Mental Ill-Health Risk Factors in the Construction Industry: Systematic Review

This systematically reviewed evidence around mental health in the construction industry. 16 studies were included (culled from an initial list of 107, after removing lower-quality & duplicates etc.). 32 risk factors were identified.

Results

Overall, although several studies have explored this topic – only a few were found to use reliable mental health assessment tools. Of the research included, focus was placed on psychosocial factors arising from working conditions & the workplace, rather then other factors such as marital status, family friction, loneliness & bereavement.

Risk factors were grouped under: job control, work support, job demand, coping strategy, work hazards, family, workplace injustice, welfare & socioeconomic factors.

Working >60h per week, work overload, low ability to participate in decision making & occupational climate were most the most identified risk factors.

A ranking of risk factors is shown below, with 1 having the highest threat level.

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Some factors will now be covered.

Lack of job control:

This was a major risk factor, reflecting limited opportunities for people to influence decisions; an inability to speak about happenings in the workplace; imbalanced work distribution; authoritatian culture; & strict rules for scheduled work routines. This was primarily present in contracting firms and resulted in higher rates of depression.

Welfare concerns:

This included job insecurity, low income / financial insecurity & inability to further learning. Job insecurity was linked with a high level of anxiety across all grade levels of construction sector workers. Low income was linked with a high level of depression & suicide.

Financial insecurity stemmed from family concerns and where job insecurity was higher among married employees. Older employees feared job insecurity more than younger.

Larger project duration & values reduced concerns with job insecurity, where people on these projects showing higher emotional & psychological stability.

Fear of failure stemmed from age & overpromotion, such as placing employees at a higher job level than their technical ability (e.g. promoting up to supervisor-level etc.). Fear of failure was related to job insecurity due to fear of underperformance and led to behaviour where people tried to prove themselves; further aggravating strain and burnout, and eventually anxiety & depression.

Work Hazards:

Occupational injury/hazard contributed to posttraumatic stress (PTSD); also influencing depression & anxiety.

Job Demand:

Working >60h per week was common for contractors, leading to higher stress. Mental ill health was found to increase amongst supervisors & bricklayers as a result of fatigue.

Workplace Injustice:

This related to gender discrimination, harassment, bullying & more. Gender discrimination towards females was reported regularly. Females were often paid less than male counterparts & experienced sexual, verbal & physical harassment.

Some studies found male subordinates may not accept work orders from a female superior. Females experienced higher anxiety & depression than male colleagues.

Family risk factors:

Work demand was found to negatively impact family life and keeping up with family responsibility. Marital status appeared to act as a moderator to work stress, perhaps providing a social support network not found in the workplace.

Lack of Work Support & Coping:

A lack of work support in construction was found to influence workers to compensate through self-support mechanisms. High job demand, low work support and & job control was found to increase coping strategies; negative (maladaptive) & positive (adaptive). This can include alcohol & drug abuse, amplified by a strong drinking culture in construction.

Moving forward – a paucity of research exists covering the projective factors for mental health in construction. Extant research into protective factors has primarily just reversed the negative risk factors – which is said to lead to interventions that are shallow and ineffective.

Protective factors include: marital status, increased job control & job support, reduced job demand, workplace justice, better welfare & positive socioeconomic measures.

A conceptual model for how these factors interact is shown below:

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Authors: Albert P. C. Chan; Janet M. Nwaogu; and John A. Naslund, 2020, Journal of Construction Engineering and Management

Antonio Javier Gaspar Marichal. BSc. PGCert. CMIOSH. TechEHF

Experienced Senior HSE Manager | Co-designing, leading change, and driving operational excellence.

1y

Unsurprisingly!

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Ben Hutchinson

HSE Leader / PhD Candidate

1y

Lisa McKeown CMIOSH, Simon Davies this may interest you

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Aaron Bezzina

Passionate about Health Promotion | Helping to Coordinate National Health Surveys

1y

Great Summary Ben Hutchinson, I thought in an interesting finding in the review was the interplay between increased job demand and mental ill health. The authors mentioned the role of fatigue which precipitates from increased workload.

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