Historically, mental health was not openly discussed and only rarely acknowledged in the construction workplace–and, certainly not on jobsites. This is because it was a taboo topic generally considered to be “off-limits.” Unfortunately, when mental health was discussed too often it was done by discussing signs and symptoms of underlying conditions that only reinforced the notion of mental illness and not the possibility and hope of recovery.
Much has been written about the prevalence of serious mental and behavioral health challenges facing the construction industry workforce. This includes elevated rates for many conditions and outcomes compared to the general U.S. population. This is common in industries and occupations with heavily concentrated male workforces.
A contributing factor is that compared to women, men are less likely to seek help for both physical and mental health concerns. One explanation for this is that men are less likely to have a primary care physician and this can delay proper diagnosis and delays necessary treatment for both physical and mental health conditions.
It is well known that the construction industry ranks among the highest industries for prevalence of the certain conditions, see Table 1.
Collectively, the term behavioral health is used more broadly to capture the conditions, comorbidities and health outcomes stemming from mental and physical health combined with substance misuse and/or diagnosed substance use disorder.
How Behavioral Health Impacts Company and Project Performance
The premise of part one in this two-part series is that human capital risk impacts the other six strategic risks facing contractors and other businesses. The reality is that rising behavioral health risk factors activates all seven of the strategic risks identified in the first article and in Figure 1. Note that the “risk gauge” is marked as high to depict the current level of risk from behavioral health on individual workers and the collective workforce.
This graphic underscores the importance of contractors addressing behavioral health risk reduction through intentional and strategic investments in human capital risk management and worker well-being initiatives. An important step in addressing workplace mental health and workforce well-being is to acknowledge and reduce the negative stigma associated with mental health.
Overcoming Stigma Associated with Mental Health
In frequent presentations using interactive and anonymous polling software, a favorite question I have asked is “What is the first thing you think of when you hear the words “mental health.” Only two options are provided:
- The presence or possibility of mental illness or
2. The absence of mental illness.
In all but 8 times out of more than 240 presentations using this question since 2019, audiences of various sizes representing construction employers or labor unions across the United States, the responses have exceeded 85% supporting the first answer. In fact, the more heavily concentrated the audience is with male attendees, the more likely the response will be at or over 90%. There have been numerous audiences where the answer indicated 100% in support of the first answer.
Although this is not a scientific study, this insight offers important clues about attitudes, beliefs and perceptions about mental health. This is best explained as a tangible representation of stigma. It shows the bias of how so many people have been socialized and conditioned to think negatively about mental health or avoid the topic altogether.
Without embedded stigma, the words mental health should simply be viewed as the absence of mental illness. However, when audiences consider the words mental health, they report thinking of conditions, medications, emergencies or crises, and the like, that reinforce stigma and discomfort associated with mental illness.
Shifting from Workplace Mental Health to Worker Well-Being
One clear message in these survey results is for company leaders to shift their focus from speaking solely about workplace mental health to also expanding the emphasis on worker well-being. This can include mental fitness, resilience, and/or mindfulness. By doing so, companies can eliminate some of the inherent resistance from some workers who remain uncomfortable talking about mental health.
Worker well-being can be described as the intersection between physical health and emotional wellness. This hybrid approach is encompassed by the Total Worker Health (TWH) initiatives being advanced by the National Institute of Occupational Safety and Health (NIOSH). TWH continues to gain momentum and this bodes well for the future of workplace well-being programs and practices.
The World Health Organization (WHO) defines “mental health is an integral and essential component of health”. WHO further highlights that overall health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
WHO defines well-being as:
[A] positive state experienced by individuals and societies. Similar to health, it is a resource for daily life and is determined by social, economic and environmental conditions. Well-being encompasses quality of life and the ability of people and societies to contribute to the world with a sense of meaning and purpose.…
The shift away from describing illness and promoting holistic health is a major reason many organizations have shifted to the term emotional well-being. As defined by the National Institute of Mental Health (NIMH), emotional well-being refers to “an overall positive state of one’s emotions, life satisfaction, sense of meaning and purpose, and the ability to pursue self-defined goals”.
Shifting Toward Recovery Pathways
There is close similarity for this definition and the one offered by the Substance Use Mental Health Services Administration (SAMHSA) in describing recovery as “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential”.
This shift supports an intentional move away from focusing solely on the problem to identifying possible solutions to recognizing, assessing, adapting to, and/or treating mental stress and substance misuse. The expansion of Recovery Month celebrations offers a positive shift to decreasing stigma and reinforcing hope for overcoming challenges associated with both mental health and substance use.
Areas of additional opportunity to promote worker well-being include the Recovery-Ready Workplace movement initiated by the White House’s Office of National Drug Control Policy and the U.S. Department of Labor.
The Power of the No Shame Pledge Movement
The No Shame Pledge Form used by national nonprofit SAFE Project is an effective “stigma-busting” tool. Increasingly, employers, unions, families, and individuals are using this pledge form to break the ice and reduce stigma associated with substance use, misuse, and addiction. By doing so, these leaders are opening the doors to multiple pathways for treatment and recovery. In the process, they are banishing stigma and associated shame, judgement, and blame.
See Figures 2 and 3 to consider how the No Shame Pledge can help your organization reduce stigma and address prevention and recovery for all types of mental health conditions.
Conclusion
Construction leaders are wise to consider the rising risks of behavioral health. Addressing behavioral health challenges requires intentionality. The need for proactive and preventive physical health and emotional well-being services and supports has never been greater. And, this matches the rising openness of workers to seek support from employers.
Cal Beyer, CWP, is senior director for SAFE Workplaces for national nonprofit SAFE Project. SAFE stands for Stop the Addiction Fatality Epidemic. Beyer has more than 30 years of construction risk management, safety and well-being consulting experience. Beyer serves on the Executive Committee for the National Action Alliance for Suicide Prevention and helped launch the Construction Industry Alliance for Suicide Prevention in 2016. He also serves on Advisory Groups for MindWise Innovations, Goldfinch Health, and the Lived Experience Advisory Committee of the Suicide Prevention Resource Center. Contact Beyer at cal@safeproject.us or via cell at 651-307-7883. www.safeproject.us.
Leading Mental Health and Well-Being Resources for Construction Companies
Alliance for Naloxone Safety in the Workplace:
www.answ.org
American Foundation for Suicide Prevention:
www.AFSP.org
Construction Center for Research and Training:
www.cpwr.com
Construction Industry Alliance for Suicide Prevention:
www.preventconstructionsuicide.com
Construction Suicide Prevention Week:
https://constructionsuicideprevention.com
Man Therapy:
https://mantherapy.org
National Alliance on Mental Illness:
www.nami.org
SAFE Project:
www.safeproject.us
Wellbeing Think Tank:
www.wellbeingthinktank.org
