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, with 1 having the highest threat level.

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:

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

Study link: https://doi.org/10.1061/(ASCE)CO.1943-7862.0001771

Link to the LinkedIn post: https://www.linkedin.com/pulse/mental-ill-health-risk-factors-construction-industry-ben-hutchinson

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