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

All 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 midyear 2023.

Steve made 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. 

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. 

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 companies to report on payment performance every six months. 

Kari cited the Causeway report which identifies irregular and long working hours as a 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!” 

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.

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 duty 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.

Steve told us that people joining the workforce often arrive a bit broken. Veterans and 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 training to enter the construction sector. 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. End of course feedback indicated that the participants wanted training in how to manage their money and 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.

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. 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 silver bullet, but it is critical that we work together.

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 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 and 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 timeframes 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, which has happened in other industries

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.

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.