With one of the highest suicide rates, the construction industry desperately needs to retool its approach to mental health
Mental wellness is an increasingly essential topic in the occupational health and safety sector, with some industries more at risk than others. In a study published in 2018, the U.S. Centers for Disease Control (CDC) assesses that, in the United States, one of the highest suicide rates among men was workers in construction and mining jobs, totalling 43.6 deaths for every 100,000 workers in 2012. This rose to 53.2 deaths per 100,000 in 2015.
“It’s a significant issue; it’s the second leading cause of death in our industry behind cancer,” says Donna Grant, marketing and proposal manager with Scott Construction Group as well as a member of the firm’s mental health committee.
The numbers are staggering, not just in North America but globally, too. Australian mental health organization MATES in Construction (MATES) published a report in 2017 with findings on mental health in the construction industry. The report estimates that between 2001 and 2003 in Australia, the rates of suicide among male construction workers were 2.3 times that of other male workers. Between 2011 and 2013, these rates were found to be 1.7 that of other male workers.
“Suicide doesn’t impact equally; most suicides are by men, and being a male-dominated culture, there’s even more [in construction],” says Jorgen Gullestrup, founder and CEO of Australia’s MATES.
Although numbers are more difficult to come by for the Canadian construction industry, Statistics Canada reports that suicide remains one of the top 10 causes of death in Canada: Around 11 people die by suicide each day. This number is influenced by gender and age. Statistics Canada reports that men in the 45-59 age category are at greatest risk and that the suicide rate among males is three times higher than that for females.
Nevertheless, suicide in the construction industry has only in the last few years become a growing concern.
Why is the industry so high-risk?
One of the reasons why suicide and mental health issues are so prevalent could be because construction is a male-dominated industry and men are less likely to talk about their issues with their employers, colleagues or families. However, one must take care in making gender-related assumptions and, in any case, it is much harder to address and find solutions for mental distress when both male and female workers are not being open or maybe not even realizing that they have a problem.
Gullestrup explains: “One of the things we found when we talked to the mental health experts is that, if the men don’t seek help, we can’t do what we’re called to do.”
“There are some specific reasons why it’s at that level in our industry… It’s a more male-dominated industry; more women attempt suicide, but men use more lethal methods,” says Grant.
The World Health Organization (WHO) estimates that, globally, 800,000 people die by suicide every year. Furthermore, it estimates that around 20% of global suicides are due to pesticide self-poisoning (occurring in rural agricultural areas). Other common methods of suicide include hanging and firearms. In this instance, construction workers certainly have ready access to fatal instruments and materials, which could be a factor.
MATES’ report raises a host of reasons why suicide is so prevalent in the construction industry. It points to problems such as isolation, precarious working conditions, poor attitudes toward help-seeking and the stigma facing those with mental health issues, alcohol and drug use and sleep and physical activity.
“Substance abuse is definitely a problem in our industry,” says Grant. She points out that 25% of B.C. fentanyl-related deaths are fully employed construction workers. “It's such a physical industry. We're always battling those tight deadlines. People who get injured or even just an ailment may not take the time to heal.” Workers may get opioid prescriptions from doctors to help them get back to work faster.
Grant says substance abuse and suicide seem to go hand in hand. She says that “suicides can cluster; if there's a suicide in a group, the chance of another one increases by 75%.”
This is made worse by the fact that, due to the nature of the industry, workers can feel very isolated. Some contracts lead workers to be separated from friends and family for long periods of time.
Gullestrup explains that the structure of the industry is projects-based, which means that project managers go out to find builders based on how fast and cost effective they are. Managers find sub-contractors on the same basis, who then staff their sites. “Workers are often employed by small businesses on a project-by-project basis. There’s very little connection between employees and employers. They might invest in a small core, but most people come and go … This is a highly competitive environment.”
Grant says workers in the industry often face precariousness and financial instability. “It can be a feast or famine industry. When you’re working, it can be very long hours, but if you're not working, you’re very worried about where the next job is going to come.”
And men in the industry are afraid to speak up about it, she says, notably out of concern for their careers.
“People are worried about being left out of things, professional development and promotions, if they speak up about suffering from a mental illness. People are worried about how it could impact or slow their career. Ultimately, people are worried about being fired, not in a transparent way but for an alternative reason,” says Grant.
Gullestrup agrees. “It’s really a situation where you can’t talk to your employer about it because they want 100%, so each sign of weakness can make you unemployable.”
What does the industry need to do?
“I think that, first and foremost, leadership needs to embrace the fact that people are not going to milk a claim of mental illness to their advantage. People don’t claim mental illness to have a day off for skiing. In fact, people are more likely to say they have the flu when in fact they may be suffering from depression and anxiety,” says Grant.
Gullestrup says one thing we can do is change employment practices to make workers see that it won’t be detrimental to their jobs to have mental health issues. We also need to make sure there’s access to mental well-being programs with multiple ways of access both inside and outside of the traditional employment structures. People need to trust the program and take the time to understand it. Essentially, actors in the industry need to open up a dialogue among employers, workers and legislators.
Grant is optimistic. “I think we’re doing better than we were.” But she says construction firms need to “reduce the stigma. It's what keeps people suffering in silence. Forty per cent of people suffering from depression and anxiety are not telling their managers. Fifty per cent of people over 40 will experience a mental illness in their lifetime.”
As a member of her firm’s mental health committee, Grant says they spend at least as much time on mental wellness topics as they do on mental illness topics. They encourage people to make that mind-body correlation. For example, the committee brought in a holistic nutritionist to talk about how nutrition affects mental health and the importance of gut health. The committee also provides links to podcasts, books, guided meditation online, etc. They go on company hikes and “Beat the Blues” bowling every January.
The committee acts as a bridge between workers and mental health resources, says Grant. “None of the members of the committee see themselves as being mental health professionals; we're a compassionate ear when needed and bridges to resources. There are so many resources available. If I could have my wish, it would be that mental health is a standard part of education in high schools.”
Grant adds, “While men are less likely to talk about these things, I’m finding that’s really changing. When I first started on the mental health committee at Scott [Construction Group], the first thing I did was a site rollout on suicide awareness and prevention. I was going to a job site with young men in our company who I hadn’t met before — I thought it might be a very awkward. It ended up being the exact opposite. They were hungry for information; it was so different than what I expected, and they inspired me to continue.”
Started in 2008, Gullestrup’s group, MATES, is an industry-based organization and a collaboration between trade unions and employers’ organizations. “This program is speaking directly to the workers. One of the weak points is that we don’t have a strong relationship with the employers. Quite often when we talk to employers, they don’t actually know what they’re doing. We realized we had to fix this ourselves as an industry — workers, unions, employers and employer associations … We want to be the ones who ride the bus and then pull in the most suitable and the most qualified for the job. It has to be on our terms and with our unique cultural understanding,” he says.
“We talk about what it looks like when one of our mates in struggling.” Gullestrup explains that this is why they introduced the concept of a “connector” — someone who will look out for a worker in need. He says the program gets between 20 and 30 per cent volunteering. MATES trains key workers and encourages those involved to form connector committees to understand current issues.
He says MATES wants to start a conversation around how to motivate somebody to accept help. Over time, MATES has generated a network of about 15,000 volunteers across the industry as well as 2,000 to 3,000 interveners. These volunteers have become the core ambassadors of the program.
Gullestrup says the program is based on a Canadian module, LivingWorks. Based in Calgary and started in 1983, the organization offers two suicide prevention programs: LivingWorks ASIST and safeTALK, which uses a “train the trainer” model for dissemination. MATES aims to raise awareness around the topic, create stronger networks and provide case managers. MATES also partners with researchers to see what progress could look like. Gullestrup says that, in the last 10 years, there’s been a market shift and that MATES is part of it. Now, he says, a number of large companies want their sites to be MATES-accredited.
This is essential as Gullestrup says that “the smaller companies depend on the larger companies, so when we get the larger companies on board the smaller companies have no other choice but to comply.”
What about women?
Although they make up a smaller part of the workforce, suicide in the industry also affects female construction workers.
“We are talking a lot about men’s mental health, we need to be, but there's an aspect of being a woman in a male-dominated industry,” says Grant. “I’ve had women tell me they’re already seen as a liability on the job just because they’re a woman, so they’re even more reluctant to reveal they may be suffering. That's something we also need to talk about. If you're a woman working on a construction site, you're a rare breed; they're about five per cent [of the workforce].”
Gullestrup concurs. “It’s an issue we’re becoming more and more aware of … We’ve looked at suicide rates and the numbers are very small, but what we’ve actually found is that suicide rates among men in the construction industry have [been] reduced and those among women have increased, which tells us we’re not doing the job as well as we can.”
However, Gullestrup says, women are more likely to call MATES’ helpline and become volunteers and connect with the workers. “There’s something in the program they tend to identify with.”
The industry certainly has a lot on its plate. “I think change has started, which is fantastic, but we can't take our foot off the gas and we've got to continue talking about it,” says Grant.