An important discussion of mental health and well-being with mining and construction workers.
By Joe McGuire, PhD, Emily J. Haas, PhD, Lucas Simpson, MS, Vince Hafeli, DBA
Mining and construction are often cited as inherently hazardous and stressful occupations and can pose risks to workers’ mental health and well-being.1,2 Psychosocial risk factors that can increase the occurrence of mental health conditions for workers in these industries include: the remote nature of some locations that require travel-related risks or extended time away from family; pressure to produce during seasonal times of the year; limited participation in decision making; irregular shift work or inflexible work hours that can impact sleep schedules and anxiety; unsupportive management practices; and poor workplace communication. 3-5
The need to prioritize workers’ mental health and well-being continues to gain attention among industry safety and health (S&H) professionals. Although companies are focusing more on this topic, negative attitudes and stigma remain major barriers to seeking help for mental distress, especially in male-dominated work settings.6 In this article, the authors highlight evaluations of a mental health and well-being module that was shared directly with mining and construction workers during annual refresher training. By showing ways that education and training practices associated with mental health and well-being can facilitate a supportive safety culture, the authors hope that U.S. companies and their workers have more confidence engaging in this topic.
Mental health and its connection to safety, productivity, well-being
Mental health encompasses emotional, psychological, and social well-being. The World Health Organization (WHO)1 defines mental health as a state of “mental well-being that enables people to cope with the stresses of life, to realize their abilities, to learn well and work well, and to contribute to their communities.” Similarly, Greenwood and Anas7 indicate that mental health is the foundation for emotions, thinking, communicating, learning, developing resilience, and self-esteem. Mental distress, whether stemming from personal or professional stressors, can impact sleep;8,9 relationships with friends, co-workers, and family members;10,11 and workplace safety and productivity.12,13
The most frequent mental health conditions tend to be depression, anxiety, and stress-related disorders. Empirical research has shown that depression is associated with an increased risk of injury among workers,14,15 while other studies have shown mental distress can present as physical conditions such as heart disease, ulcers, and skin rashes.16 Depression has also been shown to impact the rate of absenteeism, cause disability, loss of productivity, and poor culture in the workplace.17 From a monetary perspective, the Centers for Disease Control and Prevention (CDC),18 indicated that depression causes an estimated $200 million in lost workdays each year at the cost of $17–44 billion to employers. Consequently, it is important that workplaces have processes to identify psychosocial risk factors that might affect workers’ abilities to recognize hazards, understand associated risks, and make desired decisions concerning their safety and the safety of others.
Workplace prevention efforts
Fatality or near-miss investigations completed by the Mine Safety and Health Administration (MSHA),19 generally point to root causes associated with powered haulage hazards, lack of task training, failing to conduct workplace exams, and failure to follow lockout/tag-out (LOTO) procedures. According to Occupational Safety and Health Administration (OSHA) statistics,20 falls, electrocution, struck by, and caught in or between are the top four traditional causes of fatalities in construction. In other words, fatality investigations identify physical hazards to be mitigated; however, neither MSHA nor OSHA reports mention mental health conditions as a potential contributor of workplace fatalities.21 This lack of terminology in investigations continues to deemphasize hidden root causes of incidents and the potential need for more holistic interventions in the workplace.22 To illustrate this point, CPWR – The Center for Construction Research and Training data calculations showed in 2022 that there were 1,092 traditional workplace fatalities, 6,428 suicides, and 17,967 overdose deaths.23 These statistics show the magnitude of the problem and need to focus beyond the traditional physical hazards in these industries. Fortunately, new workplace strategies and programs to support primary prevention efforts are becoming more prevalent.
Specifically, a CDC Bulletin24 indicated that the workplace is an optimal setting to create a whole health culture because of 1) existing communication structures; 2) central programs and policies; 3) consistent social support networks; 4) incentives to reinforce healthy behaviors; and 5) availability and use of data. In other words, systems are already in place to track and manage psychosocial stressors. Goal 5 of CDC’s National Strategy for Suicide Prevention25 highlights some of these systems in the form of policies, programs, and practices that workplaces can use to support worker mental health and well-being such as implementing consistent work shifts and shared decision-making between supervisors and employees to reduce the chances of burnout and support autonomy. Other strategies to maintain engagement include providing culturally relevant communication and offering opportunities for coworker support and training. These practices are part of a broader goal to integrate suicide prevention into the workplace culture.25
Further, the National Institute for Occupational Safety and Health (NIOSH) Total Worker Health (TWH) Program focuses on both protecting the safety and health of workers and advancing their well-being by fostering safer and healthier workplaces and by addressing work organization, employment and supervisory practices, and workplace culture.26 TWH calls for workplaces to provide a culture that protects and promotes the health and well-being of its workers on and off the job.27 TWH concepts are important for preventing and addressing mental health conditions among workers because these issues often involve work-related and non-work-related factors.28 Including workers in conversations around mental health and well-being allows for the topic to be discussed more consistently and further efforts to decrease the stigma associated with mental health conditions among workers.29
Workplace responsibility and accountability
A key element of any effective workplace system is understanding and executing responsibilities as assigned. The National Mining Association’s CORESafety framework contains a module that highlights the importance of consistent, personal accountability that employs a “lead by example” model.30 Additionally, CPWR has a resilience training tool that entails nine guided activities and discussions with construction workers focusing on substance use, suicide, and mental health.31
Importantly, responsibility and accountability include employees at all levels of the organization. According to a readers’ poll launched in Safety+Health magazine in 2018, the perceived responsibility for who should be accountable for identifying and addressing mental health and well-being at work is split.21 About 52% of readers believe S&H managers are responsible for workers’ physical health and, as an extension of their duties, they should also address workers’ mental health and well-being. The other 48% of readers believe this is an area that falls under the duties of Human Resource (HR) personnel.32 The 249 comments that complemented this online poll varied in nature, but a key theme was that, while mental health and well-being is everyone’s responsibility, some guidance from S&H management is helpful to foster a supportive workplace. Ideally, S&H professionals should be both trained and trusted members of a team and identified as persons with whom frontline workers can discuss issues.33
In addition to frontline or S&H management support, research has shown that, for mental health and well-being initiatives to work, they must be rolled out and supported by the “C-Suite” before being handed off to S&H professionals or HR departments.22 Halefi discussed a mental health program Ajax Warriors developed at their Florida-based paving company in 2024. Program initiatives include certifying employees in Mental Health First Aid Training and requiring all supervisors to be trained in how to appropriately respond to mental health and suicide concerns in the workplace.22 Hafeli and his company discuss how senior leaders can begin to identify and address mental health conditions in the workplace:
- Be vulnerable and acknowledge mental distress (e.g., share a personal story or struggle, if applicable).
- Build a supportive network of employees who are champions around the topic.
- Assess and improve the ease of access to the company Employee Assistance Program.
- Evaluate the effectiveness of programs or resources to find out what is working, what is not, and update resources as appropriate.
Based on this example, companies cannot address mental health and well-being until there is management commitment and a supportive safety culture that is perceived and implemented by everyone. Part of this commitment includes taking the time to address and discuss mental health and well-being with the workforce.
Case example: Training with mining, construction workers
To date, many employee education programs and training such as Mental Health First Aid and other resources have been shown to effectively increase knowledge, reduce stigma and other negative attitudes towards mental health conditions, and increase supportive behaviors toward people with mental distress.34-36 One recent initiative funded by CPWR37 includes toolbox talks on workplace stress and training materials for building resilience. There are also prominent international programs and trainings such as Australia’s Mates in Mining and Mates in Construction peer support programs that have been empirically validated.38,39
However, mental distress and related topics such as workplace violence, suicide, and use of alcohol and other drugs are rarely given allocated time during mining and construction annual refresher training. In response to industry interest, the lead author developed an educational, engaging training around mental health and well-being for mining and construction workers. Deployed in 2024 in tandem with company annual refresher training that follow the typical interactive format described in previous Rock Products articles,33,40-42 786 individuals have participated in some form of this training to date.
The training starts with the question, “How many in this room know of someone who died by suicide…family, friend, co-worker”? To date, only 35 individuals (less than 5%) have NOT raised their hand. Immediately, people can visually see that they are not alone in being personally impacted by suicide. After providing some testimonials for individuals in the construction and mining industry, the trainers then proceed to share the Ajax Paving case example discussed above, followed by statistics of mental health conditions and various personal and work-related factors among mining and construction workers that may increase risks of suicide and alcohol and other drug use. These trainings have been evaluated with closed and open-ended questions. A summary of close-ended questions is shown in Table 1.
The authors thematically analyzed responses to the three open-ended key questions using qualitative content analysis techniques within NVivo to organize and quantify the prevalence of trends.43,33 First, participants were asked how they felt the topics discussed in the training would affect ways they engaged in certain tasks on the jobsite. Several themes emerged:
- Increased awareness and sense of responsibility: Respondents noted the need to be aware of their surroundings, co-workers, and potential hazards, reflecting on the importance of slowing down and thinking before acting.
- Importance of safety training: Participants acknowledged the value of safety training to help understand and mitigate workplace hazards, emphasizing the need for practical case examples.
- Promotion of positive workplace culture: Respondents
mentioned the importance of open communication, actively checking in on co-workers, and creating an environment where it is okay to discuss mental distress and safety concerns. - Focus on mental health and well-being: Respondents expressed a willingness to watch for signs of mental distress, provide support to colleagues, and openly discuss these topics.
- Application of learning: Respondents noted they would apply
what they learned to improve workplace inspections, speak up about safety issues, and share knowledge with others.
Second, participants were asked what they would pass on to their coworkers to help prevent incidents in the workplace. A frequency analysis of the key words shared in the open-ended answers can be grouped into four broad areas: safety procedures, mental health awareness, general safety awareness, and communication and teamwork. It is important to note that workers heavily emphasized physical aspects of safety in their evaluations including powered haulage, confined space, and personal protective equipment. However, there was almost an equal emphasis placed on mental health and well-being including lessons learned around watching for mental health concerns and engaging in conversations around this topic.
Finally, participants were asked what they liked best about the training. The graphical word cloud below represents the word frequency of the common topics listed, giving prominence to those listed more often. As shown in the larger text, the mental health and well-being training and discussion content was received positively among mining and construction workers.
Summary
The authors continue to learn from previous research and current experiences in the classroom to improve this program and share lessons learned to help others. Further, previous experience in clinical counseling and cumulative experience of over 75 years in the aggregates production and heavy highway construction industries has provided the authors an opportunity to observe workers in stressful situations related to assigned work tasks. It is not unusual to see anxiety and stress increase when workers are under pressure to produce more or work longer hours. During times of increased stress, we can anecdotally observe, and possibly correlate to incident data, that worker distraction and subsequent safety incidents are more likely to occur. Whether attributed to complacency, frustration, or a lack of communication, there are times when psychosocial stressors may affect safe decision making on the job and requires intervention. For more detailed policies, programs, and practices that are focused on community- and workplace-based mental health and suicide prevention, refer to CDC’s National Strategy for Suicide Prevention,25 CDC’s Suicide Prevention Resource for Action,45 and NIOSH’s TWH Program resources.46
Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. Mention of any company or product does not constitute endorsement by NIOSH, CDC.
About the authors: Joseph P. McGuire is an independent safety and health consultant and trainer. Emily J. Haas is the associate director for science at the Division of Safety Research within the National Institute for Occupational Safety and Health. Lucas Simpson is a safety manager at Commonwealth Electric Company of the Midwest. Vince Halefi is the president of Ajax Paving Industries.
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