Are Young Men Getting the Message? Age Differences in Suicide Prevention Literacy among Male Construction Workers

Importance of Prefabrication to Easing Construction Workers' Experience of Mental Health Stressors

Construction is widely acknowledged for its socioeconomic contributions, although it is also always considered as a dangerous and incident-prone industry. As a new method of working, prefabrication presents better work environments and other benefits that can potentially improve the safety and mental health of construction workers. This study compares the extent of stressors in traditional and prefabricated construction. Eighty-four construction site and factory-based workers in Australia were surveyed. Prefabricated construction respondents reported less experience of industry-related, management/organisational, and personal stressors. Specifically, the stressors found to be weakened by prefabrication were mental fatigue, work injuries, poor working conditions, unfavourable shift rosters, work overload, and poor work-life balance. Furthermore, the degree of the experience of potential mental health improvement factors such as labour effort efficiency, reduced on-site trade overlap, increased mechanised construction, and less dependence on weather conditions, among others, was significantly higher in prefabrication than in traditional construction. The influence of prefabrication on measures of poor and positive mental health is recommended for further studies, particularly by finding its links with the different groups of construction workers.

Epidemiological profile, temporal analysis, and future projections of suicide cases in rural cities in the extreme south of Brazil

The present study aimed to verify the time series (2000-2017) of death rates by suicide and its associated factors in 4 municipalities in the extreme south of Brazil. Data were obtained through the analysis of medical reports and police report bulletins at the Instituto Médico Legal, in the city of Rio Grande. The suicide rate in the Rio Grande region varied from 4 to 11 suicides per 100,000 inhabitants and it is estimated that by 2030 this rate could reach 16.5 suicides per 100,000 inhabitants. The rural cities of Santa Vitória do Palmar and Chuí present even higher suicide averages when compared to Rio Grande, the most populous city of the four. The death rate from suicide increased gradually in the period analyzed, with the prevalence rising among the youngest and the elderly population. A more comprehensive understanding of the influences of environmental issues on suicidal decisions constitutes an important action that needs to be taken, both because of regional vulnerabilities and the target population identified. Evidence indicates that knowledge of factors affecting individuals residing in this Brazilian region where increased suicide rates are recorded needs to be recognized as a priority.

Effectiveness of the Australian MATES in Construction Suicide Prevention Program: a systematic review

Suicide is a major public health issue globally. The World Health Organization has called for nations to create comprehensive national suicide prevention strategies including multisectoral collaboration, awareness raising, advocacy and capacity building. The workplace provides opportunity and structure for suicide prevention programs. However, many of these programs are poorly documented and evaluated. The MATES in Construction (MATES) program is a multimodal workplace-based suicide prevention program designed for and by the construction industry. This systematic review examined the available evidence for the effectiveness of the MATES program and is reported according to PRISMA guidelines. A literature search resulted in the inclusion of 12 peer-reviewed articles published between January 2010 and February 2023 containing primary data of evaluations of MATES. There was evidence of the effectiveness of the MATES program in improving mental health and suicide prevention literacy, helping intentions and reducing stigma. The results highlighted the importance of worker-to-worker peer approaches with workers consistently stating that supervisors were the least trusted resources for mental health and suicide concerns. Favourable results were found in relation to reduced suicide risk in the construction industry. The evidence base for MATES is limited in terms of causal inference with very few controlled evaluations and no experimental studies having been conducted to date. Improved understanding of how the program motivates volunteers, their experiences and research on the longer-term impacts of the program on the industry is required.

System dynamics simulation of occupational health and safety management causal model based on NetLogo

The occupational health and safety management factors of construction enterprises are critical influencing factors in their training management, and their causal principles are topics that warrant profound exploration. Drawing upon the conventional five factors, this study initially posited and authenticated a causal model among them, subsequently employing system dynamics on the NetLogo platform to dynamically simulate the model, and ultimately scrutinizing the interrelations and dynamic influence degree among the factors. The results show that the direct causes of management factors include human factors (weight coefficient of 0.583) and method factors (weight coefficient of 0.405), and environmental factors directly affect human factors (weight coefficient of 0.994), whereas material factors directly affect method factors (weight coefficient of 0.918). At the same time, it can be seen from the dynamic simulation results that the influence of human factors and method factors on management factors increases sharply in the nascent phase of the simulation cycle (the highest slope is .90), gradually decreases in the intermediary phase (the slope of the inflection point is .11), and is relatively stable in the final phase (the slope is less than 0.11). Three main conclusions have been drawn from this. Firstly, management factors are directly and positively affected by human factors and method factors respectively. Secondly, the interplay between diverse factors evinces a confluence of periodicity and exponential attributes. Thirdly, in each management cycle (set at 381 steps), the main focus is on controlling the causal factors in the early stages of management, with pivotal control points in steps 25 and 100, and the principal management factors comprising the management organization, operating procedures, and protective measures.

A blended face-to-face and smartphone intervention to improve suicide prevention literacy and help-seeking intentions among construction workers: a randomised controlled trial

PURPOSE

In Australia and elsewhere, suicide rates among construction workers remain high. Construction workplaces are thus an important setting for targeted suicide prevention programs. This study aimed to compare suicide prevention literacy and help-seeking intentions among participants receiving face-to-face suicide prevention training, with those receiving face-to-face training augmented by a smartphone application.

METHODS

A two-arm randomised controlled trial of a smartphone suicide prevention intervention was conducted among construction workers in four Australian states (trial registration number: ACTRN12619000625178). All participants received face-to-face training and were randomised to the control condition (face-to-face only, n = 575), or MATESmobile condition (face-to-face + smartphone application, n = 509). Surveys administered at baseline and 3-month follow-up measured suicide prevention literacy and help-seeking intentions for personal/emotional problems and suicidal thoughts. A mixed-model repeated measures (MMRM) analysis included all 1084 randomised participants.

RESULTS

Outcomes did not differ significantly for suicide prevention literacy, nor help-seeking intentions from formal sources, informal sources outside the workplace, or no one (did not intend to seek help from anyone). However, relative to those in the control condition, those in the MATESmobile group showed greater increase in help-seeking intentions for emotional problems from a MATES worker/Connector (mean difference 0.54, 95% CI 0.22-0.87) and help-seeking intentions for suicidal thoughts from a workmate (mean difference 0.47, 95% CI 0.10-0.83) or MATES worker/Connector (mean difference 0.47, 95% CI 0.09-0.85).

CONCLUSION

Results indicate that the MATESmobile application, together with face-to-face training, is beneficial in enhancing help-seeking intentions from MATES workers/Connectors and workmates to a greater extent than face-to-face training only. While this research provides some evidence that smartphone applications may support suicide prevention training, further research is needed.

Influence of Prefabricated Construction on the Mental Health of Workers: Systematic Review

Despite the significant contribution of the construction industry to national and global economies, the risk it poses to the health and safety of its workers is concerning. With substantial improvement in physical health and safety performance, especially in industrialised and developed economies, attention has shifted to the mental health of construction workers. The construction industry has implemented several worker-focused and management-oriented intervention programs, but problems related to poor mental health persist, and the industry ranks high in suicide figures. Entering the Construction 4.0 era, the use of technologies and new construction methods have been touted to have the potential to improve mental wellbeing. Therefore, this research addresses this lingering problem by: (1) identifying and classifying stressors of mental health and (2) assessing the relevance of adopting prefabricated construction to improving mental health. A two-phased PRISMA-guided systematic review was conducted due to the nonavailability of past studies that combine the concepts of prefabrication and mental health. Mental health stressors were grouped into three categories, with industry-related identified as having an influence on management/organisational and personal stressors. Prefabricated construction, on the other hand, by virtue of its benefits over traditional construction, is found to be capable of eliminating, or at least reducing, the impact of industry-related stressors and, by extension, promoting good mental health.

Evaluation of a workplace suicide prevention program in the Australian manufacturing industry: protocol for a cluster-randomised trial of MATES in manufacturing

Males are at higher risk of death by suicide than females in Australia, and among men, blue-collar males are at higher risk compared to other working males. In response, MATES in Construction developed a workplace suicide prevention program for the construction sector in 2007 that has been widely implemented in Australia. In the current project, this program is being adapted and trialled in the manufacturing sector. The common aims of MATES programs are to improve suicide prevention literacy, help-seeking intentions, and helping behaviours. The program will be evaluated using a cluster randomised-controlled trial design with waitlist controls across up to 12 manufacturing worksites in Australia. We hypothesise that after 8 months of the MATES in Manufacturing program, there will be significantly greater improvements in help-seeking intentions (primary outcome) compared to waitlist controls. The project is led by Deakin University in collaboration with the University of Melbourne, and in partnership with MATES in Construction and a joint labour-management Steering Group.Trial registration: The trial was registered retrospectively with the Australian New Zealand Clinical Trials Registry on 25 January 2022 (ACTRN12622000122752).Protocol version: 2.0, November 2022.

A Shorter Form of the Work Extrinsic and Intrinsic Motivation Scale: Construction and Factorial Validation

While workplace mental health has attracted attention in many countries, work motivation remains under-researched. Research identified that work motivation is associated with many organisational positive outcomes including workplace mental health. One well-recognised measure is the Work Extrinsic and Intrinsic Motivation Scale (WEIMS). Conceptualised on the Self-Determination Theory, this 18-item scale examines six types of work motivation: Intrinsic Motivation, Integrated Regulation, Identified Regulation, Introjected Regulation, External Regulation, and Amotivation. WEIMS can be too long for busy people at work. Accordingly, we constructed and validated a shorter form of WEIMS (SWEIMS), comprising 12 items that evaluate the same six work motivation types. Data collected from two professional samples were analysed to construct and validate the factorial structure: 155 construction workers (138 males and 17 females, Age 40.28 ± 11.05) and 103 hospitality workers (47 males and 56 females, Age 28.2 ± 8.6 years). Correlation analyses and confirmatory factor analyses were performed. Two items from each type were selected based on the strength of correlations with the target WEIMS subscale. SWEIMS demonstrated adequate internal consistency (α ≧ 0.65), and strong correlations with the original version of WEIMS (r = 0.73) in both samples. SWEIMS confirmatory factor analysis replicated the six-factor model of the original SWEIMS. SWEIMS can be a reliable, valid, and user-friendly alternative to WEIMS.

Healthier Construction: Conceptualising Transformation of Mental Health Outcomes through an Integrated Supply Chain Model

The construction industry is undoubtedly one of the most significant global sectors that contributes to sustainable development across physical, social, environmental and economic objectives. Globally the value of the construction industry is USD 10 trillion annually. The robustness of the sector is in serious question with a crisis in mental health. The rebuilding of economies is often led by significant capital works programs and therefore in response to the global pandemic, it is anticipated that this problem will only be exacerbated. The construction sector has a unique project-based structure of numerous intersecting subsectors, which influence the behaviours and culminate in highly demanding work environments on a project-by-project basis. We propose that to institute transformational change to the mental health problem, we need to challenge current problematisations towards presenting a new conceptual framework. The aim of this paper is to analyse the industrial organisation and the structural and behavioural context of the industry and propose a new approach to understanding interactions at multiple levels in relation to root causes of the mental health problem. Aligned to the UN SDG that we are to ensure healthy lives and promote well-being for all, this paper responds to high rates of depression, anxiety and suicide in the construction industry. There is a need to generate new knowledge about the interactions between multi project supply chain, construction project supply chain environment and construction supply chain performance in relation to mental health outcomes. Literature indicates that there is a wealth of research on stressors, coping and interventions at an individual level, however very little from an ‘insider’ construction management perspective which contextualise mental health outcomes with the environmental stressors. Coupled with this, past research designs predominantly utilised quantitative approaches reliant on questionnaires. We critique past problematisations of the mental health problem and show how it has been represented to enable the development of a reframed conceptualisation. There is a need to identify contextual evidence-based stressors throughout the construction project supply chain. We present a transformational change model integrating construction industry specific context knowledge with psychosocial expertise to improve workers’ mental health. Future research could lead to outcomes including recommendations and guidelines to engage management actors who can influence positive change through preventative strategies leading to effective and measurable mental health and project performance improvements.

Psychological distress and suicidal ideation among male construction workers in the United States

BACKGROUND

Male workers in the US construction industry have a higher suicide rate than other workers in the nation. However, related research on this population remains sparse. This study evaluated psychological distress and suicidal ideation in these workers, and possible underlying factors.

METHODS

Data from the National Survey of Drug Use and Health from 2008 to 2014 were analyzed. Stratified and multiple logistic regression analyses were conducted to examine factors associated with psychological distress and suicidal ideation among male construction workers aged ≥18 years (n = 12,034).

RESULTS

Nearly one-third (29.6%) of male construction workers in the United States experienced psychological distress (23.8% graded as moderate, 5.8% as severe), and 2.5% reported suicidal ideation in the past year. Higher odds of serious psychological distress and suicidal ideation were found among workers who were younger, worked part-time, missed workdays due to injury or illness, or were in poor health. Illicit opioid use (odds ratio [OR] = 1.87, 95% confidence interval [CI]: 1.22-2.89) and alcohol dependence or abuse (OR = 2.64, 95% CI: 1.74-3.99) significantly escalated the odds of suicidal ideation. The odds of suicidal ideation among workers with serious psychological distress were 33 times higher than those having no or minor psychological distress (OR = 32.91, 95% CI: 19.82-54.65) when other factors were constant.

CONCLUSIONS

Occupational and nonoccupational factors were associated with constructionworkers' psychological distress and suicidal ideation. Both illicit opioid use and alcohol dependence or abuse were risk factors, and psychological distress was a strong predictor for suicidal ideation. To improve workers' mental health, it is necessary to integrate workplace injury prevention with illicit opioid-use reduction programs and suicide prevention.

Domains of Psychosocial Risk Factors Affecting Young Construction Workers: A Systematic Review

Despite being a key provider of employment, construction work significantly contributes to poor mental health among young construction workers worldwide. Although there are studies on the psychosocial risk factors (PRFs) that make young construction workers susceptible to poor mental health, the literature is fragmented. This has obscured a deeper understanding of PRFs and the direction for future research, thus making it challenging to develop appropriate interventions. To address this challenge, we systematically reviewed the literature on young construction workers’ PRFs using meta-aggregation, guided by the PICo, PEO, and PRISMA frameworks. We sought to synthesize the domains of PRFs that affect young construction workers’ mental health, and to determine the relationships between the PRF domains, psychological distress, and poor mental health. A total of 235 studies were retrieved and 31 studies published between 1993 and 2020 met the inclusion criteria. We identified 30 PRFs and categorized them into ten domains, which were further classified into personal, socio-economic, and organizational/industrial factors. The findings of this review contribute to achieving an in-depth understanding of young construction workers’ PRF domains and their patterns of interaction. The findings are also useful to researchers and policymakers for identifying PRFs that are in critical need of attention.

Suicidal ideation and related factors in construction industry apprentices

BACKGROUND

Suicide rates within the construction industry are disproportionately high and there is accumulating evidence suggesting that young apprentices working in this industry may be particularly vulnerable. This study examined the presence of suicidal ideation and exposure to suicidal behaviours in construction industry apprentices, and explored associations between suicidal ideation and other demographic, workplace, and psychosocial factors.

METHODS

A large sample of apprentices were recruited for the study (N = 1402). The study employed a cross-sectional survey design. In addition to demographic items, the survey asked questions relating to suicidal ideation in the past year, exposure to suicidal behaviours, substance use, stress management, workplace bullying, psychological distress, and well-being.

RESULTS

Nearly one third of apprentices reported suicidal ideation in the previous year, and approximately half to two-thirds knew someone who had either attempted or died by suicide. Suicidal ideation was associated with knowing someone who had attempted suicide, greater psychological distress, substance use, and poorer well-being.

LIMITATIONS

The response rate was low. There were also portions of missing data. Multiple imputation was used to help overcome this, and results from the sensitivity analyses are presented. The cross-sectional design is another limitation.

CONCLUSION

Suicidal ideation in construction apprentices is common and is associated with poorer overall mental health and well-being, substance use, and knowing others who have attempted suicide. These findings can help inform the development of tailored workplace suicide prevention activities for apprentices at-risk of suicide and poor mental health.

Health Literacy in Male-Dominated Occupations

Low levels of health literacy are associated with poorer health outcomes. Both individual- and social-level factors have been identified as predictors of low health literacy, and men are known to have lower health literacy than women. Previous research has reported that men working in male-dominated occupations are at higher risk of accidents, injury, and suicide than other population groups, yet no study to date has examined the effect of gendered occupational contexts on men’s health literacy. The current article examined the association between occupational gender ratio and health literacy among Australian males. The Australian Longitudinal Study on Male Health (Ten to Men) was used to examine associations between occupational gender ratio (measured in Wave 1) and health literacy (measured in Wave 2) across three subscales of the Health Literacy Questionnaire. Multivariable linear regression analyses were used and showed that the more male dominated an occupational group became, the lower the scores of health literacy were. Results for the different subscales of health literacy for the most male-dominated occupational group, compared to the non-male-dominated group were: ability to find good health information, (Coef. −0.80, 95% CI [−1.05, −0.54], p < .001); ability to actively engage with health-care providers, (Coef. −0.35, 95% CI [−0.62, −0.07], p = .013); and feeling understood and supported by health-care providers, (Coef. −0.48, 95% CI [−0.71, −0.26],p = < .001). The results suggest the need for workplace interventions to address occupation-level factors as an influence on health literacy among Australian men, particularly among the most male-dominated occupational groups.

The MATES Case Management Model: Presenting Problems and Referral Pathways for a Novel Peer-Led Approach to Addressing Suicide in the Construction Industry

MATES in Construction (MATES) is a multimodal, peer-led, workplace suicide prevention and early intervention program developed to reduce the risk of suicide among construction industry workers through active facilitation of appropriate support. The MATES case management model provides an example of a nonclinical service for meeting the needs of individuals in the construction industry who, while at elevated risk of mental health problems and suicidality, are traditionally less likely to seek help. The aim of this research was to conduct an evaluation of the MATES case management database to quantify service demand, and to examine the demographic, occupational profile, presenting issues, referral pathways, and perceived benefit of case management among individuals who used this service. The research reports on routinely collected data from the Queensland MATES case management database, which contains records on 3759 individuals collected over the period 2010–2018, and findings from a small and opportunistic exit survey undertaken with 14 clients in 2019. Overall, findings suggest that the demand for case management through MATES has increased significantly and that clients felt that their needs and concerns were appropriately addressed. The most common presenting issues were relationship, work, and family problems, suicide, and mental health concerns. Findings confirm that causes of distress extend beyond the realm of mental disorder and span a range of psychosocial issues. Significantly, it offers an approach that may divert individuals in crisis away from presenting to over-run emergency departments, and towards services that are more equipped to meet their individual needs.

Exploring the relationship between psychological distress and likelihood of help seeking in construction workers: The role of talking to workmates and knowing how to get help

BACKGROUND

Mental health problems are prevalent in male-dominated industries such as construction, where suicide rates are higher than the population average and help seeking is typically low.

OBJECTIVE

To examine psychological distress in Australian construction workers and its relationship with help seeking via two hypothesised mediators: confidence in knowing how to get help and confidence in talking to workmates about mental health issues.

METHODS

Workers (N = 511) completed a survey that assessed psychological distress, likelihood of help seeking, and confidence in knowing how to get help and talking to workmates. Bootstrapped multiple mediation analysis was performed using the PROCESS macro for SPSS.

RESULTS

Psychological distress was higher than national estimates and most prevalent in men aged 25-44. Controlling for age and ability to recognise personal signs of mental health problems, psychological distress negatively predicted likelihood of help seeking. This relationship was partially mediated by knowing how to get help and confidence in talking to workmates.

CONCLUSIONS

Results highlight the need to redress and mitigate mental health problems among high-risk groups of male workers. It provides useful guidance on multilevel workplace strategies to reduce stigma, enhance confidence and comfort in the process of seeking help and support in construction and other male-dominated industries.

Effect of Occupational Health and Safety Training for Chinese Construction Workers Based on the CHAID Decision Tree

Background: Occupational health and safety (OHS) training is an important way to prevent construction safety risks. However, the effectiveness of OHS training in China is questionable. In this study, the CHAID (chi-squared automatic interaction detection) decision tree, chi-square analysis, and correlation analysis were used to explore the main, secondary, weak, unrelated, and expectation factors affecting the effectiveness of training. It is the first to put forward the "five-factor method" of training effectiveness. It is found that training effectiveness is positively correlated with job responsibilities, OHS training, and job satisfaction. It is also significantly related to job certificate, training time, training method, and working time. However, the effectiveness of training has nothing to do with personal age, marital status, educational level, job type, and whether or not they have experienced industrial accidents. And the workers on site expect the enterprise to provide security and opportunities such as physical safety, training and learning, and future career development. The results show that OHS system training should be strengthened in the construction industry, and classified training should be carried out according to post responsibility, training methods, job satisfaction, and working hours.

Predictors of long-term opioid use and opioid use disorder among construction workers: Analysis of claims data

BACKGROUND

Construction workers have high rates of work-related musculoskeletal disorders, which lead to frequent opioid use and opioid use disorder (OUD). This paper quantified the incidence of opioid use and OUD among construction workers with and without musculoskeletal disorders.

METHODS

We conducted a retrospective study using union health claims from January 2015 to June 2018 from 19,909 construction workers. Claims for diagnoses of chronic musculoskeletal disorders, acute musculoskeletal injuries, musculoskeletal surgery, and other conditions were linked to new opioid prescriptions. We examined the effects of high doses (≥50 morphine mg equivalents per day), large supply (more than 7 days per fill), long-term opioid use (60 or more days supplied within a calendar quarter), and musculoskeletal disorders, on the odds of a future OUD.

RESULTS

There were high rates (42.8% per year) of chronic musculoskeletal disorders among workers, of whom 24.1% received new opioid prescriptions and 6.3% received long-term opioid prescriptions per year. Workers receiving opioids for chronic musculoskeletal disorders had the highest odds of future OUD: 4.71 (95% confidence interval 3.09-7.37); workers prescribed long-term opioids in any calendar quarter had a nearly 10-fold odds of developing an OUD.

CONCLUSIONS

Among construction workers, opioids initiated for musculoskeletal pain were strongly associated with incident long-term opioid use and OUD. Musculoskeletal pain from physically demanding work is likely one driver of the opioid epidemic in occupations like construction. Prevention of work injuries and alternative pain management are needed for workers at risk for musculoskeletal injuries.

Suicide by young Australians, 2006-2015: a cross-sectional analysis of national coronial data

OBJECTIVE

To assess the demographic, social, and clinical characteristics of young Australians who die by suicide.

DESIGN

Retrospective analysis of National Coronial Information System (NCIS) data.

SETTING, PARTICIPANTS

People aged 10-24 years who died by suicide in Australia during 2006-2015.

MAIN OUTCOME MEASURES

Demographic, social, and clinical characteristics of young people who died by suicide; circumstances of death recorded in the NCIS.

RESULTS

3365 young people died of suicide during 2006-2015 (including 2473 boys and men, 73.5%); 1292 people (38.4%) lived in areas of greater socio-economic disadvantage. Free text reports were included in the NCIS for 3027 people (90%), of whom 1237 (40.9%) had diagnosed mental health disorders and 475 (15.7%) had possible mental health disorders. Alcohol consumption near the time of death was detected in 1015 of 3027 cases (33.5%); histories of self-harm were recorded in 940 cases (31.1%) and of illicit substance misuse in 852 (28.1%). Adverse life events included history of abuse or neglect (223, 7.4%), suicide of relatives, friends, or acquaintances (202, 6.7%), and financial difficulties (174, 5.8%).

CONCLUSIONS

Three-quarters of the young people who died by suicide were boys or young men, and 57% had diagnosed or possible mental health disorders, suggesting that the mental health and wellbeing of young Australians should be a key target for youth suicide prevention. To reduce the number of youth suicides, it is imperative that prevention strategies target the mental health and psychosocial stressors that lead to suicidal crises in young people.

The effect of gender on mental health service use: an examination of mediation through material, social and health-related pathways

PURPOSE

We aimed to understand how much of the gender difference in mental health service use could be due to the joint mediation of employment, behavioural and material factors, social support and mental health need.

METHODS

We used data from employed individuals aged 18-65 years who participated in the 2015-2017 waves of the Household, Income and Labour Dynamics in Australia survey. The exposure (male, female) and confounders were measured in 2015, mediators in 2016 and the outcome-whether a person had seen a mental health professional in the previous year-was measured in 2017. We estimated natural mediation effects using weighted counterfactual predictions from a logistic regression model.

RESULTS

Men were less likely to see a mental health care provider than women. The total causal effect on the risk difference scale was  - 0.045 (95% CI  - 0.056,  - 0,034). The counterfactual of men taking the mediator values of women explained 28% (95% CI 1.7%, 54%) of the total effect, with the natural direct effect estimated to represent an absolute risk difference of  - 0.033 (95% CI  - 0.048,  - 0.018) and the natural indirect effect  - 0.012 (95% CI  - 0.022,  - 0.0027).

CONCLUSION

Gendered differences in the use of mental health services could be reduced by addressing inequalities in health, employment, material and behavioural factors, and social support.

Evaluation of a Suicide Prevention Program for the Energy Sector

There is evidence indicating that traditionally male-dominated occupations are associated with greater risk of suicide. In Australia, MATES in Construction was developed as an occupational health initiative to prevent suicides in the industry. The program has recently been applied to the energy industry; however, little is known regarding exposure to suicide and suicide prevention interventions in this sector. The study aimed to examine the effectiveness of MATES in Energy general awareness training (GAT), and estimate the prevalence of recent suicidal ideation and exposure to suicidal behaviors in workers. A before and after design was used to examine the effectiveness of GAT training. Data were collected from 4887 participants undertaking GAT training at energy sites across Queensland, Australia. In total, 2% (97) of participants reported recent suicidal thoughts, 65% of participants reported they had known someone who had attempted suicide, and 69% had known someone who died by suicide. Significant improvements were found on all suicide literacy items after GAT training. Younger people were more likely to be positively affected by the intervention. The results indicate that the MATES in Energy program is successfully transitioning from the construction industry, and offers the first empirically supported suicide intervention tailored to the energy sector.

Help-Seeking Behavior and Psychological Distress by Age in a Nationally Representative Sample of Japanese Employees

Background

The present study aimed to examine the association between the presence/absence of help-seeking behavior (ie, behavior aimed at obtaining assistance from others to improve a situation or problem) and psychological distress among private and public employees by age group using a nationally representative sample of the Japanese population.

Methods

The present study analyzed data obtained from the 2016 Comprehensive Survey of Living Conditions, a nationwide cross-sectional survey. Of 568,426 participants, 78,284 private and public employees aged 20 to 59 years, who were receiving no mental health services at the time of the survey and reported at least one stressor in daily life, were eligible. The primary outcome measure was self-rated psychological distress as measured by the Kessler Psychological Distress Scale. Multiple logistic regression analyses were carried out separately by age group, adjusting for sociodemographic and job/life-related factors.

Results

The proportion of participants not showing help-seeking behavior was significantly higher among those aged 40–59 years compared to those aged 20–39 (30.5% and 22.7%, respectively; P < 0.001). Participants without help-seeking behavior had significantly higher odds ratios (ORs) for psychological distress, regardless of age group (OR = 1.9 [95% confidence interval (CI), 1.6–2.0] and OR = 1.6 [95% CI, 1.4–1.7] for the age 20–39 years and 40–59 years groups, respectively), compared to those showing help-seeking behavior.

Conclusions

Participants not showing help-seeking behavior were more likely to have severe psychological distress, and this trend appeared to be slightly stronger among those aged 20–39 years. These findings suggest that promoting help-seeking behavior is important for improving mental health among workers.