Providing Mental Health Support & Suicide Prevention in Construction

A few months ago, Stuart Binstock, CEO and President of CFMA, joined the Mobile Workforce Podcast to discuss why mental health and construction safety go hand-in-hand. If you missed that episode, listen to it here. In today’s episode, Stuart joins host Mike Merrill to dive deeper into how mental health struggles and even suicide impact the construction industry, company culture and employee productivity.

 

Key Takeaways:

  1. When an employee’s mental health suffers, so does their productivity. According to the CDC, in the U.S., mental health struggles result in 200 million lost work days per year. That research goes on to show that in a three month period, a depressed person will miss 4.8 days of work and experiences 11 days of 0.5 days of reduced productivity. Upwards of $44 billion dollars is estimated in lost productivity annually, and a person suffering from depression consumes two to four times the healthcare resources that someone who’s not depressed.
  2. Investing in mental health is good for business. The CDC also reports that one in five adults will experience some form of mental illness in their lives. That’s 43.8 million people. 60% are left untreated, 7% have depression, 18% have anxiety, and this can lead up to 27 loss work days per year. This can seem overwhelming to leaders, but the fact is investing in employees’ mental health pays off. According to Binstock, for every $1 investment in mental health, businesses see a $4 return on investment. This includes things like building awareness, starting company wide training and giving employees the incentive to take care of themselves.
  3. A company culture that values mental health retains skilled employees. Having a culture that values the mental health of the team builds a safe and successful space that employees are not going to quickly want to leave for “greener” pastures. Adding value to your employees’ lives and wellbeing at work and at home will help retain employees, saving the time and money lost onboarding new employees.

 

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Episode Transcript

Mike Merrill:

Hello, and welcome to the Mobile Workforce Podcast. I’m your host, Mike Merrill and today we are sitting down to have a second discussion with our friend Stuart Binstock, the CEO and president of CFMA. Stuart was on the show on episode number 25 a little while back to talk about why construction, safety and mental health go hand in hand.

If you haven’t listened to it, I highly recommend that you go back and give it a listen, I think you’ll really enjoy that episode and that discussion. But after recording that first episode, it was unfortunate because we just didn’t quite have time to dig into some of the other details on the importance of mental health as it relates to productivity in construction. And so after the inflow of feedback from some of the listeners, we had a request to bring Stuart back and have this further discussion. So, excited to have you here today, Stewart, we’re grateful for you to join with us and welcome back to the podcast.

Stuart Binstock:

Thanks Mike. Anytime I can have an opportunity to talk about this subject which is so critical to the industry, I welcome the opportunity. So I really appreciate this second shot at it.

Mike Merrill:

That’s great.

Stuart Binstock:

We will get it right this time around.

Mike Merrill:

There you go. I think we did a great job and again, we just ran out of time, right?

Stuart Binstock:

Yeah.

Mike Merrill:

Well, I guess just to start off just for those that maybe haven’t heard the first episode, do you mind just sharing a little bit about your background with CFMA and also the Construction Industry Alliance for Suicide Prevention?

Stuart Binstock:

Sure. I’ve been at CFMA now for this is year 11, just started a year 11. The organization actually is 40 years old, so that’s kind of historic. I’ve been here for about a quarter of the time. And time flies when you’re having fun, Mike. I’m very proud of what we’ve been able to accomplish as an organization over the last 10, 11 years. We’ve increased our membership substantially, but really the hallmark for me is we’ve increased the value to a membership. And I think, we always talked about when I came on board, let’s increase value and members will come. And that’s exactly what we’ve been able to accomplish.

Stuart Binstock:

We have a free monthly webinar and actually, I think last year we ended up being 18 free webinars. We did a great job on the payment protection program. I think eight or nine webinars, they averaged over a thousand people per webinar. During COVID, I like to say that not only did we survive but we thrived because we really met the needs of our members and we’ve seen that this year. Quite honestly, we were worried a little bit about renewals, but people renewed with the same fervor as they have in the past. And they’ve actually renewed their memberships at a greater percentage than what we expected and what we thought it would be. And I think that’s a testament to what we’re able to accomplish at CFMA this past year during some very, very difficult times.

Stuart Binstock:

Regarding CIASP, it is the construction industry alliance for suicide prevention. So CFMA started CIASP about five or six years ago. Cal Beyer, a very well-known person in the industry wrote an article with Sally Spencer Thomas, we published it in our magazine. We had no idea what would happen when we publish that. In fact Christine [Debusky 00:03:53], editor of our publication walked into my office and said, “I got an article on suicide prevention. What do we do about that?” We both looked at each other and said, wow, that’s not typical CFMA article. It’s not about succession planning, it’s not about tax planning, it is not in the controllers or CFO’s ballywick, but we published it and the rest is history.

Stuart Binstock:

We obviously hit a nerve that existed in the industry that no one else was. So we’re very proud of doing that and we very quickly realized this was much bigger than CFMA. This was an issue that really permeated the entire industry where union, non-union, whether you’re a craft, whether you’re GC, it hit across the board. So we brought in the entire industry to help us out. Now it’s a separate entity that services just the subject of suicide prevention.

Mike Merrill:

Wow. Again, kudos and thank you so much for the great work you’re doing there. This is not a topic that’s in anybody’s wheelhouse in construction, typically. It’s not something that we talk enough about.

Stuart Binstock:

Right. Absolutely.

Mike Merrill:

So just to kind of seed the discussion just a little bit and recap, a question I would have is what does the construction industry really need to know and better understand about mental health and the issues that are in the industry?

Stuart Binstock:

Well, let me give the context for why we need to know that. And that is, construction has either the first or second depending on how you measure it, first or second highest incident rate of suicide of any industry in the United States. OSHA measures what are called the fatal four. Those are the top four ways in which people die by fatalities. So it’s falls, electrical, struck by and caught in between hazards. In 2018, I think those are the most recent numbers we have, 1,008 construction workers died by one of those fatal four. The estimated number of suicides in 2018 in the construction industry was over 5,000. It’s five times, fatal four fatality rate. So that gives you some context and why this is so important.

Stuart Binstock:

This is an issue that is just gone, I wouldn’t say it’s unnoticed, but it hasn’t been discussed. I had the opportunity to talk to 30 of the largest construction companies in the United States about a year and a half ago. They’re safety people. I am a lawyer and as a lawyer, you’re supposed to never ask a question you don’t know the answer to. But I went out on a limb and at the very beginning of my presentation, I asked, please can I see a show of hands of how many are aware of suicides of employees. And over two thirds of them raised their hands, which just kind of blew me away. I shouldn’t say it blew me away, it reinforced what we already knew. It reinforced what we have seen over the last five to six years when we talk about this issue. It is unbelievable how many people have suffered from this, either themselves or family members or construction companies. So there is a real problem.

Mike Merrill:

Wow. So within the demographic, is there a certain group or subset of individuals that seem to be more at risk with this or is there any statistics that you can share on that?

Stuart Binstock:

Sure. Well, first of all, this is the first time I saw this statistic, but there actually are suicide rates by trade, which I thought was interesting. I had never seen that before. And the highest incident rate is with iron workers and followed by millwrights, masons, roofers. It’s interesting that you can actually distinguish amongst trades. But the hallmark of the incident rate and the demographic, basically white men between the early twenties through their fifties account for the bulk of suicides. And if you paid any attention to the construction industry, that’s the workforce of a construction company, and male dominated industries tend to have more suicides. 97.4% of the US construction workforce is male, so it shouldn’t be surprising that that’s a problem. And then there are all these demographics, or maybe talk about the work culture.

Stuart Binstock:

Construction folks are very stoic. So they’re not going to complain but there’s a lot, people get injured on the job site and they start taking opioids and then that’s a downward spiral that goes nowhere very well. The other factors that lead to this, a lot of times folks work remotely, so they live in isolation. They go to work and come home, they probably go drink. They don’t have a family life because they’re on the road for six months.

Stuart Binstock:

And then, I think it’s fair to say probably, there’s a little bit of access to lethal means. There is kind of a gun culture, probably in some parts of the construction industry and the easier you have access to lethal means, the more likely you’re inclined to do something. So you add all those things up, family separation, sleep deprivation, folks get laid off, the stress on a family from getting laid off because construction sometimes can be seasonal, chronic pain which leads to opioids. You add all that up, access to lethal means and it’s not a very good recipe for, unfortunately it’s a recipe for suicide.

Mike Merrill:

Yeah, there’s a lot of stark and shocking really information that you shared there. I think it makes sense. It makes sense the demographic can understand again, that opioids or substance abuse of some kind, certainly have a role to play. I would agree with that completely. So with that, the last time we had you on, we talked about some of these things but an area that we never really had the opportunity or time to drill into is how does this kind of thing, when a tragedy like this happens, whether it’s death by suicide or even an accident of some kind and somebody loses a life out on a project or within the company, what kind of an impact is felt by the organization and even financially. I mean, you’re a president of CFMA so that’s something that’s probably important to talk about.

Stuart Binstock:

Well, first let’s talk about the impact of a suicide and then let’s talk about just mental illness and mental health and how that impacts the productivity of a company. So I always tell the story, I was talking to an electrical contractor many years ago. And I was talking to him about our initiative here. And he kind of got [inaudible 00:11:47]. He looked at me and he said, how did you find out about us? I said, what are you talking about? He said, we’ve had three suicides in the last 18 months. The last one was at a fortune 100 company. One of our foreman died by suicide by hanging himself in the boiler room of a fortune 100 company. His spouse sued us, blaming us for the suicide.

Stuart Binstock:

The fortune 100 company called up the company and said, I’m not sure you guys can work at our shop anymore. This guy was the president of the company, he had to go out to the fortune 100 company which was in the Midwest and they were based elsewhere and explained to them how they were going to continue to work in the environment after one of their people had just died by suicide in their boiler room. Just think about that for a second. You’re getting sued, it speaks to your credibility with a fortune 100 company, and what’s the attitude or the mood of the people on your workforce. You add all those up and there’s a lot of lost time and a lot of cost involved.

Stuart Binstock:

So let’s talk about short of a suicide. Let’s just talk about mental health problems. So these are, I think national statistics and they’re not necessarily related to construction, but they’re overwhelming. Mental illness results in 200 million lost work days per year. In the three month period, a depressed person will miss 4.8 days of work and 11 days of 0.5 days of reduced productivity. $44 billion dollars per year is estimated in lost productivity and a person suffering from depression consumes, and this is an interesting statistic, two to four times the healthcare resources that someone who’s not depressed.

Stuart Binstock:

To think about all those costs that are really hidden costs, and one in five adults will experience some form of mental illness, they say. That’s 43.8 million people. 60% are left untreated, 7% have depression, 18% have anxiety, and this can lead up to 27 loss work days per year. Depression is the leading cause of disability and increases risk of other chronic medical conditions. So you just start to add all that up and it’s kind of overwhelming. So let’s talk about, maybe some other factors. A $1 investment in mental health results in a $4 return on investment.

Stuart Binstock:

So this is good business. I will tell you that we’ve gotten involved recently in the diversity and inclusion issue as well. Contractors won’t necessarily do the right thing because it’s the right thing to do, but if you can make a business case, then they’ll listen. And there’s a business case to address this, just like there’s a business case to address diversity inclusion. So 33% of workers complaints in men and 66% of women had an existing mental health condition, and 50% report symptoms of depression in the month following an injury, and nearly half have a co-occurring substance abuse disorder.

Stuart Binstock:

When we talk about suicide, let’s talk about way short of suicide and just mental health and all the impact of this on a company. It’s a hidden cost that nobody really understands. And those statistics, I think are going to be eye-opening for people. And I think they’ll make them think twice about, we’re not necessarily always talking about suicide, we’re talking about mental health. This is part of mental health. Unfortunately, the ultimate act of losing your mental health is suicide. But before you get to that, there are all sorts of things that can happen and all sorts of things that can really hurt a company from a productivity standpoint.

Mike Merrill:

Yeah, so what I’m hearing you say and it makes perfect sense, if we can attack the issue at the root before it becomes more severe, we can prevent far more suicides by addressing the mental health issues. And then I also heard that a lot of them seem to stem from maybe an injury. So giving extra attention to those that have had an injury and making sure that they have a clear path to recovery, maybe how the extra attention and resources that they need to get back into good health is probably a very good preventative cause for some of these issues that can come down the line.

Stuart Binstock:

Absolutely. I think we’ve all heard and it goes way beyond construction, but we’ve talked about opioid use in this country. But in the construction industry, opioid use primarily, probably is connected to injuries and then taking some kind of opioid and then getting hooked on the opioids. And then, goodness knows what happens after that and possibly suicide, but certainly, certainly a loss of productivity at the very, very least.

Mike Merrill:

Well, and I think everybody listening and you and I included directly, we’ve all had bad days at work where we just didn’t get as much done, we weren’t very productive. So if we have something that is recurring and persistent that’s causing us that issue or those challenges, then it only makes sense that they don’t lead to anywhere good and certainly nowhere productive.

Stuart Binstock:

Yeah. Well, I mean, think about having a bad day and then thinking about having anxiety or depression on top of that.

Mike Merrill:

Yeah, every day.

Stuart Binstock:

Every day. Think about how effective that employee is going to be and think about, how do you find out about that? That’s kind of, I think probably the major questions that people might ask is how do you know that you’re dealing with a disgruntled employee or a depressed and anxious employee. There are warning signs and at the Construction Industry Alliance for Suicide Prevention, we have little cards that you can purchase that talk about what are the warning signs for depression. So they’re things like feeling sad or depressed most of the time, increased use of alcohol or drugs, feeling hopeless and helpless, sleeping too much or too little, withdrawing from family and friends, talk about being a burden to others. Those are kind of all signs that someone’s going through something.

Stuart Binstock:

And then in construction, actually some construction specific warning signs, once again decreased productivity, increased conflict among coworkers, near hits, injuries and accidents. Someone’s not paying attention, their mind is elsewhere, decreased problem solving ability and increased tardiness absenteeism. So you add all those up and it’s not a perfect formula. You’re not going to get this right all the time. But if you know the warning signs is important. We at CFMA, CIASP, we don’t expect people to be mental health experts. That’s really not what CIASP is all about. It’s all about understanding what are the possible problems and getting someone help.

Mike Merrill:

Yeah. I keep thinking of the old adage. My mother used to say all the time that an ounce of prevention is worth a pound of cure.

Stuart Binstock:

There’s a lot of truth to that. And as we discussed, it really has a monetary impact in the construction industry. I mean, it’s a serious monetary impact. If someone’s not going to do it because it’s the right thing to do, it’s also the right thing to do from a business standpoint.

Mike Merrill:

Yeah, fascinating. And again, not something that we hear enough about. I think back to my career in construction for over a decade and this is going back a couple of decades, I don’t remember anybody ever talking about it at that time, so.

Stuart Binstock:

Well, Mike, let’s add another layer to this. How about the last and a half during COVID? I mean, talk about putting stressors on people. There’s a lot of anxiety in the world today. Hopefully it’s lessening and hopefully people get vaccinated, we can return back to normal, that’s my little pitch. But that has nothing to do with suicide prevention, my own personal pitch, for God’s sakes get vaccinated. I mean, just really think about it, everything we’ve just talked about and then think about COVID over the last 15 months and how the stressor that is put on people, on families, on construction companies, really the whole world.

Mike Merrill:

Well, and tragedies are always… I tend to view the world this way, I try to view it this way. Tragedies are always an opportunity to regroup, to buckle down, to improve, to learn, and let’s use COVID if nothing else, to raise awareness and to be more in tune with the mental health and just the general wellbeing of our coworkers, of our work family, of our employees.

Stuart Binstock:

Yeah. I speak at a fair number of places and so I’ll go to safety and health conferences and I’ll say, you’re all fine talking about safety. Wear a hard hat, you have toolbox talks, I get all that. But when it comes to health, well, health it’s a little more complicated, but mental health, nobody wants to talk about that. It’s hard, it’s complicated. It’s not an easy issue. I don’t think we need to blame people and blame the industry. It is understandable that people don’t want to talk about mental health, but we’re at the point where, and Cal Beyer, really the father of this whole initiative talks about removing the stigma, get away, we need to talk about it. And that’s the only way this issue is going to get better.

Mike Merrill:

Yeah. When you mentioned that, I think of, a lot of people are aware of alcoholics anonymous or other organizations were admitting that there was a problem as an industry, that’s something we just need to be better at.

Stuart Binstock:

Yep. And I’ll tell you interestingly enough, they’re better at this in the UK and Australia. I can’t really explain the why, but they have a program called Maxim Construction in Australia. They have a budget of $1.5 million to spread the word about this issue. Ours is a fraction of that or 10 times the size of that country. So it is something we need to spend more time on.

Mike Merrill:

Do you have any ideas or thoughts on what companies can do to at least take a first step towards this? Are there programs, are there websites? I mean, resources?

Stuart Binstock:

Yes. I’m glad you asked that question. The website for CIASP is www.preventconstructionsuicide.com. There are a host of resources on the website. One of them is how do you evaluate a company’s mental health and suicide prevention, preparedness and culture, which is a very long word. But it’s really an expression, but it’s kind of a needs analysis and implementation. So you can go in to the website and almost check off whether you’re doing this or you’re not doing that, and will give you a good sense of where you are on the continuum of what probably would be ultimately the most enlightened company and the company that’s treating this best versus the worst, depending on kind of what you come up with as a score after you do this needs assessment.

Stuart Binstock:

But I think that’s a first step to do kind of a needs assessment. And then the second is to start doing some training. We have some training programs at our website. I think one is an hour long course that just gives you a real overview about preventing construction suicide, what you should do if you’re with somebody and you think they might be suicidal. These are very troubling and difficult issues, particularly for someone who’s a novice in that area. So there are a host of things you can do. The first thing I would tell people is get started, do something. That’s really kind of my mantra when it comes to this issue.

Mike Merrill:

Yeah, and I can’t help but think as well, you talk about the productivity and the loss productivity, but even if I feel like I’m doing fine, if my buddy to the right or to the left of me is not, and heaven forbid they have an accident or mental lapse or a challenge, it’s going to affect me as a crew member. It’s going to affect my project, it’s going to affect my mental stability too. My concern or my worry, I can’t help but think that the ripples that occur from an issue like that don’t reach everybody in the company.

Stuart Binstock:

I think they’re of enormous proportion. You’re absolutely right, they’re from the person who works next door to the person in HR who’s got to deal with a death in the organization, to the CEO who’s got to worry about the liability that the company might face, because somebody might sue them and blame them for the suicide. I mean, it’s endless and it really does cut across the whole. The foreman who might think he’s going to get blamed for pushing somebody too hard. I mean, really when you think about it, it cuts across the entire company, a suicide cuts across the entire company.

Mike Merrill:

And we all know socially when somebody passes that we’re connected to even in our personal life, the impact that’s felt by hundreds or thousands of people immediately that they’re gone and grieving, it’s going to do the same thing in your work life.

Stuart Binstock:

Absolutely, absolutely. It is going to definitely have a devastating, well, I mean, I think it’s going to have a devastating impact of your company, but I don’t think you even understand what impact it will have on your company. And it’ll be different for every single organization just depending on the makeup of the company, makeup of the person, makeup of the way they handle the situation. There’s unmarginable opportunities for a problem and for something bad to happen, when something like that happens to a company.

Mike Merrill:

Well, and in an environment where again, we have all these other stresses with lumber pricing and concrete prices and steel prices and people are busy and you can’t find enough good help and we’re already running around probably a bit frayed and ragged as an industry right now.

Stuart Binstock:

And let’s think of something that of course we all think is a great opportunity, but from this perspective, the unintended consequence could be negative. And that is the infrastructure legislation, which is a great opportunity for the industry. But if the industry is not manned enough and ready to do that, I mean, we’ve always talked about worker shortages before COVID. We do a confidence index survey every quarter. We ask our members what their confidence level is and we ask them what are the top five issues that they’re concerned about.

And workers shortage prior to COVID was five times higher than any other single factor. So post COVID when everyone’s back, then the infrastructure bill passes, oh my God, the concern about worker shortage. I have seen people talking about prefab and robotics. There’s got to be a solution because with the current workforce, we will not be able to handle what’s coming through the pike.

Mike Merrill:

Yeah. We both know and I’ve had a couple of guests on here, Letitia Hanke runs a contractor school out in California to teach young roofers coming out of school to be trained up in the trades and has just a wonderful program called The LIME Foundation. We’re seeing it everywhere, it’s not just in California where there’s just major worker shortages as it is. So we just can’t afford as an industry and as a society to keep looking the other way, whether it’s intentional or not, we really need to put our eyes fixed on this issue and start making some changes.

Stuart Binstock:

Well, I will tell you, and I know people never think of it this way, but you could think of this from a recruitment standpoint. A company that is known as a caring culture and takes care of its people, people are going to want to work for that company. And I think millennials even more so, seem to be a little bit more independent than some of us old folks. And I think they look at that kind of stuff more than I think our generation did. And so if you come across as not being a caring culture, I think you have an issue in terms of your future employees. So it’s a recruitment tool. No one ever thought mental health was a recruitment tool, but I think it really can be perceived that way.

Mike Merrill:

I love that you bring that up. People generally, we’re feeling, caring beings. So they know when you’re interested in them from a physical perspective, from an emotional perspective, they know when you care about them and I think you’re right. I think a company culture has that same spirit of what that company is about and I think people will take notice.

Stuart Binstock:

I think so. Yep.

Mike Merrill:

So tell me Stuart, if you were to sum up the conversation today and boil it down to one key takeaway, what would that message be for the listeners as we wrap up today?

Stuart Binstock:

Two words. Do something. Do not sit still, do not just say, oh, this was an interesting conversation, it’s somebody else’s problem because it could be your problem tomorrow. You have an obligation to your employees and you have an obligation to yourself as a company too. You can think of this Mike as a risk management issue as well. There’s so many ways to think of this issue, but the bottom line is do something. You can start out small, you can maybe train some of your supervisory staff so that they’re familiar. We have a host of information available on the website that you can use, free of charge and so we really want people in the industry to use the material that we’ve created. We do accept contributions from people, but we don’t have membership fees. We’re just trying to do the right thing and do the right thing for the industry.

Mike Merrill:

I love that. I’m hearing a Stuart tell the audience, “Take action”, right?

Stuart Binstock:

You just took my words and you put them into yours and they worked very nicely.

Mike Merrill:

All right. Well, thank you again for this great conversation, Stuart. Before we hang up here, I just wanted to check in and see, is there anything, any meetings or conferences or opportunities that CFMA has coming up that the listeners can participate in or sign up for?

Stuart Binstock:

Well, Mike, now that you mentioned that, of course there is. Our annual conference and exhibition this year is going to be a hybrid. Last year, it was all virtual. This year we’re going 2.0 virtual, which means we’re going to be live in four cities; Dallas, Texas, Phoenix, Arizona, Atlanta, Georgia and Washington DC. So we’re going to have a limited number of people that we’re going to allow to attend in those four cities and have the opportunity to network with one another. And everyone else, it will be virtual.

Stuart Binstock:

It’s July 19 to 23. It’s interesting when you do a conference like this, I think we have more sessions and more CPEs than we would if we were at a live event. We have 32 sessions, we have 60 CPE credits, and I know one of the things that’s always popular with our members of the small, medium and large firm round tables, where contractors get to talk with similarly sized companies about issues that are troubling. So we’d love to have people attend that and all information is on conference.cfma.org.

Mike Merrill:

That’s great. Well, thank you, Stuart, and I highly encourage everyone to check that out. We’ve been members of CFMA and involved, going on 11 years now. And I know that again, I think I said this on the first podcast we did, CFMA always continues to grow. It never shrinks. Nobody ever leaves it, they just keep coming and coming and coming. So we excited to have more people come and join in the conversations on the education happening there.

Stuart Binstock:

Thanks so much, Mike.

Mike Merrill:

You bet.