Mental Health Crisis: How to protect construction workers

15 May 2019

Good mental health is great for staff – and for business, too. Simple strategies are making a huge difference to employee wellbeing, with ancillary benefits for employers. Discover the programmes that work in this, the second part of our two-blog special. And read expert advice on how to devise an effective action plan for your workforce.

Helplines. Apps. Publicity material. Mental health first aid courses. Resources are abundant for construction employers wanting to boost worker wellbeing. This is great news, but it presents a challenge, too; the abundance of choice makes it difficult to know what to implement and where to start.

A wealth of materials, training and services have come to the fore since 2017, when the tragic consequences of poor mental health among construction workers were highlighted in Suicide By Occupation*4, a report issued by the Office for National Statistics (ONS).  

Every year, about 400 British workers in the engineering and construction sectors take their own lives, it revealed. Low-skilled male construction workers were reported to have the greatest risk, at 3.7 times the national average. And a risk of twice the national average is found in the building finishing trades, including plasterers, painters and decorators.

Additionally, stress, depression and anxiety related to their jobs have overtaken musculoskeletal disorders as the most reported health issue by workers in the construction industry, according to the Institute of Occupational Safety and Health*5

Worldwide, the figures echo those in the UK, with the industry demonstrating one of the worst records for employee mental wellbeing, regardless of country. 

These shocking numbers are not new; similar figures were being discussed in the trade press*6 as far back as 2003. But the more recent ONS report prompted a sea change in the way the construction industry perceives the issue within its workforce. Now, stats that were once seen as distressing and ‘just one of those things’ are (quite rightly) regarded as unacceptable. Increasingly, companies are committing themselves to change.

Worker needs

To benefit construction workers, mental health initiatives must be appropriate and responsive to the needs of a male-dominated workforce encumbered by an unhelpful ‘just get on with it’ attitude towards stress, anxiety and depression.

A set of industry-specific barriers reinforces these attitudes, and they need to be negotiated by construction firms wanting to do the right thing by their staff.  

On a positive note, the industry is implementing change. For example, in the UK, 13 Mental Health First Aid instructor training courses have been funded by the Construction Industry Training Board (CITB). Some 156 construction workers are being trained in mental health first aid skills and, starting in September 2019, these instructors will train a minimum of 2,500 onsite staff. 

Four simple steps to better employee wellbeing

Read this blog for advice on promoting wellness and managing employee mental health. It contains:

  • Construction companies’ moral and legal obligations

  • A three-part wellbeing action plan

  • Practical risk management considerations when setting up mental health programmes

  • Tools and resources available to employers, both in the UK and globally.  

This construction mental health blog is the second of a two-part special. Read part one, Mental Health and Construction: How to Defuse a Global Timebomb to find out why construction is so damaging to its workers’ mental health. Discover the consequences of diminished worker wellbeing, especially with regard to employee sickness and suicidality. And find out the knock-on effects related to construction liability insurance claims. 

Also outlined are the benefits of improved worker mental health, both to employees and their families, and to a company’s productivity. 

Staff Mental Health: What ARE MY responsibilities?

Contractors and developers need to manage their employees’ work, and the manner in which they do it, to ensure their health and safety, both physically and mentally. These steps will help to reduce mental health issues that could lead to a worker harming themselves. They will also help to lessen the incidence of accidents and workplace injuries that could trigger ‘psychiatric injury’, which could lead to self-harm and suicidality.


Suicide is a devastating act that impacts heavily on the lives of family, friends and co-workers of the deceased. No contractor or developer wants construction site staff to feel they have nowhere to turn if they are experiencing anxiety, depression or other mental health difficulties. 

Mental Health Crisis in the construction industry, people on construction site

Further distress could be caused to the family / dependants of the deceased as typically, on site, suicidal individuals don’t leave a note. That being the case, the dependants / family could be burdened with considering whether the death could be a suicide rather than an accident. Proving that a death is a suicide can be difficult, as the suspicion has to be backed up by evidence.


Legally, employers have a duty of care to protect their staff from a working environment that could be detrimental to their mental health. 

“Employers will be liable for suicides connected (ie, causatively linked) to the employee’s work for them in circumstances where there has been a breach of the employer’s duty of care,” says Jonathon Tetley of Plexus Law.

“The breach could involve an accident in the workplace causing physical injuries that lead to psychiatric injuries and, eventually, suicide. It could also stem from overwork, unfair treatment or bullying and harassment, causing psychiatric injury and suicide.”

Ignorance is no defence

Company bosses also have a legal duty to keep abreast of news and developments affecting their industries, points out Paul Donnelly, partner in DWF Law, who has a number of construction clients. 

Donnelly notes that, following the 2017 publication by the ONS of Suicide By Occupation*4, from a legal standpoint, employers should consider themselves ‘on notice’ due to the widespread attention sparked by the report in both the national and the trade press.

Due to this publicity, above-average rates of poor mental health and suicidality are likely to be considered a known construction risk.  

When is an employer not liable?

“Employers will not be liable for suicides unconnected (ie, not causatively linked) to the employee’s work for them,” adds Tetley. “It would be unreasonable, indeed impossible, for employers to foresee and take reasonable steps to guard against such events. There is no duty on employers to prevent employees from deliberately self-harming for reasons unconnected to their work.”

Where a main contractor engages with a sub-contractor, legal advice might need to be sought in connection with the interplay of contractual clauses and legal duties, says Donnelly. 

What does an employee mental health action plan look like?

Company procedures need to help employees address and manage stress, anxiety and depression, particularly when their difficulties are connected with their work. Legally, employers are entitled to believe that their staff are ‘of reasonable fortitude’ when they are taken on, unless, of course, they are provided with information that might put them on notice of concerns. The law does not require them to place employees under constant ‘suicide watch’. However, company bosses must do all they can to put robust construction risk management systems in place. 

Your construction mental health toolkit

All companies operate differently. When conducting a construction risk assessment, and embedding a strategy, managers need to pay attention to staff make-up, company culture, and attitudes towards mental health. It goes without saying that sickness absence must be managed and that staff with mental health difficulties must be provided with appropriate occupational health and HR support.

Preventative measures include, but are not limited to:

Risk assessment: Employers have a legal duty to protect employees from stress at work by assessing the risks and acting on the findings. Visit the HSE website for guidelines on formulating a mental health risk assessment*7. Advice can also be sought from specialist companies that help construction employers optimise their employees’ mental health. 

Staff survey: Optimise your mental health policies by encouraging employees to identify and articulate their needs. Maximise survey participation by considering the following:

  • Issue invitation emails and reminder memos to employees.
  • Print and distribute leaflets – many staff might not have access to email.
  • Encourage participation during toolbox talks.
  • Use multiple formats to promote the survey. Drum up attention with posters, newsletters, intranet postings and notice reminders added to email signatures.
  • Gain employee confidence. Make it clear the survey is anonymous. Detail how their working lives will be improved by the feedback they give.
  • Make the survey easy to take. Keep it short and to the point; use clear, concise language.
  • Recruit supervisors and influential employees. When workers feel confident their supervisor values their opinions, and see that company influencers are supporting the initiative, they’re more likely to take time to complete a survey.

The construction site risk assessment and (if taken) staff survey should pinpoint areas of concern. Practical steps that need to be taken include:

  • Create a safe working environment for employees, with suitable equipment.
  • Train staff effectively. Provide them with clearly defined roles and realistic targets.
  • Control the hours worked to ensure they are not excessive. Be confident that employees are able to manage their workloads.
  • Allow employees to take appropriate breaks. Provide them with designated areas for rest and relaxation.
  • Protect staff from bullying, harassment and discrimination, whether from colleagues or third parties.
  • Put in place appropriate, confidential employee assistance programmes. For resources, scroll down to the Mental Health Resources for British and Irish Workers section, below.

Mental health strategies are a crucial part of risk management in construction projects. They must be flexible enough to respond to the needs of the workforce. Optimise your policies and processes by auditing them regularly:

  • Carry out regular mental health screenings.
  • Consult staff on issues that concern them.
  • Enable employees to raise concerns through appropriate channels and forums.
  • Promote good mental health practices regularly. Boost promotions by dovetailing with annual campaigns such as Stress Awareness Month (April, in the UK. Dates vary internationally); Mental Health Awareness Week (second week in May, in the UK. International dates vary), and International Men’s Day (19 November).

How to tailor a mental health plan for construction workers

In our first blog, Mental Health and Construction: How to Defuse a Global Timebomb, we discussed how specific aspects of working in construction can increase the risk of poor mental health in staff. 

The occupations associated with construction work present specific challenges when structuring and implementing a mental wellbeing policy.

For example, working from height is a high-risk activity; almost one in five construction industry deaths involves roof work*8.  Additionally, two of the key factors linked to suicide are a vulnerable individual’s access to method, and also the availability of opportunity*9. Employers must consider how working from height creates an amplified risk for roofers and tilers with mental health difficulties.

This is not just a best-practice issue. If a staff member deliberately harms themselves, failure to address job-related challenges could also impact also on a firm’s legal liability.

Construction risk managers also need to consider how the following issues might affect uptake of the help made available to them:

  • Spreading the word. As they are not office-based, site workers could have little or no access to an employer’s intranet, HR department or occupational health staff. This can limit their awareness of the support available to them.
  • Lack of training. Workers need to feel reassured that supervisors, site managers and others further up the chain of command will offer a compassionate receptive ear, and will keep their personal information confidential. The construction sector’s lack of knowledge surrounding mental health issues means that managers could be ill-equipped to deal with the difficulties faced by their staff. Training for managers needs to run parallel with resources made available to workers.
  • Knowing vs doing. There is a difference between knowing what is good for you and doing something about it. During periods of stress, depression, anxiety or extreme fatigue it could be difficult for employees to muster the mental and emotional resources required to talk about their issues, and to create change in their lives. Consult with your company mental health provider for advice on dealing with this issue.

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The pioneering programme that’s setting the agenda

Australia’s Mates in Construction (MiC) programme has emerged as an industry leader, training more than 100,000 construction workers across the country. It enables workers to recognise when a colleague is struggling, and shows them how they can help. MiC was established in 2008, and its first five years in operation, in Queensland, coincided with a 7.9% drop in suicide among construction workers.*10

As an ancillary benefit, employers have seen a return of AU $4.60 in return for each AU $1 invested in the programme. That’s a 360% return on investment. 

Mental health resources for workers in Britain and Ireland

This guide is not exhaustive. Managers and supervisors should also consult their occupational health and HR departments for advice on mental health provision. 

Help for construction workers

The Construction Industry Helpline & App offers confidential 24/7 information and advice on many wellbeing topics, including stress, anxiety, depression, anger and suicidal thoughts. Construction Industry Helpline packs are available to employers, containing cards, posters and stickers that publicise the service.

Workplace training 

Mates in Mind (MiM) is a programme delivered to the UK construction industry with the support of the Health in Construction leadership Group. It is based on Australia’s MiC programme, and aims to break the silence and stigma surrounding mental health in construction. It helps employees understand how, when and where to get support. By 2025, it aims to have reached 75% of the construction industry. 

Resources for employers

Building Mental Health helps construction employers embed wellbeing initiatives, including mental health first aider training.

General workplace mental health resources

Global Overview: Support for construction workers in selected non-uk countries

New Zealand: Currently, the Australian MiC programme is undergoing trials by New Zealand construction firms. Those in distress are advised to contact their local GP or mental health provider, or to contact Samaritans New Zealand

North America: The Construction Industry Alliance for Suicide Prevention hosts events and promotes awareness of mental health and suicide prevention throughout the US construction industry. And Working Minds provides information, resources and practical tools for workers.

Mental Health Crisis in the construction industry. men on construction site, sitting and talking

Canada: At the time of writing, there is no industry-specific initiative. However, in 2018, construction firms were urged to form mental health committees during Bridging the Gap*11 a Canadian safety conference. For workers in distress, the Canada Suicide Prevention Service (CSPS) offers phone, text and chat support.

Hong Kong: Employees of all types in the territory report high levels of mental health problems, lifestyle risk and low levels of help-seeking. Work is cited as a key stressor by 30%. Depressive symptoms are reported by 31% of workers and anxiety symptoms by 24%*12.

There are no construction-specific mental health resources, but Hong Kong’s City Mental Health Alliance offers business-to-business assistance, enabling employers to create mentally healthy workplaces. Its aim is to help workers at all levels talk about mental health without fear of stigma, and offers training and other resources for staff and employers. 

Asia / Pacific region: Asia could be sitting on a public health time bomb, precipitated by long working hours, workplace stress and a lack of social support, among other factors. Mental illness affects one in five people of working age, and is the second largest contributor to years lost due to disability in the region*13.

Multi-sector collaborations and public-private partnerships are emerging to support community-based care in the APEC region. The APEC Digital Hub shares best practice. And healthcare company Janssen operates a Healthy Minds programme that supports research, awareness building, and mental health scholarships. 

Take Action Now

Globally, the increased focus on mental health means that more is being expected from employers to safeguard the mental wellbeing of their employees at work.

It is crucial that businesses protect their employees by putting in place appropriate measures to monitor and support vulnerable workers, including those suffering or likely to suffer from stress, anxiety and depression.  

By doing so they will, at the very least, protect themselves from the potential impact of Employers’ Liability claims. They could see an improved business edge, too, says Marc Preston, CEO of New Foundation Counselling, which offers mental health services for employees in the construction and property industries.

Research has shown that only two in five employees work at peak performance*14. So it’s no wonder companies are starting to invest in their teams’ wellbeing. Firms who appreciate that safeguarding and improving employee mental and emotional wellbeing are the key to unlocking their teams’ full potential will, in all likelihood, thrive beyond their competition. 

Workers are likely to appreciate the chance to talk, with enough encouragement, says Preston, citing the well-documented experience of a senior royal: “Prince Harry sought counselling while struggling to come to terms with the death of his mother, and he makes a very good point: ‘The experience I have had is that once you start talking about it, you realise that actually you’re part of quite a big club.’ 

“And it’s true. Whether you are a prince, a CEO or tradesperson, everyone has mental health. The acceptance of this simple truth will, I believe, revolutionise the approach to mental health. And it will remove the stigma that forms the barrier to dealing with this everyday issue.” 

Read part one of this blog to discover:

  • Why UK construction has a suicide rate that’s more than three times the national average.
  • How suicide rates compare with other English-speaking countries.
  • The costs of poor employee mental health in the construction industry, both to workers and companies.
  • Employers’ liabilities and the construction claims landscape.

Make construction insurance and risk management work harder for your company 



  • Paul Chesterfield
    Peter Chesterfield

    As Partner in Marsh JLT Specialty's Construction division, Peter provides comprehensive risk and insurance solutions to support clients in achieving their important risk transfer objectives. 

    Solutions provided by the team range from local to global programmes across the suite of construction and operational risk products. The industry sectors he works with include contractors, developers, owners, international developers, PPP projects and surety.

    If you would like to talk about any of the issues raised in this article, please contact Peter Chesterfield, Partner, Marsh JLT Specialty Construction Practice on +44 (0)20 8108 9324.


*1 Construction Industry Training Board: CITB funding to train nearly 2,500 mental health first aiders for construction by 2020 
*2 Considerate Constructors Scheme: New App Launched to Support Construction Workers’ Mental Health  
*3 US National Library of Medicine: The Impact of a Suicide Prevention Strategy on Reducing the Economic Cost of Suicide in the New South Wales Construction Industry  
*4 Office for National Statistics – Suicide by Occupation
*5 Six Things We Learned from IOSH's First Annual Construction Conference
*6 The Dark Side of Construction
*7 Stress risk assessment 
*8 Roof Work – What You Need to Do 
*9 World Health Organization: Methods of Suicide: International Suicide Patterns Derived From the WHO Mortality Database  
*10 Inside Construction: Mates in Construction Launches in NT
*11 Council of Construction Associations: Construction Safety Includes Suicide Prevention
*12 City Mental Health Alliance: HK Resources
*13 Economist Intelligence Unit: Mental Health and Integration
*14 Deloitte Centre for Health Solutions: At a Tipping point? Workplace Mental Health and Wellbeing