Clive Johnson of the U.K., who helped establish the Health in Construction Leadership Group which brings large construction companies, unions and safety organizations together to address health issues states that, “national statistics show that two people per week in construction had taken their lives. It was very unacceptable and frankly, shaming on the industry.”1

Under the HCLG banner, chief executives of 150 top companies met last year to tackle occupational health, including mental health. Five companies, Wilmont Dixon, Balfour Beatty, Careys, Heathrow and Tideway are now trailing a version of the Australian Mates in Mind Programme that tackles stigma on building sites, which includes a 45-minute session on mental health wellbeing for individuals. Supervisors get 3.5 hours of coaching and managers attend a two-day mental health first aid course.1


  • NBC News Mental Health Problems Rising Among College Students
  • NBA Should Offer More Mental Health Resources to Players
  • Prevalence of Mental Health Disorders Among Public Safety Officials
  • Celebrities Speak Out About Mental Health
  • NFL Talks Openly About Mental Health Problems
  • Doctors Struggling With Mental Health Problems

One can tell from the headlines above that no matter the industry, mental health problems are real but most of the time are invisible to us. Only a few of us will ever know if a co-worker is struggling with depression or other mental issues until something bad happens. This tends to be because people keep mental health problems a secret.

For example, I had no idea one of my employees was having a terrible time with depression until he came to me and told me that his wife left him. When I asked him why, he explained that for years he had been dealing with depression and that his wife had come to the point where she had just had enough.

It’s a Secret

At work, you see me at my best, but at home, you might see me differently or you might not recognize me at all. Work allows for an escape, a distraction, an income and a place to go, even though I can barely make it through a day.

In our industry, we may see people who get hurt but do we see people who are hurting? As employers, we try hard to keep our workers safe from injuries. We have safety plans, safety training, warm ups, morning safety reminders, safety officers and fall protection plans all designed to keep our workers safe, save money and improve our mod ratings knowing there is a substantial financial benefit if we do so, but are we aware if workplace injuries are related to mental health problems?

Things to Consider

  • One in four people will experience some kind of mental health problem each year.
  • Anxiety and depression are the most common mental health problems.
  • Nine out of 10 people with mental health problems experience stigma and discrimination.
  • One in five people take a day off due to stress.
  • Less than half of employees said they would feel able to talk openly with their manager if they were suffering from stress.
  • In the last six years the number of working days lost to stress, depression and anxiety has increased 24 percent.
  • 70 million working days are lost each year due to mental health issues.
  • Roughly 15 percent of every dollar spent on physical conditions is linked to poor mental health.
  • 56 percent of employers said they would not hire someone with depression even if they were the best candidate.2

According to a USA Today report, based on research completed by Harvard University Medical School, untreated mental illnesses cost the U.S. a minimum of $105 billion in lost productivity each year. Most organizations’ health coverage plans show that physical ailments are covered, while mental health problems lag far behind. Serious mental illnesses cost society almost $200 billion in lost earnings per year according to the American Journal of Psychiatry.

Mental health issues are a silent tsunami in the workplace, one that will engulf organizations in myriad of productivity and profitability problems as well as legal liabilities unless mental health issues are addressed as seriously as are marketing, compensation and strategic plans.3

Ronald Kessler, a Harvard University professor of health care policy and lead author of a study of the National Institute of Mental Health, cites data that shows 60 percent of Americans with a mental disorder receive no treatment.3

Stew Freedman, writer in the Harvard Business Review, argues that business leaders have a moral and practical imperative to address the issue of mental health in their workplaces: “You can enable them [employees] to feel free to ask for the help they need…by changing how you think, how you talk and how you act. In turn they are bound to repay you with extraordinary effort and commitment to your goals and to your company.” 3

Cornell University professor Phyllis Gabriel states “the burden of mental disorders on health and productivity throughout the world has long been profoundly underestimated … mental health problems strongly influence employee performance, rates of illness, absenteeism, accidents and staff turnover.” 3

Roughly six months ago, Patrick Ross knew things had reached a breaking point at work. An angry email he had sent to a superior—combined with occasional temper flare-ups and brusque interactions with colleagues—was endangering his job of two years as deputy director of communication at the United States Patent and Trademark Office. Therefore, before a scheduled meeting with his boss about these problems, Mr. Ross decided that he needed to reveal something he had not told anyone outside his immediate family: He has bipolar disorder.⁴

Construction workers’ mental health volunteers have found that construction workers are six times more likely to die from suicide than falling from heights on site. The Building Engineering Services Association, the CIBSE Patrons and the Electrical Contractors’ Association organized and hosted a ceremony that discussed how depression and suicide were the “forgotten health and safety issue.”⁵

One in Four

Statistics indicate that if you have 50 employees, 12 of them are struggling with mental health issues. If you have 100 employees, 25 of them are having mental health issues. Larger companies having 500 to 1,000 workers have between 125 to 250 workers struggling with mental health issues.

In the end, it comes down to money and the stigma associated with having a mental health problem. Do construction workers make enough money to pay for mental health treatment? Do employers have a moral obligation to help?

The U.S. Substance Abuse and Mental Health Services Administration have recently released its annual report on drug use and mental health disorders in America. Its findings confirm that Americans cannot afford the cost of their mental health treatment — even if they have insurance.

Stigma is when someone views you in a negative way because you have a distinguishing characteristic or personal trait that’s thought to be, or actually is, a disadvantage (a negative stereotype). Unfortunately, negative attitudes and beliefs toward people who have a mental health condition are common.

Stigma can lead to discrimination. Discrimination may be obvious and direct, such as someone making a negative remark about your mental illness or your treatment. On the other hand, it may be unintentional or subtle, such as someone avoiding you because the person assumes you could be unstable, violent or dangerous due to your mental illness.⁶

Skanska executive vice president Gregor Craig adds that raising awareness and the importance of dialogue is key to tackling the stigma. One way firms can start a conversation is by dedicating time for employees to discuss the issue, Craig says. “One of the things that was surprisingly really successful was that we did a stand-up on mental health. Across every single location in Skanska, we were talking about [the issue] all at the same time.”⁷


Is it possible that a significant number of accidents or injuries are the result of construction workers having mental health issues? Why do so many workers take risks like not tying off or not taking the time to put guardrails on scaffold platforms? Why do so many workers not show up for work on Monday but are always there on payday? Why is drug and alcohol abuse so prevalent in the construction industry? Is it just a phase the industry is going through?

One in four construction workers having mental health issues means that 25 percent of your work force has some mental health problem. We keep asking why productivity continues to decline from past years, but have failed to find an answer.

Is there a relationship between mental health and lower productivity now knowing that 25 percent of your work force is dealing with depression, anxiety or some other mental health problem? This is not an easy question to answer, but it is something to seriously consider because as we utilize better tools, technology, training, processes and systems, productivity continues to decline. As productivity declines we see increased construction costs, which we think can be solved through robotics or prefabrication.

With driverless cars on the horizon, we are offered a glimpse of how computers will remove the human failure or weakness factors. Remove the human frailty factors and it’s a game changer in terms of productivity. Remove the human frailty factor and we see consistency.

I was talking to a tradesman on a flight recently who said, “I’ve hit the ceiling on my trades earning potential and I don’t see any hope of earning more.” As we talked about it, he made it clear that he had come to some realizations that were obviously affecting his perspective:

  • What if my body doesn’t hold up over the long haul?
  • What if I get hurt?
  • My income will only marginally increase as the cost of living goes up.
  • What if the economy tanks again?
  • I don’t have a backup plan.
  • What if my retirement gets cut in half?

As I listened to all of his valid ‘what ifs’ I realized he had come to these conclusions because life had changed for him. Marriage, kids and mortgages have a tendency to do that, but in the end it’s all about how he deals with the ‘what ifs,’ and the other curve balls life seems to throw at him. Will he become one of the 25 percent of construction workers having mental health problems? I have no idea, but I do know that the number of workers with mental health problems will only increase over time if nothing is changed.

An Investment in Mental Health

The literature on mental health problems in the workplace suggests that the personal toll on employees — and the financial cost to companies — could be eased if a greater proportion of workers who need treatment were able to receive it. The authors of such studies advise employees and employers to think of mental health care as an investment — one that’s worth the up-front time and cost.

Most of the research on the costs and benefits of treatment has been tested on employees with depression. The studies have found that when depression is adequately treated, companies reduce job-related accidents, sick days and employee turnover, employee productivity, as well as improve the number of hours worked.

However, the research also suggests that treatment for depression is not a quick fix. Although adequate treatment alleviates symptoms and improves productivity, one study found that in the short term, employees might need to take time off to attend clinical appointments or reduce their hours in order to recover.

To overcome barriers of accessing care and to make it more affordable to companies, the National Institute of Mental Health is sponsoring the Work Outcomes Research and Cost Effectiveness Study at Harvard Medical School. The researchers have published results from a randomized, controlled trial of telephone screening and depression care management for workers at 16 large companies, representing a variety of industries.

During the two-phase study, mental health clinicians employed by an insurance company identified workers who might need treatment, provided information about how to access it, monitored adherence to treatment and provided telephone psychotherapy to those workers who did not want to see a therapist in person. The outcomes of 304 workers assigned to the intervention were compared with 300 controls, who were referred to clinicians for treatment but did not receive telephone support.

The researchers found that workers assigned to the telephone intervention reported significantly improved mood and were more likely to keep their jobs when compared with those in the control group. They also improved their productivity, equivalent to about 2.6 hours of extra work per week, worth about $1,800 per year (based on average wages)—while the intervention cost the employers an estimated $100 to $400 per treated employee. The researchers are conducting additional research on how to improve access to mental health care in the workplace and how to quantify costs and benefits for employers.

Studies such as these suggest that in the long term, costs spent on mental health care may represent an investment that will pay off—not only in healthier employees, but also for the company’s financial health. 

Mental Health Treatment

One study found that after only three weeks of mental health treatment, the number of employees suffering from a diagnosable mental illness decreased by 50 percent. This same study indicated that after a little over four months of treatment more than 75 percent no longer experienced any work-related impairment.

In a study by ValueOptions, employees who completed at least one session with a mental health provider reported decreased absenteeism and a significant improvement in both productivity and overall mental health.

As psychology continues to be integrated into the workplace, measures of productivity and happiness will increase.

Placing mental wellbeing at the center of this movement includes workplace meditation and yoga, referrals to appropriate mental health professionals, mental health consultations and more robust employee assistance programs. The long-term investment in psychological health will create returns that outweigh the crippling loss of productivity in absenteeism.

Prioritizing the mental and emotional wellbeing of employees will increase profit, improve lives, and transform culture.⁸

Mental Health Innovators

How many owners, CEO’s, executives or managers do you know have come out of the mental health closet and admit to their staff that they are dealing with depression, anxiety, bi-polar disorder or some other mental health issue?

The odds are very good that an executive reading this article has either experienced a mental health problem or is going through a mental problem and is more than likely keeping it top secret. However, you don’t have to come out and you can use your experience to implement a plan that addresses mental health problems within your company.

How much will it cost, what’s the payoff and what are the risks are all trivial questions when you consider that right now, 25 percent of your workforce is suffering and your company is paying for it. Again, it boils down to money. Employers can pay by letting the suffering continue or employers can pay to implement a plan to reduce the suffering.


  • Designing Buildings U.K.
  • Mental Health, U.K.
  • Ray Williams Psychology Today
  • New York Times, Alena Tugend
  • Building Design and Construction- Josh Phillips
  • Mayo Clinic Staff
  • Construction News- Lucy Alderson
  • Inc. Magazine