led by Tideway with the support of six organisations: Balfour Beatty, Careys, Heathrow Airport Ltd, Tideway, VolkerWessels UK and Wilmott Dixon. The charity aims to:
- Raise awareness and understanding of mental health and mental ill-health in UK construction
- Help people to understand how, when and where to get support
- Break the silence and stigma by promoting cultures of positive wellbeing throughout the industry.
The charity – established in September 2016 by the Health in Construction Leadership Group (HCLG) with the support of the British Safety Council – provides support to employers through expert organisations like Mind, Samaritans and Mental Health First Aid England. Its aim is to reach 100,000 workers in the first year, and to have reached 75% of the industry by 2025.
The need for support in this area is clear when you look at statistics linked to mental health. In September, recruitment agency Randstad published the results of a survey of 3,400 construction workers in which more than a third (34%) said they had experienced a mental health condition in the last year; and almost a quarter said their mental health was making them consider a career change.
People in precarious employment are very vulnerable when, or if, they raise health and safety issues
Gail Cartmail, Unite
The survey also found that, that rather than seeking help, one fifth of workers self-medicated by increasing the amount they drink or smoke as a result of their mental state.
This follows a report by Public Health England (PHE) earlier this year that concluded that men working in the construction industry are at the highest risk of suicide of all occupational groups. The information came from research commissioned by PHE and carried out by the Office for National Statistics (ONS), which looked at all suicides in England between 2011 and 2015, of which 13,232 had information on the deceased’s occupation. It found that low-skilled male construction workers had the greatest risk, at 3.7 times above the national average.
Previously, the ONS has said that occupations may have a higher risk because of low pay and job insecurity – something Unite union assistant general secretary Gail Cartmail believes is fundamental to what she calls the “mental health crisis” within the industry. “I’m not surprised by the statistics,” she says. “The structure of the construction industry in the UK is driving conditions that cause mental ill-health.
She highlights what she calls “precarious employment”, which affects a large proportion of the on-site workforce. “We support industry initiatives, but if you go to a site where the tier one contractor has subcontracted the work, the majority – if not the entire workforce – are false self-employed, and the good intention campaigns don’t touch them.
“People in precarious employment are very vulnerable when, or if, they raise health and safety issues. And even if there’s a Mates in Mind poster up, where’s the support? Who’s going to pay for it? If you’re self-employed you’re responsible for your own mental health.”
However, Cartmail describes herself as an optimist, who wants to be constructive and work with the industry. She says many Unite members take up “mental first aider” roles on sites, and encourage their colleagues to do the same so that every worker on a construction site has got someone they can talk to about mental health issues.
Mental health first aiding
Costain is one of the companies in the industry that has adopted mental health first aiding, with 250 people throughout the business so far trained by Mental Health First Aid England to carry out his role.
“We’re not trying to train our people to be psychiatrists, but to detect the signs and symptoms of mental ill-health, provide a listening ear and be confident that they can signpost to professional support,” explains Costain health and wellbeing manager Veronica Robins. “It is part of our safety, health and environment strategy that every person working on site or in an office should have access to a trained mental health first aider.”
In addition to the two-day mental health first aider training, the contractor runs a half day awareness course for managers. And next year it will add a 45-minute programme called “Let’s start the conversation”.
“We have been focusing on wellbeing for quite a long time, but we feel that mental health is just as important, so we started rolling out the training in 2015,” says Robins.
Rugby League experience
The company also uses other specialist organisations and charities to bring their perspective on mental health, including State of Mind – a charity initially set up to promote positive mental health among Rugby League players. “We are going to be working closely with them,” says Robins. “We have already had former rugby players visiting sites and sharing their experiences. It has been extremely well received.”
Costain has also used drama-based learning organisation Dramanon to provide mental health training through acting out scenarios.
Similarly, contractor Bam Nuttall has been using mental health charity Mind to provide awareness training for a cross section of its workforce, and more intensive training for the company’s “mental health champions”. “The statistics are really shocking,” says Bam Nuttall people and culture director Alasdair Henderson. “As a group or population, people in construction haven’t really spoken up [about mental health] in the past. What we’re doing is creating safe places to talk about it, supporting people with counselling if they would benefit from that, and making sure there is a sympathetic return to work for anyone who has been away because of a poor mental health.”
If someone starts behaving in high risk or anti-social ways, it might be an indicator of something else
Alasdair Henderson, Bam Nuttall
The awareness training helps people to look out for signs that someone might be struggling with stress, anxiety or depression. “Like a lot of businesses, we’ve concentrated a lot on behaviour in the past, says Henderson. “If we see a behaviour we don’t like, then we go down the disciplinary process.
“But if you look at it as a mental health issue, then the behaviour could be a symptom, which means it’s important to ask why is that behaviour happening, and offering support instead of going through the disciplinary route. For example, if someone starts behaving in high risk or anti-social ways, it might be an indicator of something else that could be work-related or home-related.
“Or if you’re making mistakes, and that’s out of character, then someone should be asking if you want to talk, or if there’s something we can help with,” he continues.
Self reported illness
The HSE says there were an estimated 79,000 cases of self-reported work-related illness every year in the construction sector between 2013 and 2016. Of these 18% were due to stress, depression or anxiety.
Added to that, the ONS figures indicate that there were 1,419 suicides among people working in skilled building trades alone between 2011 and 2015. So, while it is vital that construction employers provide support to people when they have mental ill health, it is also important to try to prevent it happening in the first place.
Cartmail says that the combination of a chronic skills shortage and “precarious employment” means there is pressure to work long hours – a major source of stress. And she says that workers living away from home are particularly vulnerable, as they can be isolated, away from their families and in uncomfortable or inadequate accommodation.
It is an issue Costain is aware of, according to Robins. “A lot of our workers do live away from home during the week, and that brings with it problems – feelings of isolation and missing your family,” she says. “And that can lead to mental health issues.”
Henderson agrees. “The nature of our industry is that the work you do is never in your back yard – that’s what makes it different from other industries,” he says. “We do a great deal around flexible working; and when people do have to work away from home, we provide them with things like broadband so they can Skype their families, and a really good gym – something they can build a social life around.”
The physical health agenda has been established in the industry far longer than the focus on mental health.
Construction employers routinely provide health screening for employees – and their supply chain in some instances – and offer other incentives for a healthy lifestyle, like gym membership and healthy food options.
Bam Nuttall people and culture director Alasdair Henderson says his company has offered health screening to all its staff for 20 years, something that is welcomed by staff.
“This is free screening,” he says. “If you identify a heart condition, it is better to know about it and seek treatment than to suddenly succumb to something.”
Until now, the information collected at the health screenings has only been used to make recommendations to the individuals concerned, but Henderson says the company is now planning to use the data to inform decisions.
“We ended up with a snapshot, which allowed us to identify individuals and get them help. But what we should be doing is turning the assessments into practical action.”
The screening might identify someone who has a susceptibility to, for example, hand arm vibration syndrome. The onus is then on the company to make sure that individual avoids vibrating tools – although confidentiality issues could make that difficult.