CPD: Mental health in the construction sector

What are the factors influencing mental health in the construction sector? Matt Wilson outlines some of the stressors construction employees come up against.

Construction safety has improved drastically over the past decade, but work-related ill-health remains higher than the UK-employed norm (HSE 2020). Ill health is not just physical, in the form of an injury sustained as trips, slips, or falls, but includes mental health such as depression, anxiety or stress.

Some 0.4 million working days are lost due to stress, depression, and anxiety (Burki 2018, Mates in Mind, HSE 2020), and recent studies have been highly critical of the construction industry’s record of tackling work-related stress (Burki 2018). Psychological ill health is such a concern that the HSE has included work-related stress as one of its priorities for its construction sector plan for health and safety.

The HSE’s focus and urgency are merited, as stress can have profound physiological effects in the form of hypertension, musculoskeletal disorders, and immune-related disorders, which can result in psychosocial ailments such as fatigue, burnout, depression and even suicide (Lipsedge & Canlan 2010, Neal 2010, Maqsoom et al 2018, HSE 2020). The worker suicide rate is over three times higher than other industries (Burki 2018, Kotera 2019) putting into context the severity and urgency of the issue.

Though the industry is a predominantly site-based occupation, there are other professions that experience their own set of stressors, such as surveyors, allied trades, office-based roles, project management and health and safety roles. This diversity of occupations within the construction industry means not all employees will be exposed to the same physiological or psychosocial stressors (Leung et al 2015). The construction sector employs circa 2.2 million people in the UK in some form, with employment varying from manual labour to office-based staff. It represents around 7% of the total UK working population and 8.5% of GDP (Shibani et al 2020, Kotera et al 2020).

What is a ‘stressor’?

In order to fully understand the term stressor, we will use the definitions offered by Monroe & Slavich (2016): “Psychological stressors are social and physical environmental circumstances that challenge the adaptive capabilities and resources of an organism”.  Within the construction industry these ‘circumstances’  can represent an extremely wide and varied array of work environments.

Psychosocial risk can pose a significant risk to health and safety, and if not correctly managed could lead to absence, injury or death (Hammer et al, 2015). Management of these psychosocial risks should be embedded in the culture of the organisation in the same way that a risk assessment would.

Indeed, under the Health and Safety at Work Act (1974) it is the employer’s duty to ensure the health, safety and welfare of their staff. In this instance, stressors are considered psychosocial risks that need to be mitigated or controlled, and if possible, eliminated.

Demands placed on workers

Demand plays a significant part in stress creation at all levels of the industry, and the construction industry is renowned for its tight deadlines and contractual penalties for overdue work (Burki, 2018).

Using the theory of scarcity hypothesis (Kotera et al, 2019), we can theorise that the quantity of time and energy an individual has is fixed. Excessive workload or too many conflicting roles leads to overloading, which could result in stress.

The construction work environment is an abundant source of physical stressors (Sherratt, 2017) as it has many hazardous environments. This could be in the form of repeated hot works, working within a confined space in the form of a lift shaft, or working in excessively cold, hot, or noisy environments.  There are also long-term repercussions of work patterns on stress, such as night shift work and the associated fatigue on stress levels (Leung et al, 2015).

Additionally, demand can be reviewed as stressful if the individual’s skill or ability is not suitable for the task they are required to undertake, such as in the case of a newly promoted site manager or young worker (Maqsoom et al, 2018).

The importance of control

The ability to manage their workload and make decisions regarding their work and how it is carried out can have profound effects on a worker’s mental health and productivity (Leung et al, 2015). Unfortunately, those further down the supply chain have little control over how they do their work (Burki, 2018; Kotera, 2020).

Principal contractors often dictate how a subcontractor’s work is to be carried out via an agreed method statement, often with little input or feedback from those completing the work.

This inability to ascertain some form of control is only exacerbated by the industry’s multi-lingual and international labour. Discrimination because of race or ethnicity may further cause negative psychological responses (Neal, 2010; Maqsoom et al, 2018).

Support from employers

How quickly stress becomes serious enough to warrant intervention or become a diagnosable mental health illness is largely down to how much support their employer can offer. Those who can talk about what is causing their stress are in some form insulated against the effects of it (Broadbent, 1985) and there is a correlation between leisure satisfaction and stress reduction.

However, the industry is rife with mental health stigma (Milner et al, 2018) with nearly half of all employees who take time off to deal with stress choosing not to disclose this reason to their colleagues (Burki, 2018).

A recent study undertaken by the think-tank RAND revealed that only 25% of workers were aware of the support services that were available to them. This confirms that this lack of awareness combined with the lack of managerial support could contribute to stress (Mates in Mind, 2020).

Relationships at work

There is potential for conflicting personality types which may lead to the development of anxiety, depression or stress (Leung et al, 2015). Poor mental health can be attributed to bullying because of conflicting personality types or can be racially motivated (Maqsoom et al, 2018), which is exacerbated when combined with other stressors.

Whilst construction is not unique in this regard, the very nature of the industry could give rise to the predominance of certain negative character traits in management roles. Similar to other hyper-masculine and male-dominated industries, the stigma of speaking out or seeking support can result in further stress (Ness, 2012).

Roles outside of work

Beyond the workplace, many in construction have extra societal roles in the form of family or volunteering. Kotera et al (2020) refer to the “spill-over theory”, where stress from one domain or role can negatively affect another. Domestic issues can affect productivity and increase susceptibility to work-generated stressors (Maqsoom et al, 2018).

Whilst some research would suggest that multiple roles can lead to personal distress, conflicting evidence shows workers who fulfil multiple roles have lower levels of mental health problems. This could be associated with the ability to fulfil those roles successfully (Kotera et al, 2020).

An issue for both the senior management and workers is that excessive role responsibility may lead to greater pressure and increased risk of burnout (Shibani et al, 2020; Mates in Mind, 2020).

Drugs, narcotics and alcohol

Whilst it is important not to overstep the boundary of corporate responsibility into workers’ individual decisions, it is critical that aspects of their health be managed to ensure the effects of choices such as alcohol consumption and drug use do not affect health, safety and performance.

Excessive consumption of alcohol and drugs not only worsens the psychosocial effects of stress but can lead to the exacerbation of existing mental and physical health issues (Chick, 2010) and give way to serious safety concerns in an industry where operating plant and machinery are commonplace (Sherratt, 2017).

Substance abuse is a known coping mechanism for stress, so it is paramount that the industry controls stressors and takes responsibility for the impact its work has on employees.

Managing change

Whether it be last-minute design changes or an unexpected change in personnel, if not correctly communicated, change can cause significant stress to an employee.

There are three key areas where focus on correctly managing change is required to prevent stress in construction: technology, Brexit and pandemics, like Covid-19. Change can often trigger feelings of uncertainty (Maqsoom et al, 2018) and at the time of the writing, these have presented great challenges for the sector.

Covid-19 significantly disrupted the industry and typical office and on-site practices have fractured.

Team and one-to-one meetings and social events were replaced by online meetings for many. Due to the age of some staff and the inability, or unwillingness, to adapt to new communication practices, there have been feelings of isolation and miscommunication. A recent study revealed that 68% of remote workers find it harder to maintain relationships with their peers and managers (IOSH, 2021).

A lingering threat to the industry is Brexit. The significant loss of migrant labour aside, there is also the unknown effect on supply chains and procurement in the future, which may lead to lower profit margins, more bureaucracy and ultimately, stress (Shibani et al, 2020).

Future stressors

The skills gap within the industry will likely put a significant burden on the younger generation of construction professionals. A recent report by the IPPR states that only 15% of workers in the industry are under 30, and with 750,000 workers looking to retire within the next 15 years this could be a huge source of potential stress if the industry does not prepare (Watkins & Hochlaf, 2021).

The UK’s skilled-based immigration policy could leave the industry short of thousands of semi-skilled migrant workers, putting additional pressure on an industry where demand is already a source of stress (Mates in Mind, 2020; Leung et al, 2015).

Building Information Modelling software use is slowly becoming a part of construction design and management, and with many larger construction firms and design agencies utilising this approach at tender, many workers may find themselves unable to secure procurement, contracts or manage projects without sufficient training and investment. For the older generation who may struggle with the uptake and investment of new technology, this may be an additional source of stress (Lipsedge & Canlan, 2010).

A future article by Matt Wilson will explore some of the strategies that can be used by construction employers to support mental health and wellbeing.

References

Broadbent, D E (1985). ‘The clinical impact of job design’, The British journal of clinical psychology, pp. 33.

Burki, T (2018). ‘Mental health in the construction industry’, The Lancet. Psychiatry, 5(4), pp. 303-303.

Chick, J (2010). Substance Abuse, Hunter’s Diseases of Occupations, Tenth Edition, Part 6 – Work and Mental Health, pp.859-868.

Hammer, L B, Truxillo D M, Bodner T R, Rineer J, Pytlovany A and Richman A (2015). ‘Effects of a Workplace Intervention Targeting Psychosocial Risk Factors on Safety and Health Outcomes’, BioMed research international pp.836967-12.

Kotera, Y, Green, P and Sheffield, D (2019). ‘Mental health shame of UK construction workers: Relationship with masculinity, work motivation, and self-compassion’, Revista de Psicologia del Trabajo y de las Organizaciones, 35(2), pp. 135-143.

Kotera, Y, Green, P and Sheffield, D (2020). ‘Work-life balance of UK construction workers: relationship with mental health’, Construction management and economics, 38(3), pp. 291-303.

Milner, A, Law, P C F, Mann, C, Cooper, T, Witt, K, and Lamontagne, A D (2018). ‘A smart-phone intervention to address mental health stigma in the construction industry: A two-arm randomised controlled trial’, SSM – population health, 4, pp. 164-168.

Maqsoom, A, Mughees, A, Safdar, U, Afsar, B and Ali Zeeshan, B (2018). ‘Intrinsic psychosocial stressors and construction worker productivity: impact of employee age and industry experience’ Economic Research 31:1 pp1880-1902.

Ness, K. (2012) ‘Constructing Masculinity in the Building Trades: ‘Most Jobs in the Construction Industry Can Be Done by Women’’, Gender, work, and organization, 19(6), pp. 654-676.

Sherratt, F (2018). ‘Shaping the discourse of worker health in the UK construction industry’, Construction management and economics, 36(3), pp. 141-152.

HSE (2020). Construction statistics in Great Britain, v.1 Published 11/20.

Lipsedge M and Canlan (2010). Work, Stress and Sickness Absence: a Psychosocial Perspective, Hunter’s Diseases of Occupations, Tenth Edition, Part 6 – Work and Mental Health, pp.804-819.

IOSH (2021), ‘A Year of COVID’, IOSH Magazine, Mar/April 2021, pp.16-17.

Leung, M-y, Chan, I Y S and Cooper, C (2015). Stress Management in the Construction Industry. Hoboken: Hoboken: John Wiley & Sons, Incorporated.

Mates in Mind (2020) – Let’s Talk Stress – Managing stress in your workplace, publication CMIM1913.

Monroe S M and Slavich G M (2016). ‘Stress: Concepts, Cognition, Emotion, and Behaviour’. Handbook of Stress Series VoL.1, Pages 109-115.

Neal A (2010). Mental Health at Work: Psychosocial Interventions, Hunter’s Diseases of Occupations, Tenth Edition, Part 6 – Work and Mental Health, pp.823-832.

Shibani, A, Dyaa, H, and Nehal, S (2020). ‘The Effects of Pandemic on Construction Industry in the UK’, Mediterranean journal of social sciences, 11(6).

Watkins, O & Hochlaf, D (2021). Skills For A Green Recovery – A Call to Action For The UK Construction Sector The Institute for Public Policy Research, published 02/21.