‘No satisfaction… no thanks’ – what construction can do about its mental health crisis

“He came home one night, went upstairs and didn’t come back down.”

Bill Hill, chief executive of the mental health charity Lighthouse Club, is recalling a phone conversation with a mother of three whose husband had worked in the industry for 16 years.

“That guy most likely did not know we were there,” Hill says. He believes the organisation’s 24-hour helpline could have provided the self-employed worker with a light at the end of the tunnel in which he evidently felt trapped. “I’m not saying we would have stopped that suicide but we would have had a damn good try [...] He was in serious debt and it can become overwhelming. We have experts who can help.”

The Lighthouse Club is a charity funded by and offering support to those in the construction sector. Both historic data and new data shows that its services are vital and necessary.

So why are mental health problems so prevalent in the construction industry? And what can be done to change this situation?

Finances and fragmentation

Data from the Office for National Statistics shows that more than 2,000 construction workers took their own lives in the UK in the decade to 2017.

Preliminary findings from a more recent Glasgow Caledonian University study, commissioned by Lighthouse, show the problem is getting worse. The number of suicides per 100,000 construction workers rose from 26 to 29 in the four years to 2019 – and that was before the pandemic hit. People in the construction industry were three times more likely to take their own lives in 2019 than those working outside it, the researchers found.

Hill says financial issues are a huge factor in construction, causing stress, anxiety and depression, with large numbers of self-employed individuals who are “brilliant trades people but haven’t had an education about how to run a business”. He adds: “They win a project, someone pays them a big invoice but they don’t put money aside for VAT [and then] the taxman asks for payment so they get finance. It tumbles from there. Sole trader-style business management should be taught at apprenticeship level.”

The nature of the construction sector not only makes it inherently more stressful but also creates a challenge in reaching individuals in crisis.

“The industry is hugely fragmented,” Hill adds. “Fifty-three per cent of the 2.8 million people working in construction are self-employed, on an agency contract or on a zero-hours contract. It is very difficult to get to those people.

“Some larger companies have done a fantastic job on mental health but only apply their programmes and workshops to their own staff. Until you get to the huge mass of very capable tradespeople who are getting no input, one of the biggest problems is awareness.”

Stark new findings

CITB head of analysis and forecasting Marcus Bennett agrees that the structure of the construction industry provides a major challenge in looking after its workforce, pointing out the vast majority of firms in the sector have fewer than 10 employees.

“There are a number of big organisations who are positive modernising influences in the industry,” he says. “They are the same organisations embracing digitalisation and modern methods. They see that if you have a diverse, healthy workforce, you are more likely to innovate.

“My question to the leaders of those companies is: how are you looking after your supply chain? You probably put them under a lot of pressure to deliver on time and specification but that is dependant on their employees being well, well-trained and well-equipped.”

“If an industry is so clearly disproportionately damaging its workers, then it is not down to the normal everyday stresses of life. There is something about the construction industry that is having a significant impact on people’s wellbeing”

Marcus Bennett, CITB

As well as a “moral imperative”, there is a cold business logic why firms should act to help those beyond their own direct payroll, Bennett argues. “Mental health does not exist in isolation,” he says. “Construction has a very poor reputation on productivity. In some areas, quality of output has been an issue for some years.”

Future challenges include building more homes to tackle the housing crisis, a widescale programme of retrofitting to meet zero-carbon goals and overcoming a skills shortage, Bennett adds. “If your workforce is disproportionately suffering poor health, you don’t have to look too far to see where some of the solutions are to make the industry more attractive, more productive, more able to address these challenges.”

In a horrifying glimpse of just what further damage the pandemic may have done to already fragile mental health in construction, the CITB has exclusively shared with Construction News two statistics from research it is due to publish imminently.

The organisation found, via interviews with 500 construction employees, that 97 per cent have experienced stress over the past year, and more than one in four experienced suicidal thoughts.

“If an industry is so clearly disproportionately damaging its workers, then it is not down to the normal everyday stresses of life,” Bennett says. “There is something about the construction industry that is having a significant impact on people’s wellbeing.”

As well as financial pressures, additional factors include tight deadlines, responsibility for colleague safety in difficult environments and working away from home, according to Bennett.

Confrontational contracts

Electrical Contractors’ Association (ECA) director of corporate social responsibility and public affairs Paul Reeve believes poor mental health is a symptom of a wider “malaise” in the industry, a culture of “confrontational contracts and poor payment”. The ECA, which represents 3,000 members, is in the process of conducting its own survey on mental health.

Reeve says that with so many micro-businesses in construction, a high proportion of workers take on high-level responsibility: “We are concerned about stress and the context of senior managers and owners who are struggling because of the inherent way construction does business,” he says. “A boss who is stressed because of a cashflow problem is not making rational decisions.”

But the pandemic has had a negative impact on the mental health of operatives as well as managers, Reeve says: “Our sector has worked through the pandemic but worry has come on due to uncertainty.”

A further difficulty for managers can be that as well as suffering from a number of pressures that can cause stress, they often don’t feel able to speak about how they’re feeling. “There is a cultural approach in the industry that, at management level, you should be able to deal with stress; that if you opened up and spoke about problems, it would be bad for your career,” Reeve says.

“I am perceiving that some companies feel that putting in place a first aider has sorted the issue – but it must be supported by effective management”

Paul Reeve, ECA

“Construction needs to engage with mental health issues in a grown-up, professional way. If I turned up at work and said I’d broken my ankle skiing, they would send me to Bupa and give me three months off – I would want to be looked after in the same way with a mental health problem. There are too many pockets of the industry where that isn’t the case.”

Reeve is keen to use the ECA survey to push the debate beyond raising awareness and into finding real solutions to tackle the problem, suggesting that some firms have used currently available initiatives as little more than box-ticking exercises. As an example, Reeve cites the Mental Health First Aiders scheme – which, through a contract between the CITB and Lighthouse, has seen some 10,000 people in the industry gain the skills to spot the triggers and signs of mental health problems and to step in and intervene.

“We greatly support mental health first aiders but they are partial solutions,” Reeve says. “Under no other health and safety risk would you rely on a strategy of first aid. I am perceiving that some companies feel that putting in place a first aider has sorted the issue – but it must be supported by effective management.”

The ECA has published a guide for managers on how they can spot and help someone struggling mentally.

“You should start by listening and looking at what you’re asking people to do,” Reeve adds. “Is it reasonable? Do they have the experience to handle it? If not, then act. Are you confident your team could speak to someone about issues they have? What would you look for as signs of stress? Is anyone showing those signs?”

Progress… but not enough

Construction Industry Council chief executive Graham Watts says the sector has made positive strides on mental wellbeing over the past 40 years but is still not doing “nearly enough” to support staff in this area.

“When I joined the construction industry in 1979, no one talked about mental health,” he says. “Sites were even more male-dominated then than now and I suspect that the prevalence of macho attitudes meant that workers suffering from mental health issues would bottle them up in the workplace.

“Today, I would hope it is easier to be more open about mental health. I’m impressed by the leadership that is being shown by some companies – for example Tideway, where chief executive Andy Mitchell has ‘mental health first aider’ immediately after his email sign-off – but it is still only being exhibited by the best of the best.”

Watts says such practices must be adopted throughout the industry, adding that he believes a more gender-diverse industry would help. Hill and Bennett agree that getting more women into construction would help tackle embedded cultures that are detrimental for mental health.

“You will get a better culture,” Hill says. “Male stoic behaviours would decrease. Softer skills would come in.”

Working on it like physical fitness

One person who firmly believes the industry needs to focus on employee mental wellbeing at an earlier stage than it usually does is qualified electrician Tom Forster, the founder of mental health coaching company Bemeta. He sought support for his own issues after suffering depression and anxiety. Once he suffered a panic attack that led him to injure himself. “I lost control of my senses and what I was doing in the moment and drilled a 6mm hole in to my hand,” he says.

He now works full time as a coach, focusing on construction site mental wellbeing. “There is a lot of stress in construction; everything has to be done yesterday, using the cheapest materials – there is often no sense of satisfaction and no thanks,” Forster says.

And he points out some of the difficulties of relying on safety nets for crises. “I was hit with a mental breakdown and I didn’t ring a helpline,” he says. “A helpline means a man or woman in a macho environment has to admit they need help. There is a language change required. For example, I [didn’t want to] ring a charity as I used to get bullied at school for wearing a charity [shop] jumper.”

Bemeta’s vision is to be “cool and current”, something people are proud of engaging with to maintain positive wellbeing. “You don’t go to the gym after a heart attack; you go so that you don’t have one,” he says.

The essence of its strategy is to get people to understand and acknowledge that they have mental health, then to identify where it currently sits on a defined scale and appreciate that they can work on it like they do their physical fitness.

“You don’t go to the gym after a heart attack; you go so that you don’t have one”

Tom Forster, Bemeta

“Other industries are well ahead. Construction is culturally behind,” Forster says. Ironically for an industry now flooded with data showing how serious and sector-specific its mental health problem is, he admits a major obstacle to wider take-up of Bemeta’s methods and similar approaches is a lack of available statistics about outcomes and results from them, as these take time to develop.

Lighthouse’s Hill agrees that more data is required. “I’m trying to organise an annualised dashboard of wellbeing because there is so much research in this area and it’s not being combined into one place where we can see if the dials are moving in the right direction,” he says.

“If you want to get accountants behind a programme you’ve got to show a return on investment. Good leadership knows this is the right thing to do – improve the mental health of the workforce – but you can only go so far without showing return on investment.”

Lighthouse is working with partners including Glasgow Caledonian University and the Safer Highways charity to start improving information availability. The dashboard he is looking to create would compile annual industry stats by geography and profession. “This would show accidents, falls from height, calls to helplines and so on. The first thing is suicides,” says Hill. “That is the number one benchmark of all the work we are doing – are we reducing suicides in the industry?”