Building Minds: Why is there a mental health crisis in the construction industry? And what can we do about it?

Workers in construction are now nearly four times more likely to die by suicide than in any other sector, and in 2021 alone there were 507 deaths by suicide among construction workers. That accounts for approximately 10% of all suicides in the UK (source: the ONS).

Building Minds, our three-week event addressing the mental health crisis in construction, launched in late November 2023. We held a panel discussion with four guests representing the intersection of mental health and construction. The framing questions for the panel discussion were “Why is there a mental health crisis in construction?” and “What can we do about it?” The following article is a summary of the main points of the discussion.

The Panel:

Jack Woodhams is the founder of Menfulness, an organisation that supports men with their mental health. Menfulness brings men together to socialise and exercise in a supportive and environment with the aim of improving mental and physical health. Menfulness has partnered with Serendipity, a professional counselling service to ensure a clear pathway to expert help.

Kara Thompson is a director with Faction UK, an Australian real estate consultancy. Her work as a project manager and consultant positions her as an intermediary between multiple stakeholders within the organisational structure of a project. This position gives her a nuanced and sophisticated understanding of the competing motivations of the project participants. In addition, she brings a unique insight by comparison, having joined the UK construction sector from the Australian construction sector.

Kari Sprostranova is the health, safety & wellbeing director at Mace Construct. Before joining Mace, Kari was Director of Health, Safety, Environment and Sustainability at Balfour Beatty. Prior to that, Kari held a senior role in the Health and Safety Executive as Principal Inspector delivering field activities in the construction sector. Kari understands government, corporate, and site perspectives, and can act as a link between these communities.

Steve Kerslake is the founder of Construction Sport and has his own groundworking business. Construction Sport seeks to address the mental health crisis in construction through the medium of sport. Steve’s personal and professional history positions him on the frontline of the mental health crisis in construction. Some years ago, Steve was attacked with acid and consequently experienced PTSD. As he began his recovery, he found that there was a paucity of resources available to him. He also realised that there was very little support for construction workers recovering from PTSD having witnessed a death on site. He believes that the lack of mental health support is one of the reasons for the high rates of suicide among construction workers.

The Talk:

After the panellists had introduced themselves, we started the conversation by asking why is there a mental health and suicide crisis in the construction sector?

 

Late payment

All of our panellists agreed that the primary cause of mental health crises in construction was late payment.

Kara told us that the construction sector had a rate of 19% late payments in 2020 and that the figure has jumped to 53% in 2021 which was the highest jump of any sector. There were three main stressors for the sub-contractor: cost of living, cost of materials, and finance. Late payments are unacceptable as they put pressure on the supply chain.

Steve expanded saying that late payment creates a cascade effect. If a sub-contractor is not paid on time, they can’t buy the materials they need for the next job. If the contractor can’t pay his workers, they might default on car, nursery, or mortgage payments. The impact of late payment is not easily absorbed by the people who do the work because they do not have the cushion of capital reserves. He pointed out that around 4500 companies have collapsed in the construction industry at mid-year 2023.

Kari explained that this is not well understood by the paymasters who are salaried office workers. They do not experience the hardships caused by late payments as their salary arrives regularly. Build UK is working to expose and remedy the problem of late payment by pushing company’s obligation to report on payment performance every six months.

Kari cited the Causeway report which identifies irregular and long working hours as key stressor on sub-contractors. It also mentions the pressure of tight deadlines that lead to the long hours. Contractors not knowing when or if they will be paid for their work are under unimaginable stress; unimaginable for the people working on the corporate side of things. Kari said, ‘contractors may wait days or weeks to be paid’; someone in the audience called out ‘three months!’

Steve said that when he asks contractors how they support the mental health and wellbeing of their workers they say, “we try to pay them on time”. They don’t want to be taken on fancy days out if they’re going to be paid late, they’d rather the boss stay in the office and ensure they’re paid.

Kara pointed out that, in the UK, there are no significant consequences for companies that pay late. In Australia, if you pay late, you get barred, you get charged, there are progressive punishments. Consequently, 98% of payments are on time. The money is available, it is just being delayed. Kara is in the process of setting up a committee to lobby for changes to the Payment Act.

Steve makes the point that for small businesses who want to pay their workers, late payments ‘turn honest people dishonest’: they have promised to pay and are forced to break that promise. This can be a trigger for suicide.

Health versus Safety

Kari said that in the industry, “We’ve been shouting ‘Safety’ and whispering ‘Health.’” There are two pieces of related work to address the mental health crisis: how do we prevent the stress, and how do we deal with it?

Steve raised the issue that suicide is not reportable under RIDDOR (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013). He finds it shocking that it is not an investigative procedure for the HSE.

Kari, responding to this as a former HSE inspector, said that although suicide is not RIDDOR reportable, as an employer or contractor there is a responsibility to investigate. She strongly feels that we need to do more on the health side of health and safety than we have been doing. The Construction Leadership Council have put out a note on how to drive this forward.

The psychological profile of the construction workforce

Steve told us that people joining the workforce often arrive a bit broken. Veterans, rehabilitated prisoners often find their way into the construction sector. Steve told us a story about an ex-forces colleague who did not want to work with anyone called Mike. A strange request – it turned out that ‘Mike 2’ was a call signal from an operation that had gone badly and was a trigger word for his PTSD.  Steve remarked that we sign off our machinery every day, but we don’t sign the person off.

Steve said there was a significant problem in not recognising or acknowledging PTSD within the industry. Furthermore, the work can take you to places where you experience trauma. When working on a Crossrail project there were multiple suicides on the line, one of which his team witnessed. They were offered some days off which they were unable to take because they would have lost their pay.

Jack told us about the suicide prevention initiatives he runs in York college for young people taking training to enter the construction sector. Five minutes ago, they were in the playground with their mates; now they’re on a cold, wet site at 5.30am and it looks like this is the only future they have. For many of them, construction wasn’t a choice; they didn’t achieve great academic results. Some of them have reported that the wellbeing checks from site managers are a box-ticking exercise not offered with any genuine intent.

In defence of the site managers, this is due to time pressure and a lack of training in how to have wellbeing conversations. The feedback at the end of these courses indicated to Jack and his team that the participants were well aware of the counselling resources available to them. What they wanted was training in how to manage their money, how to support their own wellbeing and that of their families. Studies have shown that people who take their own lives overwhelmingly do so because of money problems and/or family problems.

 

We asked the panel the second framing question, ‘what can we do about the mental health crisis?”

Kari summarised the main points of attack. We communicate how people can get help. We change the culture by ensuring people know that it is ‘okay to not be okay’. More importantly, we look at prevention. We look at payment terms. We look at long hours. We learn about the neurodiversity of our workforce and learn how to support them. Recent research has suggested that, for younger people, communications of this nature are most effective conducted through apps. Apps that allow a direct line of communication with the subcontractor and the main contractor through which workers can say what they need. We take account of the life cycle of a project which comes in peaks and troughs of pressure and build in support at various points. We set up project teams effectively to respond to the changing needs of the workforce. We bring in more diversity in gender and ethnicity into the industry to challenge stereotypes and get broader viewpoints. There is no magic wand, but it is critical that we work together.

 

Bidding with integrity

Kara said that as a project manager she tries to avoid promising to get something done quicker than is reasonable, even if it means losing out on work. A competitor recently promised a programme six months quicker than her, which was a fairly ridiculous reduction. It’s important to set ourselves up for success, not over-promise, and speak with conviction. If we take longer with the design and flush out all the issues, it allows the supply chain to buy right first time. That then takes the pressure off the profit margins and, when everyone gets to site, it’s getting installed in the right sequence, it’s not rushed, there’s no coming back to fix it. Let’s set realistic programmes that are deliverable in the right way at the right time – that will have a huge impact.

We need to act collectively as an industry to overcome undercutting. If we don’t push the main contractor for an extra percentage, so they don’t push their supply chain, we can show the value of paying people adequately and on time and maybe get a better outcome for everyone.

Kari added to this saying that early collaboration between main and subcontractors at the tendering stage can be powerful. Realistic time frames informed by the entire supply chain presented collectively will remove some stress from a project. She also said that there is some hope that the Building Safety Act will drive up standards in this regard because of the way the designs will have to be set especially for high-risk buildings. She would love to see work done around undercutting and overpromising in terms of timeframes, which has happened in other industries.

 

People versus profit

Kara made the point that, although there are weightings in the tendering process for how a bidder treats its workforce, 95% of the weighting is commercial. Steve said that until you can demonstrate to the people paying for the project that the wellbeing of the workforce is profitable, there is unlikely to be change.

Kari reminded us that during COVID, schedules were reorganised with shorter shifts and yet productivity was exceptionally high. We weren’t burning people out. If you give people shorter shifts and more breaks, productivity actually increases. However, some people want to work overtime, maybe need to work overtime, so it’s about finding a balance.

Steve spoke about an initiative at Kier where they offered to pay site staff twelve hours for eight hours work as long as there were no issues on site. On that project, they finished ahead of schedule because the team pulled together.

Jack made the point that for every pound spent on mental health you get five pounds back. Alleviate the stress of the workplace and you don’t lose money to absenteeism through ill health. There is a great ROI on wellbeing.

 

Conclusion

The conversation highlighted a chief cause of suicide and mental distress in the construction sector as late payment. Some developers are unaware of the impact of late payment. Some developers are intentionally withholding payment to retain their capital for as long as possible to accrue interest. They are able to do this because there is no effective regulation for late payment.

This is causing people to take their own lives, creating untold misery for colleagues and families, and making the construction sector the most dangerous sector in the UK economy.

The sector should work collectively to remedy the issue. Lobbying for better legislation around late payments and bidding processes may be necessary.

The people who make up the workforce of the UK construction sector have demonstrated their ability to be flexible, to respond to difficult circumstances, to collaborate, and through it all, to excel.

They are valuable; they deserve to be paid on time.

Where you can get help

If you are having a difficult time and feel like you are struggling, help is always available.

Free listening services: 

These services offer confidential support from trained volunteers. You can talk about anything that’s troubling you, no matter how difficult: 

• Call 116 123 to talk to Samaritans, or email: [email protected] for a reply within 24 hours 
• Text “SHOUT” to 85258 to contact the Shout Crisis Text Line, or text “YM” if you’re under 19 

If you’re under 19, you can also call 0800 1111 to talk to Childline. The number will not appear on your phone bill. 

These services will only share your information if they are very worried about you or think you are in immediate danger. 

Information on coping during a crisis:

The mental health charity Mind has information on ways to help yourself cope during a crisis. 

This includes calming exercises and a tool to get you through the next few hours.