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Mental Health in Construction: Why It Must Be Treated as a Health & Safety Risk
Mental Health in Construction: Looking After the People Behind the Project
Construction is an industry built around managing risk.
We assess excavations, lifting operations, work at height, plant movements, electrical systems, hazardous substances and countless other hazards every day. Yet one of the most significant risks facing people working in construction is often far less visible.
Mental health.
A worker struggling with stress, anxiety, depression, financial pressure or problems at home may arrive on site wearing the correct PPE, carrying the right competency cards and working under an approved RAMS package — but that does not necessarily mean they are OK.
Mental health needs to be treated as part of health and safety, not as a completely separate subject.
The Scale of the Problem
The latest Health and Safety Executive statistics show just how significant work-related mental ill health has become.
During 2024/25, an estimated 964,000 workers in Great Britain were suffering from work-related stress, depression or anxiety. Overall, approximately 1.9 million workers were suffering from work-related ill health, meaning stress, depression and anxiety represented around 52% of all self-reported work-related ill-health cases.
The impact is not only personal.
HSE estimates that 22.1 million working days were lost because of work-related stress, depression or anxiety during 2024/25, with each affected person losing an average of approximately 22.9 working days.
For construction, the picture is particularly concerning.
Analysis publicised by the Lighthouse Construction Industry Charity found that 507 suicides were attributed to construction occupations in 2021, of which 503 were male. This represented a rate of around 34 deaths per 100,000 workers, up from 26 per 100,000 in 2015. Lighthouse reported that the 2021 rate was approaching four times that seen across other sectors.
These are not simply statistics.
Behind every number is a person — a colleague, friend, partner, parent, son, daughter or member of a site team.
Why Can Construction Be So Difficult?
Construction can be an incredibly rewarding industry, but it can also create a unique combination of pressures.
Long working hours, early starts, travelling considerable distances, working away from home, programme pressure, uncertainty over future work, physical exhaustion and financial concerns can all build over time.
The Lighthouse Charity also highlights issues such as job insecurity and the vulnerability associated with self-employment. When someone depends on being physically able to work in order to earn, an injury, cancelled project, bad weather or gap between contracts can quickly create financial pressure.
Add personal difficulties such as relationship problems, bereavement, debt, loneliness or caring responsibilities and it becomes easy to understand how someone can begin struggling.
Construction has also historically had a culture of simply getting on with it.
That attitude can be useful when solving practical problems on site. It becomes much less helpful when it prevents somebody saying:
"I'm struggling."
Creating a better safety culture means making that conversation acceptable.
Mental Health Is a Health and Safety Issue
Employers should not view work-related stress simply as a wellbeing initiative.
HSE states that employers have a legal duty to protect employees from stress at work by assessing the risk and acting on it.
HSE's approach identifies six key areas of work design which, if poorly managed, can contribute to work-related stress:
Demands – workload, working patterns and the working environment.
Control – how much influence someone has over the way they carry out their work.
Support – the encouragement, resources and assistance provided by managers and colleagues.
Relationships – promoting positive working relationships and addressing conflict or unacceptable behaviour.
Role – ensuring people understand their responsibilities and are not placed under conflicting expectations.
Change – how organisational or workplace changes are managed and communicated.
These form HSE's Management Standards for work-related stress.
There are obvious parallels with construction.
Consider a site manager managing several subcontractors, responding to client demands, dealing with design changes, completing paperwork, managing programme delays and receiving calls after leaving site.
Or a worker travelling hours each day, worried about the next contract while trying to meet production targets.
These are foreseeable pressures and should be managed in the same practical way as other workplace risks.
What Can Construction Companies Actually Do?
Mental health management does not need to become another complicated layer of paperwork.
Some of the most effective controls are relatively straightforward.
Start Conversations
Managers and supervisors should feel comfortable asking someone how they are doing — and actually listening to the answer.
A simple conversation can sometimes identify an issue before it develops into something much more serious.
Mental health can also form part of inductions, toolbox talks, safety stand-downs and regular team meetings. The objective should not be to turn site managers into counsellors. It is to create an environment where asking for help is normal.
Look at Workload and Working Hours
Repeated long days, excessive travel, unrealistic programmes and constant pressure eventually take their toll.
Review workloads, working patterns and expectations, particularly where individuals appear to be carrying significant responsibility.
The HSE Management Standards specifically identify demands as one of the six areas that organisations should consider when managing work-related stress.
Train Managers to Recognise Changes
Managers do not need to diagnose mental health conditions, but they should be aware of changes that might indicate someone needs support.
That could include someone becoming unusually quiet, withdrawn, irritable, emotional or distracted; changes in attendance or performance; increased conflict; or simply behaving differently from normal.
The important part is noticing the change and being confident enough to start a conversation.
Create Somewhere People Can Turn
Employees and contractors should know what support is available to them.
The Lighthouse Charity provides emotional, physical and financial wellbeing support specifically for the construction community, alongside mental health awareness, suicide awareness and Mental Health First Aid training.
Support information should be visible rather than buried inside a company policy.
Consider including it on:
site noticeboards;
welfare facilities;
induction material;
company intranets;
QR-code posters;
wellbeing cards;
toolbox talks; and
supervisor briefing packs.
Someone who needs help should not have to search through a management system to find it.
Don't Forget the People Managing the Site
There can sometimes be an assumption that wellbeing initiatives are aimed mainly at operatives.
They shouldn't be.
Site managers, supervisors, project managers, engineers, safety professionals and business owners can face enormous pressure.
They may be managing programme, cost, safety, quality, subcontractors, clients and workforce expectations simultaneously.
Leadership does not make somebody immune from struggling.
In fact, the perception that a manager is supposed to have all the answers can sometimes make asking for help even harder.
A healthy organisation therefore checks on its managers as well as expecting those managers to check on everybody else.
Mental Health and Safety Culture Go Hand in Hand
A strong safety culture is not created simply by producing more procedures.
It is created when people trust each other enough to speak up.
We regularly tell workers:
Stop work if something is unsafe.
The same principle should apply when someone feels overwhelmed or unable to cope.
People should be able to say:
"I'm not comfortable doing this."
"I'm too tired."
"I'm struggling with the workload."
Or simply:
"I'm not OK today."
Without fearing ridicule or believing it will damage their career.
That is what a genuinely mature health and safety culture looks like.
Moving Beyond the Tick-Box Approach
Putting a mental health poster in the welfare unit is positive.
Training Mental Health First Aiders is positive.
Running an awareness week is positive.
But none of these measures should replace looking at the underlying causes of work-related stress.
If employees are consistently working excessive hours, facing unrealistic deadlines, receiving poor management support or working in a culture where asking for help is viewed as weakness, the organisation needs to address those issues.
HSE's Management Standards encourage employers to identify the underlying causes of stress and make practical improvements rather than simply reacting after someone becomes unwell.
Mental health should therefore form part of the wider health and safety management system.
That means identify, assess, control, communicate and review.
The same principles we already use to manage risk throughout construction.
Sometimes the Most Important Question on Site Is the Simplest
Construction is getting better at discussing mental health, but there is still work to do.
We rightly invest enormous amounts of time preventing falls from height, electrical incidents, plant collisions and exposure to hazardous substances.
We should apply the same commitment to protecting people's psychological health.
It doesn't require site managers to become therapists.
It requires businesses to understand workplace stress, managers to recognise when something has changed, teams to look out for each other and individuals to know that asking for help is acceptable.
Sometimes good health and safety starts with a risk assessment.
Sometimes it starts with four words:
"Mate, are you alright?"
And then taking the time to listen to the answer.
How Lloyd Health & Safety Can Help
At Lloyd Health & Safety, we believe effective health and safety is about protecting the whole person, not simply preventing physical injury.
We can support construction businesses with practical health and safety management, workplace risk assessments, site inspections, policy development, safety culture improvement and proportionate systems designed around the realities of construction work.
If you would like to discuss how your organisation manages health, safety and wellbeing, get in touch with Lloyd Health & Safety.
Sources: Health and Safety Executive (HSE) workplace health statistics and stress Management Standards; Lighthouse Construction Industry Charity and its published analysis of ONS construction suicide data.
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