A Longitudinal Assessment of Two Suicide Prevention Training Programs for the Construction Industry

Workplace interventions to prevent suicide: A scoping review

OBJECTIVES

To map organisational interventions for workplace suicide prevention, identifying the effects, mechanisms, moderators, implementation and economic costs, and how interventions are evaluated.

BACKGROUND

Suicide is a devastating event that can have a profound and lasting impact on the individuals and families affected, with the highest rates found among adults of work age. Employers have a legal and ethical responsibility to provide a safe working environment for their employees, which includes addressing the issue of suicide and promoting mental health and well-being.

METHODS

A realist perspective was taken, to identify within organisational suicide prevention interventions, what works, for whom and in what circumstances. Published and unpublished studies in six databases were searched. To extract and map data on the interventions the Effect, Mechanism, Moderator, Implementation, Economic (EMMIE) framework was used. Mechanisms were deductively analysed against Bronfenbrenner's socio-ecological model.

RESULTS

From 3187 records screened, 46 papers describing 36 interventions within the military, healthcare, the construction industry, emergency services, office workers, veterinary surgeons, the energy sector and higher education. Most mechanisms were aimed at the individual's immediate environment, with the most common being education or training on recognising signs of stress, suicidality or mental illness in oneself. Studies examined the effectiveness of interventions in terms of suicide rates, suicidality or symptoms of mental illness, and changes in perceptions, attitudes or beliefs, with most reporting positive results. Few studies reported economic costs but those that did suggested that the interventions are cost-effective.

CONCLUSIONS

It seems likely that organisational suicide prevention programmes can have a positive impact on attitudes and beliefs towards suicide as well reducing the risk of suicide. Education, to support individuals to recognise the signs and symptoms of stress, mental ill health and suicidality in both themselves and others, is likely to be an effective starting point for successful interventions.

Effectiveness of suicide prevention gatekeeper training: 12-month follow-up of SafeTALK training to community members

OBJECTIVE

Long-term assessments of gatekeeper training (GKT) with multiple follow-ups are rare. Therefore, the aim of the current analysis is to examine 12-month follow-up outcomes of SafeTALK training in addition to the earlier analysis of pre-, post-, and 6-month follow-up.

METHOD

Two hundred and sixty two community volunteers participated in half-day (4-h) gatekeeper training sessions. Before, after, and 6- and 12-month follow-up surveys were used to assess participants' knowledge, efficacy, and reluctance to intervene. Linear mixed effects regression was used in statistical analysis.

RESULTS

Fifty six participants (21.4%) completed the 12-month follow-up, representing an attrition rate of 78.6% from pre-test. Linear mixed model analysis revealed a significant, consistent effect for time for knowledge, efficacy, and reluctance. Post-hoc testing revealed significant differences between scores at pre-test and 12-month follow-up for GK knowledge and efficacy; however, no significant difference was seen between these time points for reluctance to intervene. No significant change was measured between the 6 and 12 months for any outcomes. GK knowledge and efficacy remained significantly above pre-test scores.

CONCLUSION

The evaluation of the GKT demonstrated the long-term effectiveness of community-based suicide prevention training programs to improve and maintain GK knowledge and efficacy.

Examining burnout in the electrical sector in Ontario, Canada: A cross-sectional study

Workers in the trades sectors often experience mental health issues and decreased work ability due to occupational stress, workplace hazards and living in danger or constant fear of injury. Understanding the impacts of psychosocial risk factors on construction workers' mental health can aid in decreasing workplace injuries, lessening disabilities and increasing worker productivity. In this study, we focus on understanding and assessing the mental health and wellness of individuals in the electrical sector that are members of the Employer Engagement Project (EEP) from the Ontario Electrical League (OEL). The subset of potential participants included electricians and plumbers in Ontario working for small to medium sized employers (SME). The recruitment took place in 2022, with a total of 82 participants who completed a survey collecting demographic information, assessing the importance and availability/satisfaction of workplace factors and stress-and burnout-related questions. The data were analyzed using IBM SPSS Statistics 29.0. Two-sample Mann-Whitney U tests were performed to test for associations between the availability of work-related factors and burnout scores among the participants. Burnout scores were determined using the Copenhagen Burnout Inventory. Our findings demonstrate that dissatisfaction of the following factors: Workload allocation, internal staff development opportunity and stable staffing/minimal turnover, were associated with high burnout levels. The findings indicate there may be a relationship between certain work-related factors and burnout levels experienced. There is a need for improvement of workload allocation in SMEs to help enhance the mental health and well-being of employees.

Exploring the Impact of Social Identity on the Bullying of Construction Industry Apprentices

BACKGROUND

There is a lack of literature specifically examining the workplace bullying of apprentices and trainees in traditional, male-dominated sectors such as the Australian building and construction industry. Using social identity theory (SIT), the aim of this study was to gather the attitudes, thoughts, and feelings of construction industry leaders to better understand how social identification (i.e., group membership) impacts bullying on targets and perpetrators and the willingness to report bullying to targets and bystanders.

METHOD

One-on-one, semi-structured interviews using a purposive sample of eight leaders from construction and blue-collar industries. Qualitative data were analysed using reflexive thematic analysis.

RESULTS

Four overarching themes were identified: difficulties for apprentices transitioning into industry, the need for continued improvement in industry culture, reluctance to report bullying, and rethinking apprenticeships to empower. Each theme provides insight into the psychosocial phenomenon of the bullying of trade apprentices and suggests that an apprentice's level of social identification with work groups shapes how bullying is identified, interpreted, and prevented.

CONCLUSION

Findings from this study will be important for tailoring evidence-based interventions, human resource policies, and initiatives for education and awareness training. Themes also highlight systemic inadequacies impacting apprentices' mental health and skill development, with implications for the future sustainability of apprenticeship training agreements.

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.

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.

Evaluating Dialectical Behavior Therapy Training With Mental Health Clinicians

A substantial body of research supports dialectical behavior therapy (DBT) as an evidence-based treatment for those with borderline personality disorder (BPD); however, there remains a lack of mental health clinicians trained in this modality, resulting in limited clinician competencies and skills. Furthermore, the effectiveness of DBT trainings with mental health clinicians remains understudied. The present study evaluated a comprehensive 5-day DBT-Linehan Board of Certification training program. Informed by the Theory of Planned Behavior, this study assessed changes in clinician knowledge, attitudes, perceived behavioral control (PBC), intentions, and behaviors relevant to DBT at baseline, posttraining, and 6-month follow-up. Results showed large, significant pre-to-post training improvements in clinicians' knowledge, attitudes, PBC, and intentions related to DBT implementation. Large improvements in knowledge, attitudes, and PBC were sustained at follow-up. A significant improvement in actual behaviors was also found at follow-up. Implications of the present study and directions for future research are discussed.

Engaging Employers in Apprentice Training: Focus Group Insights from Small-to-Medium-Sized Employers in Ontario, Canada

Several factors have been identified to influence the registration and retention of apprentices in the construction trades. Employer engagement is a key factor to promote growth in apprenticeships in the construction trades as participation rates continue to be low among small-to-medium-sized employers. In this study, we evaluated the effectiveness of the Ontario Electrical League's (OEL) employer mentorship program through the perspectives of small-to-medium-sized employers using a qualitative approach. Two focus groups were conducted virtually with 11 employers. Focus group audio transcripts were recorded and transcribed for thematic analysis. Themes were generated using a data-driven approach to examine the relationships between mentorship program outcomes and perspectives on industry-related recruitment and retention barriers. Three themes were identified: (a) long-term apprentice recruitment and retention challenges; (b) equity and mental health in the workplace; and (c) industry challenges and mentorship program outcomes. Generally, this sample of employers appreciated the value of the OEL mentorship program through praise of the continued educational support, employer management expertise, hiring resources, and apprentice onboarding tools despite industry barriers in trade stigma, equity and mental health in the workplace, and recruitment and retention challenges. Industry partners should work with these small-to-medium-sized employers to develop workplace initiatives and engage external partners to provide ongoing apprenticeship mentorship support to address the recruitment and retention barriers identified in this study.

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.

Mental Health Outcomes among Electricians and Plumbers in Ontario, Canada: Analysis of Burnout and Work-Related Factors

(i) Background: Working in the electrical and plumbing sectors is physically demanding, and the incidence of physical injury and work disability is high. This study aimed to assess the mental health and well-being of skilled trades workers working in the electrical and plumbing sectors; (ii) Methods: Forty participants completed an online survey assessing burnout, work-related factors, and mental health issues. Data were analyzed to determine the association between demographics, the availability, and importance of work-related factors, and burnout using a two-sample Mann-Whitney U test; (iii) Results: Our findings showed that among the work-related factors, workplace safety, family commitments, income and benefits, and full-time employment opportunities might be crucial factors to keep study participants working at their current position. Financial support for external training, which was found to be the most important factor in preventing colleague-related burnout, was available to the satisfaction of approximately 50% of the participants; (iv) Conclusion: Work-related factors such as workplace safety and the availability and support for external training may be protective against all types of burnout among this population. Future studies may consider a larger sample size with a more diverse group of participants and perform an intersectional analysis to incorporate minority identities in the analyses.

Associations Between Work-Related Factors and Psychological Distress Among Construction Workers

OBJECTIVE

Identify work-related factors associated with the mental health and well-being of construction workers.

METHODS

We completed eight key informant interviews, six worker focus groups, and a survey, informed by the interviews and focus groups, of 259 construction workers on five construction sites. Negative binomial regressions examined associations between psychological distress and work-related factors including safety climate, work-to-family conflict, psychological demands, social support, harassment, and job security.

RESULTS

Three themes emerged from the interviews and focus groups, job demands and structure, social support and workplace relations, and job precarity. From the survey higher psychological demands, higher work-to-family conflict, lower supervisor support, higher discrimination, and higher likelihood of losing a job were associated with higher psychological distress. When combined into a single model job demands and work-to-family conflict remained significant.

CONCLUSIONS

Work-related factors were associated with high levels of distress.

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.

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.