Staying silent no longer:
mental
health
matters.
PEOPLE
Mental health suffering is often a silent crisis within the construction industry, with males three times more likely to take their own life than those in other sectors. To discuss some of the complex factors potentially at play, Dr Paul Hanna, psychologist at Hoare Lea, joined Rob Muldoon from Lighthouse Construction Industry Charity and Matt Jones, Central North Business Unit Lead at Hoare Lea. Together they talk candidly about their experiences within the construction industry over the past quarter of a century…
Matt
We’ve had some heartbreaking incidents of late, which have been pretty terrible and brought the issue of mental health to a point where we have to do more than we currently are. For me, there is a challenge in industry: it is just too fast, too much. There’s this danger that while it’s reasonable from a status quo context, from a construction context, if the industry pushes somebody on the wrong day then it’s that straw-that-broke-the-camel’s-back moment. It strikes me that the architecture of the whole industry is set up to exploit financial pressure for gain. That has got a consequence, and we’re beginning to feel what that consequence is. And that is very uncomfortable.
Rob
Definitely. If you look at CDM regulations, they’re all set up to protect the people that are building these projects at every stage. There’s all the health and safety regulations to protect them and we get the safety part right most of the time. At the end of all the projects that I used to work on they’d hand over a health and safety file, which covered everything that was built, and before we even got on site, there had to be the welfare facility set up because of people’s safety and wellbeing. But there’s nothing that protects people when they’re sat in meeting rooms getting torn to pieces because they’re 15 days over a programme where they’ve had to deliver a ridiculous amount of work for millions of pounds on an unrealistic schedule. The client can sit there and lay into them and put all this huge, unnecessary pressure on because it ultimately comes down to money, and they’re going to lose money. What if we turn around to people and say; ‘well, how much does it cost to come late on a project? What’s the human value against that?
Matt
Completely. I see that all the time.
Paul
I think there’s an added pressure there as well because it doesn’t really matter how many wellbeing centres you might set up on a site. My background is not in the industry; I worked largely in mental health as an academic and my last role was leading a clinical psychology training programme. I did a lot of work with men and mental health and the main thing we found was that the idea of talking to someone wasn’t very appealing.
There was a stigma around it, obviously, but sometimes we also used to find that sitting there and talking wouldn’t necessarily solve the problems. There are different ways that men can work with their own mental health and that’s why we’ve seen loads of organisations established in community psychology, looking at different spaces that offer a different social environment. So it may be a sports club, it might be that ‘men’s shed’ sort of thing, where things come out but it’s not talking therapy in the sense of: come and sit in a room with a psychologist or mental health practitioner. That actually raised alarm bells for most people who were relatively humble in their life. That wasn’t the way they were brought up.
PAUL
I did a lot of work with men and mental health and the main thing we found was that the idea of talking to someone wasn’t very appealing.
Paul
We used to talk about how, really, it’s a tiny number of people that mental health services are really set up for. Generally speaking, it’s very open, white women. That tends to be the model of service delivery we’ve adopted and it doesn’t work for so many other people – we call them ‘hard to reach’ but it’s not about them being hard to reach. We just don’t have the right support. So there’s a whole range of issues even when you have those kinds of sticky-plaster services on site. I’m not convinced that they’re great.
I did stuff in the theatre industry that wasn’t too dissimilar. What we used to find there, for males and females, was this narrative around the pressure: ‘the show must go on’. ‘The project must be delivered’ is very similar. That’s, arguably, the heart of the problem here and it doesn’t necessarily need to be like that. That’s the frustrating bit. Having come into the industry as a complete outsider, I wonder: why? It’s partly because the people promising stuff don’t have any knowledge of the day job. And that’s another systemic issue.
Matt
I’ve driven quite hard in the businesses that we’ve created; been one of those saying: we can do this, we can do this. I like to think I see the system but it’s only really this year we’ve had to really stand back from it and say we need to challenge what we’re doing here. There’s a disconnect; you can do it every day for 10 years and you don’t see it, and then one day, it will come home and then you can’t unsee it. I don’t get the sense that the construction community is particularly harsh, there’s just an unknowingness. Most clients I work with are great people and if you said to them; ‘we’re pushing too hard here and I can show you, Ghost-of-Christmas-Future style’, I’m pretty sure they’d say; ‘let’s just stop right now, that’s not what we want at all.’ But until you’ve been through it, you can’t feel it.
Rob
I think the industry is realising this and changing. When I started in 2000, there weren’t very good facilities on site and you’d eat your lunch on scaffolding, and everybody would be smoking in the cabin – you’d just see feet shuffling about because it was thick with smoke – and there was all the usual page-three stuff on the walls. I think the industry realised that it needed to change – it doesn’t look good, it’s not professional – and we needed to look after people better. We’re at a tipping point now with mental health in the industry, realising that we have got a huge problem. Are we causing it all? No, I don’t think we are but we’re certainly not helping ourselves. People probably aren’t getting it right at the minute because they don’t know what to do and they’re just stabbing in the dark trying to see what works. Are we’re going to get it right all the time? Absolutely not, but it’s good that industry is realising this and trying to move forward and bring in professionals to help us get it right. It’s the same as us getting a consultant in for air conditioning units on a project. You bring someone in to give options and make you look at the situation a bit differently. We need to ask people who actually know about this.
ROB
I think the industry realised that it needed to change – it doesn’t look good, it’s not professional – and we needed to look after people better. We’re at a tipping point now with mental health in the industry, realising that we have got a huge problem.
Paul
Just to pick up on that, can you just talk a bit more about what you do with Lighthouse?
Rob
I’m an ambassador for Lighthouse Charity so I go around in a really inconspicuous multi-coloured transit van, giving talks on construction sites up and down the UK. I’m part of the #MakeItVisible team who raise awareness about what the charity does. It has been around since 1956 – set up as a bit of a benevolent fund by a couple of bricklayers in the North East – I think it was Whitley Bay. They had a colleague who died after an accident on site, and they wanted to support the family, so they raised a bit of money and the charity grew to what it is now.
We support thousands of construction workers all over the UK and Ireland with physical, financial and mental wellbeing. A lot of people think that it’s just mental health, which we absolutely can help with, but a lot of things can lead to a crisis so we try and be proactive in helping people understand how to work through things, build themselves back up, look after themselves in the future. We help with things like tax returns. I was in a good position to pay my tax bill this year, but it’s not always been like that. We can help negotiate payment terms, teach people how to fill in the forms so that next year they’ve already got that knowledge. Someone might get home from work and the freezer has blown up and all the food’s ruined. Not only can Lighthouse replace the white goods, but they can replace the food. We spend in the region of £7-10,000 a month on food shops for people. If the van fails its MOT, we understand that you can’t earn money if you can’t drive your van to work, and that it could start a vicious cycle. We can help get that van back on the road and avoid a crisis.
We help their families as well. Their partner could be in chronic pain and need help getting physiotherapy appointments – we can arrange that – or if their child is getting bullied at school, we can help the child to get through that time and support the parents in dealing with those situations. It’s all totally free and confidential. It never gets fed back to work. Nobody will ever know you use our services because we understand how hard it is to reach out and ask for that help. A lot of companies now use it as their employee assistance programme, and they find it difficult because we won’t report back. We won’t say how many people use the service, ring the helpline, turn up to the e-learning stuff. We just break it down into regions and trades and give them the impact report around April time.
We also run a 24-hours-a-day, seven-days-a-week helpline. We know that not everybody speaks English as their first language so it’s in 13 different languages – same with the text service – and we’ve just launched a live chat on the website in 120 languages. So they can be sat in the canteen in their office or on the train or bus to work, chatting to us, and nobody else in that room knows; they just think they’re texting somebody. It’s about making the journey as easy as possible.
Paul
That sounds amazing; that advocacy role is so understated. I’ve done a lot with Citizens Advice in the past and while they’re not a mental health provider, they do provide mental health services in a sense because for most people in distress, when the next thing goes wrong or they get certain letters through the door, it’s just too much. Typically, the stigma around mental health still very much exists and the idea of walking to a wellbeing unit can be a difficult challenge so the idea that you can just sit there and text in the yard, and have something completely discreet, is fantastic.
Rob
That’s it; we go out and give the talks to show that we are just the same as the people that work out on site, getting up at four o’clock in the morning, turning up to work. There’s a team available now to go out and do it, and we’ve all got different backgrounds, individual tales and lived experience within the construction industry. We try and make it tangible to people and help them feel; well, if they can get through it all, so can I, and it doesn’t mean I’m any less of a person.
MATT
Most clients I work with are great people and if you said to them; ‘we’re pushing too hard here and I can show you, Ghost-of-Christmas-Future style’, I’m pretty sure they’d say; ‘let’s just stop right now, that’s not what we want at all.’ But until you’ve been through it, you can’t feel it.
Matt
And do you think the situation is getting better or worse?
Rob
I think it’s definitely getting better. Although, looking at the statistics, it probably doesn’t look like it’s getting better. But I think that’s because more people are being more open and honest and talking about this stuff, so you are going to go through a period where the statistics probably will go off because more people are reaching out. But hopefully we can get to the peak of that and it levels out or starts to come down. Prevention is better than cure, but the industry is lacking knowledge. I can tell you about bricks – when I went to college, I got taught different types of bonds, how to lay bricks – but nobody ever told me how to budget and look at finance and do tax returns. Or that 80% of the industry is self-employed. The tax bill comes in and it’s like: ‘Oh God, what do I do with this?’
Matt
We did a bit of research in terms of the numbers and stats for construction, and they’re so stark compared to other industries, which suggests to me that there is something systemic within construction – probably to do with commercial pressures, time pressures, the way the industry is set up. The whole model feels like it really compounds a number of other issues.
Rob
Definitely. I did a project in Stockport, near where I live, and the contractor was struggling to get somebody to do a concrete floor. There was already a contractor on site that could do that work but he was refusing to do it because they wanted him to do it at a loss. He said: “Put it this way, would you risk £250,000 to make 1500 quid? Absolutely not. And that’s if we do really well, everything goes perfectly and we don’t lose any days to the weather.” I think that that’s part of the issue within the industry: unrealistic expectations. Even on the domestic side, it’s always the builder’s fault. But it’s not really – people are outlaying all this money, trying to get things done, and maybe the tiniest problem snowballs into a huge problem further down the line. The culture around that is: just get on with it. Shut up and put up and get on.
Matt
It feels like a problem that’s everywhere, and everybody’s contributing to it in their own way but nobody wants to contribute to it; it’s the whole momentum of the system that drives it. The only way we’re going to change it is with everybody changing it. It’s not a main contractor issue or subcontractor issue or client issue: everybody has to be committed. Look at Grenfell: 72 people killed. Everybody’s very on board with action, and rightly so – looking to take this process apart and put it back together to avoid that situation happening again. Yet the numbers for suicide in construction are probably getting on for 10 times that. It strikes me that because it’s not happening at the same time, it doesn’t quite get that moment of attention systemically.
MATT
There is something systemic within construction – probably to do with commercial pressures, time pressures, the way the industry is set up. The whole model feels like it really compounds a number of other issues.
Rob
The suicide may not happen out on a building site, it may happen in the individual’s home. And it’s difficult to bring the two together: is it because of this? Is it not because of that? The last lot of figures we have is 2021’s figures from the ONS – 507 construction workers took their own life in 2021. Three of those were female, the rest of all men. They tell us that the biggest killer within construction is falls from heights and, in that year, we unfortunately had 17 families that lost a family member who went to work and never came home. It’s absolutely devastating to those families and we absolutely still need to keep pushing hard on that. But we also need to think about those 507 families who lost people.
I don’t believe the industry is causing everything but, in the same breath, it’s not doing enough to help. The culture needs to change from many different directions and it’s not going to happen overnight.
Paul
Even though you can’t have the cause-and-effect model with something like suicide – it’s impossible to because everyone’s lives are far too complex – what you can do is compare across employment types. From memory, the construction industry is disproportionately high. So even though you can’t draw the complete parallel, there are parallels that can be drawn, relative as you say to the number of people falling on construction sites. I don’t ever see a spotlight on suicide in the construction industry, even though it’s disproportionately high. It’s very taboo. How do we address that? You’ve both been in the industry, heard the narratives that exist socially, seen people’s approaches to dealing with distress. What are your views on how we move beyond that?
Rob
We need to make it an easier conversation to have. You touched on the point earlier that sometimes it needs to be more than talking therapy, and I absolutely agree, but we need to start with people being more comfortable to have these conversations. Then those conversations can lead to ideas. People work in this industry because it’s part of our makeup to adapt, overcome problems; we do it every single day on site, with whatever material we’re working with. I think we need to do that with the way that we treat mental health and wellbeing. Because with those 507 people that we lose, it’s not the mental health that’s killing them, it’s the stigma that surrounds the subject. I feel the way we can start to break that stigma down is to normalise the conversation of: ‘you know what, I’m not feeling it today’. If you can stand there and talk about it, and your work colleagues can see that, you can then bring that into the business and that can positively spread out.
PAUL
The stigma around mental health still very much exists and the idea of walking to a wellbeing unit can be a difficult challenge so the idea that you can just sit there and text in the yard, and have something completely discreet, is fantastic.
Matt
Completely agree. As I say, we’ve worked with loads of firms and what I’ve observed is that it’s not that anybody really doesn’t care. All the individuals we speak to care passionately. It feels like we struggle to get the system approach: you can only deliver a project by the use of hundreds of component parts and people. It’s a chain. Everybody works together to deliver the wall or the ME install. But on something like mental health and suicide, we really struggle to tie that same system up. We do whatever we can for our people, I’m sure everybody does, but you can’t be in control of all the other component bits. So as a system, it’s a real problem. We’ve only got control of a small component. The whole construction community needs to come together: we can only solve this together so how collectively do we push in this space? That is a difficult thing to answer; it’s fraught.
Rob
The thing with physical health is you can see it. Although you can argue that when people are not turning up, not looking after themselves, you can start to see them break down as an individual. But how many people pay attention to that and think: Rob’s not turned in today, Rob’s not going home, Rob’s overeating, coming into work smelling of booze, falling asleep at his desk, not getting his hair cut – these sort of things. He’s a bit snappy. A lot of individuals are trying to change that but we’re just struggling to bring it together.
ROB
Because with those 507 people that we lose, it’s not the mental health that’s killing them, it’s the stigma that surrounds the subject. I feel the way we can start to break that stigma down is to normalise the conversation of: ‘you know what, I’m not feeling it today’. If you can stand there and talk about it, and your work colleagues can see that, you can then bring that into the business and that can positively spread out.
Paul
I think I think people are very good at masking. One thing mentioned earlier was about 80% of people being self-employed. Insecure employment is a big predictor of mental distress. I’m assuming that they’re self-employed for a reason, i.e. when the work dries up, they don’t get paid which limits the liability of a company to have to keep paying someone when work’s not there. So I wondered what your thoughts are – if there are any initiatives in that line?
Matt
It comes back to the same issue that the system is financially optimised and that’s got a cost to it. And now there’s a lot more going on with society, a lot of other things happening, and that increasingly optimised financial system is just churning out really uncomfortable problems.
Rob
Because budgets are so tight and deadlines are so short, if you lose days to weather and you’ve got 55 people sat in a cabin waiting for it to stop raining, each individual’s costing you a lot of money. But if they’re self employed, you can turn around and say; ‘well, you’re not laying, you’re not earning so go home’. There’s a cost-save there – on pensions that they must contribute to, National Insurance, holding pay and sick pay.
Paul
That’s an interesting point on the squeeze financially, because I wonder how many clients would feel comfortable if you highlighted the implications for that squeeze. Even if it was at a very basic level and you said: ‘okay, we’re going in at this price and we’re very cheap but as a result of us being cheap, I’ve got 80% of people that haven’t been paid because it’s been raining for the last two months, and we haven’t made progress, and now they can’t afford their bills’. Would people sit there and still think that was value for money? What seems like a big problem in all of this is what we’re considering value – at the cost or the expense of humans, be it in their lives, finances, security, their wellbeing more generally.
MATT
The whole construction community needs to come together: we can only solve this together so how collectively do we push in this space?
Matt
One of the things I’ve always loved about this industry is that generally the people you meet are really decent. And we’ve seen things change around carbon, the way projects are measured and have become more expansive, and people appreciate there’s something different that we’re doing and maybe that needs to be paid for. Maybe it doesn’t, but there’s a much more balanced view of that. I think the challenge with this is that you can isolate the issue with a physical condition like white finger but with mental health it’s so difficult to isolate where the issue is. It’s never one thing. Construction can apply a few of the last straws. There may be some other underlying issues there but it can be a pretty tough space.
Rob
I think we’re very reactive as well. We don’t change a lot of stuff until there is a serious incident then we learn from it and move on and hope it never happens again. I think we’re realising this with mental health and wellbeing; that we need to change this. But we’re all individuals and we all have individual needs, and you might be able to put up with a certain amount of stress that I can’t and vice versa. With white finger, we all know that after a certain amount of time anyone’s finger is going to deaden off – after 50 minutes’ trigger time throughout the day. Whereas I might be able to go out and deal with huge amount of stress, be fine with it, and you could go out and react very differently to it. It’s like: what is the industry standard?
ROB
I don’t believe the industry is causing everything but, in the same breath, it’s not doing enough to help. The culture needs to change from many different directions and it’s not going to happen overnight.
Paul
And it varies even within individuals – what you might be able to take one day compared to what you might be able to take in a week’s time when you’re quite vulnerable because of other life events. It’s that emotional intelligence piece which isn’t something you can necessarily teach or train.
Rob
I think that people aren’t as self-aware as you think they are. I was very guilty this for a long time: of saying ‘I’ll just keep going. I’ll just keep going.’ And it led to burnout for me. I thought I’d be alright, and there were some days where I was fine. I remember one project I was doing in Staffordshire, where several of the managers had moved on to different projects but I was still there. I thought it was great: ‘I’m the only one left now, I can do this job, I can get this over the line and really feel like I’ve achieved something’. In reality, I was turning myself inside out when I didn’t need to. I could have turned around to who I worked for – and they were a great company – and said ‘I can’t do this’.
But I just gritted my teeth and I think that project was probably the beginning of the end of me. I just never replenished the cup: it was constantly getting filled and I was never emptying it, and I absolutely broke down. I realised that and I came back. I carried on with the job for a while because of financial pressures but I knew I had to come back and do it differently. I had to look after myself and put my own needs first.
PAUL
What seems like a big problem in all of this is what we’re considering value – at the cost or the expense of humans, be it in their lives, finances, security, their wellbeing more generally.
The guy I used to work for, said: “Rob, I absolutely love you, you’ve worked for us from 16, 17 years old, and it’s not that I don’t care, but if I came into work one day and found you at your desk, dead, because you’d given yourself a heart attack and stressed yourself out that much, your job would be advertised tomorrow. I know I put pressure on you to get these jobs over the line but you’ve got to look after yourself and make choices.”
If it does mean stepping back and saying ‘I can’t do this’, it’s absolutely fine to do that. It’s all built into the culture that we need to change, to make it acceptable to say ‘you know what, I need a bit of help with this’. But people don’t want to feel like they’re failing. I struggled horrendously with impostor syndrome, inner saboteur, whatever you want to call it; had no confidence in myself, never believed I was good enough.
That has nothing to do with the industry; a lot of it’s come through childhood. I look at my old school reports and they say; ‘Rob’s really good but he’s underachieving, he’s lazy’. I never, ever wanted people to think I was lazy so I overcompensated for it. School didn’t really work for me, I was never very academic, but I came into this industry and it clicked for me; I got it. I could visualise it, understand it. But I took it to the extreme and pushed myself too hard.
I think we all are our own harshest critic, and even now, with all the training I’ve had, and the thousands of talks I’ve given, I still put ridiculous pressure on myself; and I’m sure this is the same for many people in the industry.
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The Lighthouse Construction Industry Charity is the only charity dedicated to providing emotional, physical and financial wellbeing support to the construction community and their families.
A crucial element of the charity’s strategy is to provide a wide range of free and widely available pro-active resources to support the industry.
The charity offers a free and confidential 24/7 Construction Industry Helpline, live chat service and text HARDHAT facility which provides a range of information, guidance and support on a huge variety of wellbeing issues. These services are complemented by their free Self Support App which offers another route to support, along with their Lighthouse Beacons who provide a safe space for people to share concerns.
The Lighthouse Charity’s Wellbeing Academy offers a variety of free soft skills and leadership training delivered across a variety of platforms to suit every learning style from self paced eLearning, tutor led online courses and bespoke onsite training.
If you or anyone you know is struggling, reach out for 24/7 free and confidential support now.
24/7 Construction industry helplines:
0345 605 1956, (UK)
1800 939 122 (ROI)
Live chat lighthouseclub.org constructionindustryhelpline.com
Text HARDHAT to 85258 (UK) 50808 (ROI)
Find out more at www.lighthouseclub.org