The elephant on the worksite

As hard as it is to talk about, mental health and suicide are very real issues for Australia’s wider construction sector. Roads & Infrastructure Magazine talks to experts and stakeholders about the problem, challenges, prevention and help available.Suicide rates in the construction industry are 71 per cent higher than that of other employed men, according to Suicide in the Construction Industry from suicide prevention group MATES in Construction (MIC).

The report found 2554 construction workers died by suicide between 2001 and 2013, which represented one suicide every second day.

Likewise, an analysis of international studies published between 1979 to 2012 indicate that the suicide rates among lower skilled workers in construction were 80 per cent higher than the general working age population.

This startling statistic was detailed in Suicide by occupation: systematic review and meta-analysis – research published by a number of prolific authors, including Allison Milner from the University of Melbourne, who also authored the MIC report.
Dr. Milner’s most recent co-authored publication – Male suicide among construction workers in Australia: a qualitative analysis of the major stressors precipitating death – also revealed insight into the intricacies and complexity of the issues surrounding mental health and suicide in the wider Australian construction sector.

“The really horrible thing is that suicide is common around the world, and in many OECD (Organisation for Economic Cooperation and Development) countries you see it having a much greater effect,” says Dr. Milner.

“This is something we see in other areas of the world, which tells us there are some growing issues not just in Australian but on a global scale.”

As outlined in Suicide in the Construction Industry, between 2001 and 2003, the rates of suicide in construction workers were over 2.3 times that of other male workers. However, it also found Queensland suicide rates fell from 46.1 in 100,000 in 2001 and 2002 to around 13.8 in 100,000 in 2012 and 2013,

While the rates may be on the decline as suggested in those findings, suicide rates among construction workers remain above the average and Dr. Milner agrees the mental health and suicide are still very real issues that need addressing within Australia’s construction sector.

Addressing the issues

“’What’s driving these suicides?’ is really the million-dollar question – what might people in construction face that others might not?” she asks.

“Labourers or manual workers are the ones at risk here, and we know the working conditions are tough and often not optimal for addressing these issues, particularly as they work very long hours. Other significant risk factors in the industry that are related and also need to be faced is drug and alcohol usage. They’re not things that can be easily fixed, but can be managed better especially depending on how we view it within the industry.”

While long hours spent working manual jobs are some of the key elements here, Dr. Milner also identifies the traditional masculine stereotypes as another major factor, particularly as the manual construction sector is male-heavy.

“Over the past few years we’ve been trying to identify the issues for men in these areas and the big one is the idea of masculinity and a kind of stoicism. That stoicism was really helpful for men 2000 years ago when they were the builders and planners laying down the foundations for how many things are done today, but not now – it can be quite harmful,” Dr. Milner explains.

“That idea of stoicism brings up these potentially damaging things – men won’t speak up if they have a problem and they could have mental health problems that need addressing.”

She suggests the idea of not sharing your thoughts and feelings, particularly among other men is due to a kind of ‘toxic masculinity’ that stops men from opening up and having those honest conversations. “It’s extremely damaging to mental health and that is something that needs to be dealt with. Men might not be capable of seeking help or even starting the conversation,” Dr. Milner adds.

“It’s not only masculinity here, but the fact it can be hard to get support in an industry where people are used to working very long hours leaving little time to even talk about their issues.”

While she says that men may struggle to talk about their own thoughts and feelings about suicide and mental health issues, a recurring factor is the idea of men supporting men, and women supporting women with these problems.

“All of these factors contribute to a toxic cocktail of sorts and a list of things we need to address, but they are things we can do something about, which is where work and support people on site come into play.”

The Male suicide among construction workers in Australia study investigated and demonstrated that there are a number of inter-related stress factors that can influence suicide of constriction workers, “many of which are amenable to preventative intervention”.

The research talks about the role of the ‘gatekeepers’ – people who are able to identify, provide support for and connect those at risk of suicide with professional care. They are suggested to most likely be work colleagues in this context.

“People will see them first thing in the morning, sometimes on the drive to work, and afterwards too,” Dr. Milner says, adding that these relationships, like many workplaces, can progress from professional to a personal one quite easily.

“We need to make sure people have someone they can rely on at work, and that’s something that’s really key for mental health.”

Incentives such as R U OK? Day are great examples of how the colleagues can begin to play a role in checking in with their workmates. However, Dr. Milner says, the help needs to evolve beyond simply asking the question once.

“One of the things we need to think about when we ask ‘are you OK?’ is the follow up. It’s great to ask, but more support and engagement is needed after the initial question,” she explains, adding that having that conversation face-to-face is also a critical piece of the puzzle here.

“Actively sitting with someone and talking about mental health and suicide can be quite unnerving to do, and it can be difficult for the people who are listening too, but it’s important to know that we get a much better outcome by the fact we’re human beings and are looking someone in the eye.

“There are a huge number of contributing factors, but talking about suicide, about prevention and what people can do will help,” says Dr. Milner, adding that a big catalyst for change is often a colleague or friend making that first step.

“It’s really tough to have those conversations. I can understand people are afraid of asking the questions, but asking the questions is not going to make anything worse,” she says.

Dr. Milner adds that being aware of the services out there for helping with mental health issues is big step in the right direction.

“We also need to be able to think further ahead and what is driving these suicides and how we can make things better. We need to take an industry-wide approach to addressing them effectively and it’s really got to come from the top end of the industry itself.”

While Dr. Milner asserts that the issues are prevalent within the construction sector, she says Australia is leading the charge in changing the status quo.

“When we talk about prevention of suicide in construction, the construction industry in Australia is really world-class in leading the way. Industry has really been able to put up its hand and admit it needs to address the issue,” she says.

“I don’t think it’s all a lost cause and the Australian construction industry has a lot to celebrate.”

Taking the next step

Dr. Milner cites a number of organisations and services offering assistance and help in these areas and helping to open up conversations about the issues, particularly for construction workers.

Incolink, a joint enterprise of employer associations and unions within the Victorian and Tasmanian commercial building and construction industry, was established in 1988 to manage redundancy funds for workers.

Due to the project-based and transient work of the industry, stakeholders recognised the need to work together to ensure the sustainability of the workforce.

Incolink supports the health and financial wellbeing of workers and their families by administering redundancy, portable sick leave and income protection insurance, along with a host of wellbeing services, from prevention education to intervention and support.

Dan O’Brien, CEO at Incolink, says the goal of the business is to provide a safety net for workers in an industry where work is transient and physically demanding. He says the associated risks to their wellbeing may include financial, physical and potentially mental.

“We provide assistance in redundancy and to help make sure there is a sustainable workforce. With redundancy comes loss of financial security, which can impact the mental and physical health and wellbeing of that person.

“Without the financial stability and social connectivity of work, some individuals may struggle, yet do not know where to go for help.”

He explains that, as typical of male culture, stoicism may hinder help-seeking behaviour. This can be hard to overcome when it comes to not just talking about mental health but also vulnerability off the back of redundancy and job loss. As such, Incolink’s services extend beyond just financial and insurance support.

The organisation’s holistic approach to construction worker care makes it unique in Victoria, and potentially Australia, because the social and wellbeing support is now part and parcel of Incolink’s wider redundancy services.

“Our prevention and education team raises awareness for the entire workforce on site and provide brief intervention to those in need,” explains Mr. O’Brien. “Those who require additional support are linked to various referral pathways and support networks by our team of qualified counsellors across a range of issues, such as alcohol and other drugs, relationship, financial rights and gambling.”

Incolink-qualified health and wellbeing teams bring toolbox sessions to site, covering everything from drug and alcohol awareness through to mental health and suicide.

Those mental health toolbox sessions act as an opportunity for construction workers to talk about the issues they may be facing, but also ask themselves whether or not they want to talk to someone about the issues they may be going through.

“What we do is effective because it’s a precursor to seeking help. We’re not going to leap straight ahead to professional help because there are quite a few steps in between that, and that all comes down to a conversation,” explains Mr. O’Brien.

“When our team goes out there with these messages and the message resonates, that’s when an individual might decide they want to talk to someone.

“Sometimes it can be on our fourth of fifth visit when someone raises their hand and wants to talk about it because they feel the trust is there.”

He says trust and mutual respect on the work site are key to promoting awareness and help-seeking behaviour, whether they’re talking about drugs, alcohol, mental health or suicide.

“Having them get to the point in their mind where they think ‘this resonates with me and I need to talk to someone’ is a big first step in the right direction. Incolink is all about being a sounding board for workers and a conduit for further support.”

Frontline engagement

David Clark, who leads the prevention and education programs and teams at Incolink, agrees with Mr. O’Brien’s sentiments on the significance of trust when talking about mental health and suicide.

Mr. Clark, like the other presenters involved in Incolink’s on-site toolbox sessions, is a tradie-turned-counsellor having worked in the latter sector for the past 17 years.

“Coming from the same industry as the people we’re talking to is definitely one of the major factors to our success and that’s why all of our presenters come from trade,” he explains.

Engagement on the same level, he says, is key to building relationships and trust when delivering messages about perceived taboo subjects such as suicide and mental health, especially for some of the younger workers.

“We all haven’t had dream apprenticeships and you may not always have that support or know how to handle the pressures around you,” says Mr. Clark. “In my own apprenticeship the support wasn’t there, so I know what it can be like.”

Incolink runs a number of on-site toolbox sessions for businesses, giving the employer the options between drugs and alcohol, mental health and suicide prevention.

“We spend a lot of time making sure we’re using the same language and stories relating to the guys,” says Mr. Clark. “The more talks we do, the more we find the guys are reaching out to access the service. It’s very rare that we’ll do a toolbox where we don’t get at least two or three people staying behind to talk a bit more.”

He says the conversations are framed around stories relevant for the people on site, talking about other instances of construction workers who have dealt with mental health issues and know of someone who has attempted or proceeded with taking their own life.

“We’re really breaking down that stereotype that construction workers, and men in particular, can’t talk about their mental health,” he says, adding that many of these men often face the same issues in this space.

“I’ve been doing it for a long time and I’d be lying if there wasn’t some things that surprised me from time to time, but they’re becoming increasingly rare. A lot of the time it’s the same issues popping up for different individuals.”

He says the stigma around suicide and mental health is also changing.

“When we first started the toolbox session, it was a hard subject to approach as it was always thought of as a taboo subject. In our industry it’s increasingly rare that someone doesn’t know of someone who hasn’t thought about suicide or acted on it.”

Based on his experiences with Incolink, Mr. Clark is adamant that face-to-face engagement when talking about suicide and mental health is the most effective way of addressing and talking about the issues.

“When guys are provided with opportunity to speak about it in an atmosphere where they can express themselves, they will find it easy to open up.”

Mr. Clark says the main challenge to tackling the issues within the wider construction sector is work-life balance.

“The long hours can impact on home life and the breakdown of the family unit and relationships, which can lead many other problems, whether it’s self-medication or addiction,” he says.

Mr. Clark says over his 15 years with Incolink, he has seen the attitudes of both workers and employers change towards talking about mental health and suicide.

“The majority of men in construction don’t go seeking these kinds of services. This is where Incolink been really successful, by bringing the service to them,” he says, adding that this approach has seen more individuals and businesses approach Incolink and not the other way around.

“A few years ago, we’d be turned away because it wasn’t seen as something that was worth the time.

“What we’re finding is that our program is contributing to a shift in awareness not just with individuals but with whole organisations – that is a massive change in the industry.”

Mr. O’Brien, like Mr. Clark, says employers and unions are leading the charge in mental health awareness and suicide prevention out there, and the wider Australian construction sector is making great steps in this space.

“There’s always a tipping point with these kinds of things – the R U OK? campaign, for instance, has become widespread thanks to people seeing others get on board with it,” he says. “Our people out there on site are seeing attitudes to the issues change and are seeing a lot of change coming from the top down, which is great.

“Some companies are more proactive than others but we work within an industry where there much consideration, mindfulness and leaders wanting to do the right thing by the workers.”

More information and where
to get help

Incolink

General Wellbeing and Support Query:  03 9668 3061

24/7 Counselling & Support:
1300 000 129

www.incolink.org.au 

MATES in Construction

National Helpline: 1300 642 111

www.matesinconstruction.org.au

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