Mental health: support in construction

Well at work

6 June 2019

Reports of poor mental health in the construction industry have forced organisations to look at how they can better support their employees’ psychological well-being, not just their physical health

The built environment has a significant impact on well-being. We build hospitals to treat patients, design educational institutions to maximise learning, and develop infrastructure and public spaces to connect communities. However, we must give the same consideration to the well-being of those working in the built environment sector as we do to the end users of our projects.

The health and well-being of the working population has huge financial implications. The Health and Safety Executive reported that 1.4m people in Great Britain were suffering from work-related illness in 2017/18. This had an estimated cost to the economy of £15bn. Sickness absence in the UK is estimated to cost employers more than £29bn a year. It is thought that the cost of presenteeism, coming to work when unwell, may be over twice that of absenteeism – so the true financial cost of ill health to UK business is likely to be even higher than estimated.

In 2017, the UK government commissioned a review of how employers could better support the mental well-being of their employees. The report estimated the annual cost of poor mental health to employers to be between £33bn and £42bn, with a cost to the UK economy of £74bn to £99bn per year. These figures incorporate reduced productivity, increased employee turnover and absenteeism in the workplace, and the wider costs of treatment and support for those out of work due to mental ill health.

Traditionally, organisations have focused more on safety than on health. While the Health and Safety at Work etc. Act 1974 and The Management of Health and Safety at Work Regulations 1999 placed responsibility on employers to manage both health and safety, very often the focus was on the short term. Organisations weighed up the impact of ‘fast’ versus ‘slow’ accidents; for example, falling from height can kill someone instantly, whereas inhaling silica dust may kill 20 years after initially exposure. In 2017–18, there were 19 deaths in the construction industry related to falling from height, but 3,500 deaths from work-related cancer, thought to be predominantly caused by previous asbestos and silica exposure. Whether the motivation is legal or moral, there is clearly a need to prevent workplace ill health.

The Construction (Design and Management) Regulations 2015 (CDM) place specific responsibilities on the client, principal designer, principal contractor, contractors and workers in relation to both health and safety. The regulations require risks to be eliminated, reduced or controlled throughout the entire lifecycle of a building or project. While each stakeholder has their own defined role under CDM, cooperation and collaboration should be sought to share knowledge so health risks are identified and eliminated.

Having traditionally focused on protecting workers from physical injury or illness, over the past decade health and safety training has increasingly included mental health. In 2017, the Office for National Statistics produced its first report on suicide by occupation in England. The report revealed that the construction industry accounted for more suicides than any other industry between 2011 and 2015, with 1,409 men and ten women dying by suicide during that period. The risk of suicide in low-skilled male construction workers was three times the national average, and skilled finishing trades, such as painters and plasterers, were twice the national average. These sobering statistics have acted as a wake-up call for the industry to focus on both physical and psychological health, safety and general well-being.

Organisations can sometimes struggle to address well-being strategically – and addressing all the factors that affect an employee’s well-being can seem like an insurmountable challenge

Well-being is a broad term, and often misused. The International Labour Organization states that ‘Workplace well-being relates to all aspects of working life, from the quality and safety of the physical environment, to how workers feel about their work, their working environment, the climate at work and work organization’.

Organisations can sometimes struggle to address well-being strategically, and addressing all the factors that affect an employee’s well-being – physical, psychological and social – can seem like an insurmountable challenge. Breaking them down into the following, non-exhaustive, sections and subsections can be helpful:

  • working relationships: senior management, line managers, peers, clients, customers;
  • management of occupational health risks: dust, noise, vibration, hazardous substances, air quality, temperature, workstation set-up;
  • welfare provision: toilets, washrooms, storage for personal belongings, access to health foods, space for relaxation and privacy;
  • working arrangements: working hours, shift patterns, flexible working, travel times, access to sick pay, parental leave;
  • access to healthcare: occupational health service, public health services such as time off for healthcare appointments, private medical insurance, employee assistance programmes; and
  • workplace culture: does the organisation encourage employees to raise concerns? Are concerns acted on?

These sections and subsections can then form the basis of the following key ideas:

  • Leadership: the support of those in leadership roles is critical to the uptake and sustainability of a health and well-being programme, ensuring successful delivery and engagement with the strategy.
  • Data: a robust measurement of well-being can be achieved through employee surveys. These should consist of academically validated questions designed to ensure that the right topics are being addressed to achieve the desired outcome. The data can then provide a clearer understanding of the risks and opportunities relating to well-being and help to put together a business case for well-being investment.
  • Strategy: once a greater understanding of employee well-being is achieved, a long-term plan to address health and well-being risks can be developed and cemented as part of a responsible business strategy. It is important to define how your organisation considers well-being, including examples of actions and results in those definitions.
  • Ongoing management and measurement: key performance indicators (KPIs) can then be set to track health and well-being and the effectiveness of the strategy. Benefits to employees as well as commercial benefits can then be demonstrated.
  • Engagement: for a well-being strategy to be sustainable, there must be collaboration. This means all areas of a business must work together under the leadership of the well-being team, adhering to the agreed principles, and working out how the practices can be applied to their area of work.
  • Benchmarking: it is important to be aware of where your strategy sits in the context of the industry. Work with external organisations such as academic institutions, meet with your peers, and sign up to relevant initiatives to ensure that your business is doing all it can to develop an open culture, with wellbeing at the heart of its policies.

There are many ways that the construction sector can address health and well-being at work, but the key ideas listed above and explored in the case study can help you to create a sustainable health and well-being strategy. We can all make a contribution towards improving health and well-being at work and identifying any work-related health risks. Effective management of people and processes will help us address the impact that our actions have on others. After all, the way that we treat people may turn out to have the greatest impact of all on employee health at work.

Dr Judith Grant is director of health and well-being at Mace Group

Further information