A New Imperative for Worker Safety

Over the past decade, the construction industry has made strong strides in improving safety management. Safety is now broadly defined as a core value throughout the industry. There is an increasing focus on changing safety culture, attaining zero incidents and monitoring key safety performance metrics. An emphasis on the workforce and behavioral safety initiatives challenge business owners to widen what it means to value health and safety. Many companies talk about workers applying safety practices 24/7, going beyond work to include their families at home and during off-hour, recreational activities. Yet the focus on safety at home remains largely concentrated on physical aspects and precautions relating to safety performance. This includes buckling up and driving defensively, wearing protective safety gear and using ladders safely. However, based on industry risk factors and social demographics, the construction workforce and their families need a more holistic safety approach that encompasses mental health and suicide prevention. An industry initiative addressing mental health and suicide prevention is ushering in a new frontier for safety.

Starting with the publication of the "Blueprint for Suicide Prevention in the Construction Industry," there is a call to link mental health and suicide prevention with safety culture. It is no longer sufficient to get workers home safe each night. For at-risk workers, it is just as important to get employees back to work safely, too. Likewise, it is important to provide employees with resources and services to help them provide adequate awareness, advocacy and intervention if family members need help. Unfortunately, too many business owners have faced the tragedy of losing an employee to suicide. The death of a co-worker from suicide often carries a unique burden of grief and trauma that spreads throughout the workplace.

A Common Struggle

Because mental health conditions and suicidal thoughts are often invisible to the outside world, many people do not realize how common these challenges are.

• According to the National Institute of Mental Health, about 1 in 5 adults in the United States (approximately 43.6 million people) experiences mental illness in a given year, most often depression or substance abuse.
• Each year, more Americans die by suicide than homicides or vehicle accidents; in 2013, 41,149 people committed suicide. (CDC)
• Suicides result in an estimated $44.6 billion in combined medical and work loss costs. (CDC)
• Suicide is the tenth leading cause of death in the U.S., and the second leading cause of death among 15 to 24 year olds. (CDC)
• While death rates are declining in other wealthy countries, death rates are rising for middle-aged, white Americans, and this rise appears to be driven by suicide and substance abuse. (New York Times)
• The construction industry consistently ranks in the top nine for highest rates of suicide in the U.S. (BLS)

A Company President's Personal Story

Bob Swanson had a 45-year career in the construction industry. Twenty-five of those years were spent as a company president. In addition to success in business, Swanson's family and his faith have been his foundation and sources of strength. On March 13, 2009, that foundation was shaken when Swanson's oldest son, Michael, died by suicide at the age of 33. The cause of his death was due to an illness of the brain named bipolar disorder. Even though there had been two earlier suicide attempts, this was a devastating event to the entire family.

The Aftermath

Because of a general lack of understanding regarding all mental illnesses, there is a stigma surrounding suicide. However, there is no shame in the event of death from a physical illness. Michael's death was the result of his mental illness. Swanson said that for the first few years, the grief was overwhelming. He said it was difficult to concentrate and stay focused on a task. Anger and guilt were common thoughts expressed. He repeatedly asked himself, "Why did this happen, and why couldn\'92t this have been prevented?"

"Suddenly, all of life's priorities changed, and many things that previously seemed important soon lost their significance," Swanson said.

Healing & Recovery

Swanson found healing primarily through the loving care and support of family members. In addition, friends, the company's leadership team, employees and industry partners, provided support. That support gave Swanson the ability to move forward. Swanson said that a support group sponsored by Suicide Awareness Voices of Education (SAVE) and resources and support from the National Alliance on Mental Illness (NAMI) also played a critical role in his healing process.

Lessons Learned

Life is precious and fragile. Business success is important, but not nearly as important as nurturing and maintaining strong relationships with family members and friends. As part of Swanson's continued healing and in honor of Michael, he has chosen to help others by focusing on suicide prevention. He speaks at NAMI Minnesota and other construction industry events, and serves as an instructor of various NAMI Minnesota classes. Swanson is beginning to branch out of Minnesota with a willingness to help other company leaders to link mental health awareness and suicide prevention advocacy with their safety and wellness program.

Response to Suicide: Resilience Leads to Recovery

According to Dr. Sally Spencer-Thomas, CEO and co-founder of a Denver, Colorado-based suicide prevention organization called the Carson J. Spencer Foundation, the feelings Swanson experienced in the aftermath of his son's death are common. Spencer-Thomas said that many survivors of suicide equate the initial reaction to "falling into a canyon of 'Why?'"

Bereavement Process

Spencer-Thomas said, "The course of suicide grief is often a complicated bereavement. It does not follow a straightforward trajectory, but rather twists and turns and circles back on itself through mazes of denial, sadness, anger, shame, blame and multiple physical reactions." Described as an oscillating process, bereavement moves between loss and restoration and growth and depreciation. In this process, survivors of suicide loss can move closer to some people and further away from others.

Resiliency

As survivors of suicide loss learn to adjust and redefine life without the physical presence of their loved ones, they can feel like they have lost a part of themselves. Dr. Al Siebert coined the term "phoenix grievers" in his book The Resiliency Advantage..

Siebert opens one chapter by saying, "Survivors of extreme trauma are never the same again. Their lives have two parts: before and after. How their new life turns out for them depends on their resiliency."

Recovery

When people suffer the loss of a loved one, they often feel guilty about leading full lives afterwards. In addition, there may be a desire to do penance or the thought, "I do not deserve happiness, because my loved one has died." Dr. Viktor Frankl, a famous Holocaust survivor who helped many others find their way through the grief of losing a loved one, raised these questions to those impacted by a loss:

• "If you were the one who died and your loved one was still alive, what would you wish they would be doing?"
• "What kind of life would you hope your loved one would lead if you were the one who had died?"

Finding Meaning

Like Swanson and his family, many people find inner resilience through their support systems. They build a "new normal" over the years. While that empty chair can never be replaced, they often find ways to make meaning and find a deeper purpose. The topic of mental health and suicide prevention is a thought-provoking gut-check for owners of construction companies. Ask yourself a few quick questions to consider your company's readiness to withstand a tragedy like the one experienced by Swanson:

1. Does my company know the industry and demographic risk factors affecting the construction workforce?
2. Has my company evaluated its workforce and considered the potential for at-risk employees?
3. Does my company share resources and have services available for its employees and their families to help address mental health and suicide prevention in their personal lives?
4. How can my company integrate mental health and suicide prevention into its safety program and safety culture?
5. Has my company trained managers and supervisors on warning signs of mental health and suicide?

If you answered no to any of these questions, you are not alone. This is why the National Action Alliance for Suicide Prevention Workplace Task Force is working to advance this topic in the construction industry. As an owner or leader of a construction company, this is a call to action. Addressing mental health and suicide prevention is imperative to achieving a company culture truly focused on safety.