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Mental Health and Well-being in the Construction Industry

2021 Pulse Survey Results and Report

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Introduction

illustration of construction worker tipping their hatMental health and well-being are high priorities for organizations across industries. This was true before COVID-19, however, is even more so now.

Growing mental health concerns exist in the construction industry because it ranks second highest in suicide rates among major industries.1

Research shows that up to 90% of people who die by suicide have a mental health condition.2 Depression is the most common, however other conditions may impact suicide rates including substance use disorders — most commonly alcohol misuse, anxiety, and trauma.3

Multiple factors likely contribute to higher suicide rates and mental health concerns in the construction industry, including the following:

  • Male dominated industry, with men experiencing the highest suicide rates
  • Toughness and strength are valued, mental health conditions, or seeking help, may be seen as personal weakness
  • Stigma and fear of consequences associated with mental health issues and help seeking
  • Shame and fear of judgment
  • Chronic pain
  • Seasonal and cyclical work contributing to family and financial strain
  • High stress and deadline driven work
  • Limited job control
  • Long work hours including potential for large volume of overtime leading to fatigue
  • Separation of family when working away from home

When it comes to mental health conditions, the best outcomes occur when people seek and connect with care early.

Purpose

This pulse survey was conducted to better understand mental health experiences and needs in the construction industry. The questions focused in four key areas:

  • Leadership Engagement
  • Raising Mental Health Awareness: Resources & Strategies
  • Creating a Mentally Healthy Organizational Culture
  • Enhancing Access to Services and Supports

The survey findings and report recommendations provide a blueprint for what’s needed to support the mental health and well-being of construction workers. It also offers key insights into how issues are viewed at multiple levels of construction organizations.

Organizations across industries increasingly identify addressing mental health and well-being as a top priority given the impact on safety, quality performance, productivity, employee recruitment and retention, and the bottom line. There is growing recognition that people will care about an organization’s strategy when they believe that the organization cares for their well-being.

Methodology

The online pulse survey was launched in March 2021. It was distributed in all regions of the country by the four sponsoring organizations, along with state chapters of national construction trade associations, labor unions, and joint labor-management benefit trusts.

The survey consisted of 20 questions. A total of 1,175 respondents completed the online survey, with 26% sharing comments on the topics covered in the survey.

In addition, respondents were permitted to provide their email address to receive the survey report. Nearly half of respondents (45%) shared their email address showing a high level of interest in the issues covered in the survey.

illustration of a group of construction workers

Respondent Demographics

45% of survey respondents represented C-Suite leaders, showing the importance of these issues to construction leadership.

Type of Construction Organization

  • 28% - Specialty Trade Contractors
  • 23% - Commercial Property or Vertical General Contracting or Construction Management
  • 23% - Infrastructure, Street/Road, Bridge and Heavy/Highway
  • 7% - Industrial General and Specialty Trade Contractors
  • 4% - Site Development, Utility, Underground, and Energy
  • 4% - Crafts/Trades-worker
  • 4% - Residential Construction
  • 3% - None of the Above
  • 3% - Professional Partners of Construction Companies
  • 1% - Architectural/Engineering

Primary Job Function

  • 29% - CFO/Controller or Finance/Accounting
  • 22% - Safety/Risk Management
  • 16% - President/CEO/Owner
  • 13% - Field Management/Supervision/Project Management
  • 7% - Human Resources/Benefits Coordinator
  • 6% - Other
  • 4% - Labor Union/Trust Representative
  • 2% - Technology/Building Information Modeling/CAD
  • 1% - Architect/Engineer

Union Status

Union Status of Respondents: 35% Union, 42% Non-union, and 22% Both

Organization Size

  • 16% - Less than 49
  • 15% - 50-99
  • 20% - 100-249
  • 15% - 250-499
  • 12% - 500-999
  • 21% - 1,000 or more
  • 1% - Don't know

Location by Region

map of the 50 United States divided by colors to show survey respondents' companies' locations

  • 8% - Northeast
  • 7% - Mid-Atlantic
  • 25% - Midwest
  • 8% - Southeast
  • 9% - Southwest
  • 20% - West
  • 13% - National (multiple regions)
  • 3% - International

Key Findings

Leadership Engagement

Leaders play a key role in fostering and building a caring culture that addresses worker well-being, mental health awareness, and suicide prevention in construction. Active and continuous leadership engagement is essential in breaking down barriers in addressing mental health and worker well-being.

The survey showed that 77% of Presidents, CEOs, and Owners4 recognized as a priority addressing mental health at work by promoting awareness, helping to reduce stigma, and encouraging people to get help when needed. Whereas CFO, Controller, and Finance respondents agreed at a lower level of 48%. Other respondents were somewhere in the middle in prioritizing these issues (56% of field management/supervision and 69% of HR/Benefits Coordinators), except for Safety and Risk Management professionals, who were closer to CEOs with strong support for prioritizing these issues at 72%.

When asked whether addressing mental health at work is a sound business practice, 93% of respondents agreed. (55% of respondents strongly agreed, 38% agreed, 5% were undecided and 2% disagreed.)

Raising Mental Health Awareness: Resources & Strategies

Organizations in the construction industry recognize the value of making mental health more visible and sharing resources. This serves to educate workers about mental health, reduces stigma, and shows organizational commitment to worker mental health and well-being.

94% of all survey respondents recognize the importance of sharing mental health resources with workers to raise mental health awareness, reduce stigma, and encourage people to get help when it’s needed.

Mental Health Resources Respondent Organizations Make Available to Workers
  • 63% - Employee Assistance Program (EAP)
  • 54% - Toolbox Talks
  • 33% - Emails on Mental Health
  • 32% - Fact Sheets
  • 32% - Posters
  • 28% - Newsletter Content
  • 25% - Employee Training
  • 25% - Supervisor Training
  • 10% - Wallet Cards
  • 10% - Hardhat Stickers
Mental Health Resources Respondent Organizations Identified as Most Helpful to Share with Employees
  • 69% - Supervisor Training
  • 66% - Employee Training
  • 64% - Toolbox Talks
  • 51% - Fact Sheets
  • 48% - Employee Assistance Program (EAP)
  • 43% - Posters
  • 39% - Mental Health Apps
  • 36% - Newsletter Content
  • 33% - Emails on Mental Health
  • 31% - Hardhat Stickers
  • 25% - Wallet Cards

Construction organizations clearly see the value and importance of training. This is a key area to address with 25% of respondents currently offering supervisor training while 69% saying they would find it helpful to offer training. Similarly, 25% of respondents make worker mental health training available, while 66% reported it would be helpful to do so. The Safety and Risk Management respondents ranked highest in recognizing the importance of offering supervisor (75%) and employee (72%) mental health training to workers.

Also, when it comes to EAPs, 63% of respondents offer an EAP, yet only 48% identified an EAP as a helpful resource for employees. Of the CEO, President, and Owner respondents, only 39% say that an EAP is helpful to share with workers. A similar difference in responses exists for HR and Benefits Professionals with 79% reporting they make an EAP available, yet only 52% saying it is helpful to share with employees.

Creating a Mentally Healthy Organizational Culture

How did organizations respond when asked if they had a caring culture in which workers reach out for mental health care when it's needed? 51% agreed, 18% disagreed, 26% were undecided, and 5% didn't know.The need to create a caring organizational culture has become a business imperative for all industries. The pandemic has elevated the importance with higher rates of people experiencing excessive stress, anxiety, depression, and projected increased rates of suicide and overdose deaths.5 Many people have had time to reflect on their values and the type of environment they want to work in during the pandemic.

Also, the economy is doing well, offering workers options to change jobs, with some leaving the workforce, and rising labor shortages. Those organizations that create a caring culture are likely to experience higher retention rates, higher performance and productivity, and better business results.

What are elements of a caring culture? For starters, it’s people feeling a sense of connection with peers and belonging within the organization. Most people value feeling a sense of trust and community with those they work alongside. Organizational culture starts at the top, making it essential that leaders recognize their role in helping workers feel valued and appreciated for their contributions as key members of the work community.

A caring culture is also one in which leaders reinforce the importance of workers taking care of their mental health and well-being and reaching out for help when it’s needed. This includes leaders modeling and communicating that “it’s ok to not be ok” and reminding people to get help when it’s needed as you would for physical health conditions.

Less than half of people who experience mental health conditions receive care.6 Organizations increasingly recognize the role they can play in normalizing these conditions and breaking down barriers to people accessing care.

With caring organizational cultures, mental health is visible, not with a “one-and-done” approach, but with a sustained commitment of engaging workers by distributing resources, tools, and programs through multiple channels. This increases the likelihood that workers will feel psychologically safe to seek help when it’s needed and discuss mental health issues that may be impacting work performance, productivity, and peer interactions with supervisors or co-workers.

Many survey respondents say they do not believe that construction workers feel comfortable openly discussing mental health with supervisors (37%), while others were either undecided (31%) or did not know (15%). Only 17% thought workers would discuss mental health issues with their supervisor.

Similarly, when asked if employees feel comfortable openly discussing mental health with co-workers, only 18% agreed, with 31% undecided, 31% disagreeing, and 20% saying they did not know.

Enhancing Access to Services and Supports

For some, connection to care starts with the Employee Assistance Program (EAP). Others experience frustration in calling a toll-free number and not finding the help they need. Still others avoid reaching out, not trusting that the EAP is confidential and believing that the company will learn they are seeking help, risking negative job consequences.

Survey respondents largely agreed (71%) that their organizations recognize the benefits of an EAP as a service to offer workers. However, a closer look shows that 80% of Presidents, CEOs, and Owners recognized the benefits, while a little more than half (58%) of CFO, Controller, and Finance Professionals see the benefit.

Lower rates of respondents say that their organization promotes services of the EAP:

  • 62% of President, CEOs, and Company Owners
  • 47% of CFO, Controller, and Finance Professionals
  • 56% of Field Management

Most respondents were undecided or did not know when asked if their organization had seen a measurable impact from the use of the EAP. Low percentages of respondents say they see a measurable impact:

  • President/CEO/Owner
    • 30% - Strongly Agree/Agree
    • 60% - Undecided/Don't Know
    • 10% - Strongly Disagree/Disagree
  • CFO/Controller/Finance
    • 10% - Strongly Agree/Agree
    • 65% - Undecided/Don't Know
    • 25% - Strongly Disagree/Disagree
  • Field Management/Supervisor
    • 17% - Strongly Agree/Agree
    • 72% - Undecided/Don't Know
    • 11% - Strongly Disagree/Disagree
  • HR/Benefits Coordinator
    • 30% - Strongly Agree/Agree
    • 48% - Undecided/Don't Know
    • 22% - Strongly Disagree/Disagree
  • Safety/Risk Management
    • 30% - Strongly Agree/Agree
    • 60% - Undecided/Don't Know
    • 10% - Strongly Disagree/Disagree

Here is what respondents say about whether workers needing help with mental health or substance use disorder concerns are likely to seek care:

Strong consensus exists on the top 4 reasons why workers needing help with mental health or substance misuse conditions may not seek care when needed:

  • 78% - Shame and stigma
  • 77% - Fear of judgement by peers
  • 55% - Fear of negative job consequences
  • 46% - Don't know how to access care

Bottom Line Recommendations

Leadership Engagement

Articulate a vision and implement policies and practices that communicate that addressing mental health is a strategic imperative for the company and where senior leadership is:

  • Visible: exhibiting united leadership on the importance of addressing mental health as a sound business practice and as the right thing to do.
  • Vocal: making a commitment to regularly communicate care and concern for the well-being of employees and their families.
  • Vulnerable: sharing personal stories of “lived experience” demonstrating from the leadership level that “it is ok to not be ok” and creating empathy and trust among the workforce by reducing stigma and fear of judgment.

Raising Mental Health Awareness: Resources and Strategies

  • Integrate resources, information, and policies on mental health, substance misuse, suicide prevention, and worker well-being into the company’s existing functions, programs, and practices in key areas:
    • Human Resources: recruitment, hiring, onboarding, engagement, training and development, and coaching.
    • Employee Benefits and Wellness: examine data and engage in EAP promotional campaigns to increase utilization, improve productivity, and develop solutions for substance misuse treatment and recovery.
    • Safety and Health: safety orientations, company gatherings, daily safety huddles and warmup exercises, pre-season and pre-project kickoff meetings, and stand-downs.
  • Share a continuous stream of information and resources on mental health and substance misuse, including in newsletters, posters, and information about the EAP, crisis hotlines, and well-being resources.
  • Consider training and offering high impact resources to managers and first-line supervisors to better understand mental health and substance misuse conditions:
    • Check with your EAP about what they offer in training and resources.
    • Check with community organizations like NAMI or Mental Health America.
    • Consider consulting with the American Psychiatric Association Foundation’s Center for Workplace Mental Health or other consulting firms on customized mental health presentations and trainings available for supervisors and employees.
    • Reach out to the National Council for Mental Wellbeing which offers Mental Health First Aid courses.
    • Review resources offered by the American Foundation for Suicide Prevention to share with managers and supervisors.
  • Avoid a “one-and-done” approach in sharing resources. Show a sustained commitment in making mental health and substance misuse resources available to workers throughout the year and use multiple channels for dissemination.
  • Consider offering culturally sensitive and linguistically appropriate mental health resources for diverse populations comprising the construction workforce.

Creating a Mentally Healthy Organizational Culture

  • Build a caring culture that promotes “psychological safety” by showing concern and empathy for workers and their families and reinforces a respectful workplace culture, free from harassment, discrimination, bullying or inappropriate teasing, and harsh judgment of peers.
  • Clearly convey that workers will not be subject to negative job consequences solely for seeking help when it’s needed. In fact, seeking help should be encouraged for the well-being of workers and to ensure they can meet expectations on safety, productivity, engagement, and performance.
  • Be aware of the risks associated with offering alcohol at company sponsored events. That is difficult for workers in recovery and can lead to unhealthy alcohol misuse, especially if consumed to cope with high stress, burnout, or mental health issues.
  • Consider creating a mentorship or peer support initiative. This can be challenging for projects with tight timelines and budgets, but it can also prove helpful in retaining top talent and building a stronger sense of community.
  • Take the STAND-up pledge for the Construction Industry Alliance for Suicide Prevention (preventconstructionsuicide.com).

Enhancing Access to Services and Supports

  • Assess key issues related to your company’s Employee Assistance Program (EAP) with the list of questions below and create a promotional campaign to educate employees about the EAP. Here are issues to examine:
    • Does your company have an EAP?
    • If you’re a union contractor, does your EAP cover the field workers?
    • Is the EAP embedded within insurance coverage or a standalone program?
    • Do you know the utilization rate and impact metrics for your EAP?
    • Do you know who is eligible for your EAP? Any waiting periods?
    • Do you know your EAP benefits and frequency of services?
    • Do you share the EAP number with your employees?
    • When and how do you promote the EAP to your employees?
  • Remove barriers to care and improve access to medical and mental health care. Here are best practice strategies for doing so:8
    • Offer expanded and periodic worker education on Employee Benefits.
    • Invite spouses and partners to attend Employee Benefit Open Enrollment meetings.
    • Change EAP provider.
    • Expand number of EAP counseling sessions per issue or concern.
    • Initiate chaplaincy services to foster employee care and support.
    • Offer telehealth options for physical and mental health services.
    • Invite labor union partners to offer jobsite explanations on how to access benefits.
    • Negotiate increased preventive care services.
    • Reduce or eliminate co-pays for in-network providers.
    • Expand number of in-network mental health providers.
    • Allow biometric testing to be performed by primary care providers.
    • Sponsor family health and wellness fairs and include information about mental health and substance misuse.
    • Incentivize use of wearable monitors.
    • Provide digital apps for mental health counseling services.
    • Offer mindfulness, resiliency, and well-being apps.

Summary

illustration of a construction worker holding a pen and notepadThe U.S. construction industry has made significant progress in addressing mental health and suicide prevention, yet clearly more is needed, especially in the wake of new global challenges. Progress to date includes:

  • Leading trade industry publications featuring cover stories and informational articles on mental health, substance misuse, and suicide prevention.
  • Industry professional associations and labor organizations covering mental health, suicide prevention, and substance misuse in publications, conference presentations, and trainings.
  • Formation of the Construction Industry Alliance for Suicide Prevention in 2016.
  • 2021 National Construction Safety Week theme was “Committed to Holistic Safety” with the industry focusing on physical and mental health in maintaining workplace safety.

This pulse survey sheds light on the importance of worker mental health and well-being in construction and opportunities to continue moving forward in effectively addressing these issues.

American Psychiatric Association Foundation LogoConstruction Financial Management Association LogoCobb, Strecker, Dunphy and Zimmerman LogoHolmes Murphy Logo

References

  1. Peterson C, Sussell A, Li J, Schumacher PK, Yeoman K, Stone DM. Suicide Rates by Industry and Occupation — National Violent Death Reporting System, 32 States, 2016. MMWR Morb Mortal Wkly Rep 2020;69:57–62. DOI: http://dx.doi.org/10.15585/mmwr.mm6903a1.
  2. Brådvik L. (2018). Suicide Risk and Mental Disorders. International Journal of Environmental Research and Public Health, 15(9), 2028. https://doi.org/10.3390/ijerph15092028.
  3. Brådvik L. (2018). Suicide Risk and Mental Disorders. International Journal of Environmental Research and Public Health, 15(9), 2028. https://doi.org/10.3390/ijerph15092028.
  4. For purposes of this survey, the term “owners” refers to individuals with an ownership interest in the company and not organizations that hire contractors who perform work on their behalf.
  5. Vahratian A, Blumberg SJ, Terlizzi EP, Schiller JS. Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic — United States, August 2020–February 2021. MMWR Morb Mortal Wkly Rep 2021;70:490–494. DOI: http://dx.doi.org/10.15585/mmwr.mm7013e2
  6. Statistics published online by the National Institute of Mental Health (NIMH). Accessed at https://www.nimh.nih.gov/health/statistics/mental-illness.
  7. Beyer, Cal. (August 2021). Improving Access to Health Care and Wellness Services for Construction Trade and Craft Workers. Construction Executive. https://www.constructionexec.com/article/improving-access-to-health-care-and-wellness-services-forconstruction-trade-and-craft-workers
  8. Manager & Supervisor Training from the American Psychiatric Association Foundation (APAF). Center for Workplace Mental Health. Notice.Talk.Act.™ At Work. Creating a Mentally Healthy Workplace e-learning module. https://workplacementalhealth.org/NTAatWork
  9. Right Direction Initiative. Web-based initiative that provides employers with free tools and actionable strategies to raise awareness about depression, reduce stigma, encourage help-seeking behavior, and improve workplace mental health. https://www.rightdirectionforme.com
  10. Infographic: Five Myths vs. Facts About Depression. Developed by the APAF Center for Workplace Mental Health. https://workplacementalhealth.org/employer-resources/infographic-five-myths-and-facts-about-depression
  11. Beyer, Cal. (May 2020). Why Employee Assistance Programs Are Valuable During and After COVID-19. Construction Business Owner. https://www.constructionbusinessowner.com/workforce-management/why-employee-assistance-programs-are-valuable-during-after-covid-19
  12. Beyer, Cal and Dahl, Rob. (July/August 2021). What’s Under the Hard Hat? Addressing Mental Health in Construction with a Respectful Workplace Culture. Associated General Contractors of America. Constructor. https://www.constructor-digital.com/ngcs/0421_july_august_2021/MobilePagedArticle.action?articleId=1705456#articleId1705456
  13. Beyer, Cal and Spoor, Leia. (June 2021). The Human and Financial Costs of Behavioral Health. Construction Users Round Table. The VOICE. http://flip.matrixgroupinc.net/curt/2021/issue02/#page=30
  14. Beyer, Cal and Dyme, Bernie. (August 2021). The Impact of Employee Assistance Programs. Construction Users Round Table. The VOICE. http://flip.matrixgroupinc.net/curt/2021/issue03/#page=30
  15. Beyer, Cal and Gillespie, Chuck. (August 2021). Defining, Developing & Driving the Success of In-house Programs That Build Healthier Employees. The Why Behind Wellness and Well-being. Construction Business Owner. https://www.constructionbusinessowner.com/workforce-management/defning-developing-driving-success-house-programs-build-healthier-employees
  16. Blair, Scott and Buckley, Bruce. (July 28, 2021). Safety Advocates See Strength in Numbers to Combat Suicide and Substance Misuse. Engineering News-Record (ENR). https://www.enr.com/articles/52163-safety-advocates-see-strength-in-numbers-to-combat-suicide-and-substance-misuse
  17. Building a Caring Culture: Addressing Mental Health in the Workplace. Link to download PDF version. https://think.holmesmurphy.com/WC-WP-Building-A-Caring-Culture_Brochure--Form-v3.html
  18. Frost, Steve. (March 23, 2021). Ten Tips for Creating a Workplace Suicide Prevention Plan. Construction Executive. https://constructionexec.com/article/ten-tips-for-creating-a-workplace-suicide-prevention-plan
  19. Gruttadaro, Darcy and Beyer, Cal. (Dec 2020). Fading Away: Construction Leaders Speak Out About Mental Health. Construction Users Round Table. The VOICE. http://flip.matrixgroupinc.net/curt/2020/issue04/#page=18
  20. Kime, Mandi. (July 5, 2020). The Importance of Storytelling in Messaging Suicide Prevention in the Workplace. Construction Executive. https://constructionexec.com/article/the-importance-of-storytelling-in-messaging-suicide-prevention-in-the-workplace
  21. Payne, Ali, and Beyer, Cal. (November 6, 2020). Generational Challenges and Opportunities in Addressing Mental Health and Suicide Prevention. Construction Executive. https://constructionexec.com/article/generational-challenges-and-opportunities-in-addressing-mental-health-and-suicide-prevention

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