We’re Building a Better Future

You're Not Alone - Construction Industry Mental Health and Suicide Blog

You're Not Alone - A Mental Health and Suicide Prevention Blog for the Construction Industry by Bob Swanson

A Father's Grief
Download as a PDF

September is suicide awareness month, but every day should be suicide awareness day. Are you aware that today nearly 3,900 Americans will survive a suicide attempt and every 11 minutes an American will die by suicide? Canada has similar numbers. Not only is this a crisis that preceded the current pandemic, it is a crisis in the construction industry. There are more suicide deaths in construction than any other industry.

The impact of a suicide death is far different than any other death. As regular readers are aware, I’m a suicide loss survivor. Our oldest son died by suicide in 2009, and I continue to live with that impact. Every day since March 13, 2009 is a suicide loss day for our family. 

I have lost two parents and a brother to physical illnesses, and those losses have been far different. Let me explain. Full acceptance eventually comes after a death due to a physical illness, because the impact on the person’s ability to continue functioning was measurable. Furthermore, after those end of life situations we were surrounded with continued compassion and support.

A suicide death, however, is different. The uncertainty, the why, and the guilt lingers. What could have been done to help our son? Feelings of shame also linger. Then there is always the uncertain reaction when a new acquaintance asks, “tell me about your family.” I will usually respond that we have four adult children and ten grandchildren at first. If the conversation continues and prompts the question, “what do your children do,” my response will include that one of our children is deceased. If I’m asked what happened, I then respond that our oldest son died by suicide. Often that ends, or abruptly changes, the conversation. That, however, does not happen if I say that my mother died from pancreatic cancer. The net result is a renewal of shame and guilt about our son’s death.

Because of my guilt and shame, it took me an extensive period to tell anyone other than family members or close friends that our oldest son died by suicide. It also took me a great deal of prayer to unload much of my guilt and shame and be guided to what I am doing today. 

Each time that I speak and write about mental illness and suicide prevention, I confront my pain in losing our son to devastating illnesses of the brain, but it continues to be part of my healing. I am encouraged that our industry is acknowledging that there is a crisis and that bold steps are being taken to open the dialogue about mental illness and suicide prevention along with providing more resources for support of those in need. 
 
In basic first aid training, most of us learned what to do if someone was bleeding or having difficulty breathing. In the same manner, we need to learn what to do if someone is having a mental crisis. It is often difficult, however, to detect the symptoms of a mental crisis; but suicide is preventable. 

Terminology is also especially important. Our son did not commit suicide or want to die; he wanted his horrible pain to end. The illnesses of his brain removed all hope. By saying someone “committed suicide,” the blame and shame for our family and all suicide loss survivors continues. By saying that our son died by suicide, the diseases that he lived with are blamed, and there is compassion instead of blame and shame.

I am grateful for the work that so many are doing to change the culture of the construction industry. We need to take care of ourselves, our employees and each other, especially during the COVID-19 pandemic.

Understanding Anxiety Disorders

Download as a PDF

Anxiety disorders are the most common mental illness or brain disease among Americans today. As indicated by the National Alliance on Mental Illness (NAMI), in the United States, approximately 40 million adults and 7 percent of children ages 3-17 live with anxiety disorders. Common symptoms of anxiety disorder include feeling nervous, feeling helpless, a sense of impending panic, danger or doom, increased heart rate, hyperventilation, sweating, trembling, trouble concentrating, trouble sleeping, and having gastrointestinal problems. 

With the prevalence of these types of disorders, it’s important for employers to understand what they are, how they affect individuals and how individuals living with anxiety disorders can get help. These disorders can affect anyone, and you or someone at your company could very well be living with one (or multiple).

Feeling anxious is a normal, healthy human response to stressful circumstances. Living in our world today includes many stressful circumstances that have been compounded by the pandemic and physical isolation. Webster’s New World Dictionary defines anxious as “Having or showing anxiety; uneasy in mind; apprehensive; worried.” Webster’s New World Dictionary defines anxiety as a “State of being uneasy, apprehensive or worried about what may happen; concern about a possible future event.” 

One might reasonably question, if feeling anxious is normal, how do we identify an anxiety disorder? Anxiety can become “an abnormal state...characterized by a feeling of being powerless and unable to cope with threatening events, typically imaginary, as shown by sweating, trembling, etc.” When feelings of intense fear and distress become overwhelming and prevent us from doing normal activities, an anxiety disorder may be the cause. They involve more than a temporary worry or fear, the feelings are intense and the fear is out of proportion to the actual danger.

Here’s an example. During my last commercial airline flight on March 12, I was anxious about my health and safety since the pandemic was beginning to be present in the United States. While I was anxious, I was still able to travel home. My anxiousness did not prevent me from taking an action. Someone living with an anxiety disorder may not have been able to bring themselves to travel home.

Now that we have an idea of how to spot anxiety disorders, lets go into more detail on what causes them and how they affect people. The two main causes of anxiety disorders are genetics and environmental factors. Studies indicate that anxiety disorders tend to “run in families.” A stressful event such as abuse, violence, or prolonged illness can also lead to the presence of an anxiety disorder. People living with an anxiety disorder often also live with depression.


Different sources identify as many as 10 anxiety disorders, but four are the most common: 
Generalized Anxiety Disorder: The individual worries extensively about personal health, work, social interactions and everyday routine life circumstances. 
Social Anxiety Disorder: The individual experiences intense fear of social interaction.
Panic Disorder: The individual experiences sudden periods of intense fear that come on quickly and reach their peak in minutes.
Phobias: The individual experiences intense fear of specific objects or situations. Examples include fear of flying, heights, etc.

As with most illnesses, anxiety disorders are treatable. Unfortunately, the Anxiety and Depression Association of America indicates that less than 37 percent of individuals living with anxiety disorders receive medical care for their illness. Treatment typically includes psychotherapy or “talk therapy,” cognitive behavioral therapy and use of medications. 

Cognitive behavioral therapy is one type of psychotherapy that assists the individual in developing coping skills to manage the situation and anxiety symptoms. Behavioral therapy includes recommendations for lifestyle changes like regular exercise, using relaxation techniques, eating healthy and maintaining regular sleep patterns. Commonly prescribed medications for anxiety disorders include benzodiazepines, buspirone, anti-depressants and beta-blockers.

I challenge all employers to ask the following questions. Are any of your employees exhibiting symptoms of untreated anxiety disorders? Are you willing to provide the assistance they need on a prolonged basis? Does your company provide a culture that allows employees to get the help they need for illnesses of the brain? We as an industry need to continue shifting our culture until every company answers the last two questions with a “yes.”

To learn more about anxiety disorders, I recommend reading Embracing the Fear by Judy Bemis. Resources for this blog included the following: Anxiety and Depression Association of America (www.ada.org), Mayo Clinic (www.mayoclinichealthsystem.org), National Alliance on Mental Illness (www.nami.org), National Institute of Mental Health (www.nimh.nih.gov), and United States Department of Health & Human Services (www.hhs.gov). 
 

June 2020 - Paying Attention to Vital Signs
Download as a PDF

When I have an appointment at a medical clinic, the visit begins with the nurse recording my height and weight. This is a lagging indicator determining what has resulted since my last visit. Next, the nurse registers my temperature and blood pressure, and these are considered some of my vital signs. They are not visible outwardly, but they are an important reflection of what is happening inside me. My vital signs provide a glimpse of my heart and soul.
 
What are the vital signs of your business? The typical responses to this question generally cover: financial measures (including work backlog), cash reserves, profitability, revenue growth, a positive income statement and strong balance sheet, a strong safety program, and testimonials from key customers. All these items are considered lagging indicators. They can be measured by industry standards, and they are the result of leading a successful business.
 
What do these vital signs indicate about your employees, who are the heart and soul of your business? Your employees are vital to your business’ success. As you hire new employees, rehire furloughed employees or check in with current employees, how do you assess their vital signs? What do you measure? You can’t rely solely on an individual’s outward appearance, as that can mask the true vital signs hidden beneath.
 
Let’s go back to my medical appointment example above. When I get my temperature checked and blood pressure taken, I trust the instruments to be accurate and the nurse to use them properly. I trust that the nurse cares about my well-being. A safe environment has been established that allows me to discuss my physical and mental condition. Has your company established a safe environment for your workers to discuss their physical and mental conditions?
 
In today’s current environment, we have each endured the stress and strain of living amidst a pandemic. This pandemic has disrupted our normal daily lives. It’s affected how we work, how our children learn, our ability to socialize, our ability to worship and so much more. We’re not sure what the new normal will be, nor when it will come about.

We have all experienced the last few months differently and have had little opportunity to share our fears. As you think about what your employees have faced or are facing, consider these words from Anais Nin, “We don’t see things as they are. We see them as we are.” Your vital signs might be ok, but what about your employees’ vital signs? What are they feeling, what are their fears and what are their concerns?
 
It is more critical than ever that your employees know you truly care about their wellbeing. Difficult times like these are when we need each other. Remember, we’re all in this together. Our only path forward is through, and we’re only going to make it through by supporting one another.
 
As touched on earlier, people living with mental illnesses and substance abuse disorders (and those in recovery) are especially vulnerable right now. It is critical they stay on their treatment plan, including use of their prescription medications and maintain contact with their medical provider and support group. Thankfully, many medical providers and support groups quickly adopted virtual meeting technology to adapt to our current environment.
 
Here are several resources available to help:
 
We all are in an unprecedented and uniquely challenging time. But remember, neither you nor your employees are alone. We will pull through these times together.

April 2020 - Social Distancing and its Effect on Mental Health

Download as a PDF

During this unique period of the COVID-19 pandemic, we have been encouraged to maintain social distancing of at least six feet and avoid gathering in groups (when possible) to reduce the spread of this virus. Social distancing’s intent is really physical distancing while still remaining in social contact with others. Little or no social contact can quickly create feelings of loneliness, anxiety and depression.
 
The current situation impacts  the mental well-being of all of us, and it can especially have a negative impact on individuals living with mental illnesses and/or substance use disorders (even those in recovery from a substance use disorder). Let’s first discuss some common reactions to our current situation. It is very reasonable and fair to be worried about the gravity of this pandemic, the lack of understanding of COVID-19 and the economic consequences from our stay at home orders. 
 
Your employees are likely concerned about their health, the health of their families and their family’s economic vitality. If they’re still working, they’re uncertain for how long. If they have been furloughed or laid off, they wonder when they’ll be able to return to work. As a business owner, you are anxious about the financial viability of your business, how long this situation will last, and what impact it is going to have on your business. 
 
With all these concerns floating around, what can be done to maintain good mental health during these times of social distancing? First - social distancing does not mean social isolation. It is critical to remain connected with others on a regular basis. Maintain a regular schedule, eat well, get enough sleep, maintain good personal hygiene, exercise, get fresh air, limit media consumption, set boundaries on your work schedule when working remotely and engage in activities that bring joy.
 
As a business leader, what can you do for your employees? Encourage and facilitate regular communication with and among your employees. Use technology as much as possible for meetings and communication, because we all benefit from visual communication. Make yourself available to employees to answer questions and reassure them about work and other issues that may arise. Your employees need to know you care about their complete well-being. Make mental health visible by offering support and creating an environment where it is safe to talk about.
 
As touched on earlier, people living with mental illnesses and substance abuse disorders (and those in recovery) are especially vulnerable right now. It is critical they stay on their treatment plan, including use of their prescription medications and maintain contact with their medical provider and support group. Thankfully, many medical providers and support groups quickly adopted virtual meeting technology to adapt to our current environment.
 
Here are several resources available to help:
 
We all are in an unprecedented and uniquely challenging time. But remember, neither you nor your employees are alone. We will pull through these times together.

February 2020 - The Impact of Shame and Stigma
Download as a PDF

Shame and stigma have many negative consequences regarding mental illnesses and suicide. Stigma drives shame, and shame is one of the main barriers to someone with a mental illness getting the help they need. Not only can shame be felt by those living with mental illnesses, it can also be felt by that individual’s loved ones.

Shame is a sense of failure, a feeling of unworthiness, inadequacy, guilt and embarrassment. Shame often becomes part of a person’s identity. As mentioned above, it can prevent someone living with an illness from requesting medical treatment. Shame can cause both the individual living with the illness AND their loved ones to feel like they’re facing this disease alone.

Long-time readers will know that I lost my oldest son Michael to suicide. For many years, the only people aware of our son’s serious illness of the brain were immediate family. As a parent, I felt I failed our oldest son, because he lived with mental illnesses. Our son felt he was a failure because he couldn’t overcome his illnesses. Both of us felt tremendous shame for something we did not do. With all other illnesses, we are comforted by the ability to share our thoughts and concerns with others, and we are energized by their support.

As a suicide loss survivor, there is also a great deal of shame. The typical obituary of someone who dies by suicide merely indicates that they “died unexpectedly.” Slowly, some obituaries are beginning to state that the person lost their battle with mental illness in the same manner that someone lost their battle with cancer. Only after the help of a support group was I able to tell someone that my oldest son died by suicide. Shame prevented me from showing proper respect to our oldest son.

As I’ve mentioned in previous articles, it’s hard to tell if someone is living with a mental illness. There aren’t many physical clues. However, once it’s known that a person is living with a mental illness, stigma has many negative consequences. Only until recently, health insurance coverage was reduced or absent for people living with mental illnesses as compared to physical illnesses. 

Stigma often impacts the ability of a person living with a mental illness to secure or maintain employment, educational and housing opportunities. The stigma creates unjustified fear in the general public and the result is the person living with the illness is negatively labeled for having a disease they certainly didn’t ask for.

Think about this for a moment. Would you react differently if you discovered that a fellow employee lived with anxiety disorder, and another fellow employee is living with treatable cancer? They both require some accommodation to perform at a high level in the workplace. 

However, because of the stigma surrounding mental illnesses, you are likely not even aware of the employee living with anxiety disorder. There should not be any difference in how each of these employees are treated at work or outside of work. They both live with an illness that was not their fault. They both need our compassion and support.

Does your company have a culture that allows an employee to feel safe to say that they are living with a mental illness? Are accommodations made in the same manner as those done for physical illnesses? How would fellow employees perceive allowing an employee to work from home because of an anxiety disorder versus their cancer treatment? The culture you create and maintain is critical in reducing stigma in the workplace.

January 2020 - What Do I Do Now?
Download as a PDF

You noticed your co-worker’s behavior has changed recently, and you have also noticed some concerning verbal statements and actions. These could be clues that your co-worker is having suicidal thoughts. What do you do now?
 
What would you do if that same co-worker was bleeding? You’d take action to assist them to help prevent their situation from getting worse. That same line of thinking needs to apply to someone having suicidal thoughts. Just because you can’t physically see the injury or illness does not mean it isn’t there or that it isn’t something you should take seriously. If you think someone is having suicidal thoughts, immediate action is required to prevent possible injury or death.
 
Here are the steps to take when you suspect someone is having suicidal thoughts:
  • Create a safe place to talk alone.
  • Discuss your concerns and your recent observations.
  • Offer assurance that you are there for them.
  • Ask open-ended questions.
  • Allow them to speak freely.
  • Be patient and listen without judgement.
  • Ask them outright if they are having suicidal thoughts.
  • Stress that you want to help, and tell them you don’t want them to die.
  • Stay with them; don’t leave them alone.
  • Remove any lethal means that may be available to them.
  • Offer hope and help. “Are you ok working together to get some help?” You want their permission.
 
Throughout this process, you will need to assess the severity of the situation and what resources may be needed. At one level, assistance from the company’s employee assistance program (EAP) may be appropriate. In extreme situations, a 911 call may be necessary. If the individual confirms having suicidal thoughts, assistance from a mental health professional is necessary.

There are several resources available to help:
  • The company’s Employee Assistance Program phone number.
  • National Suicide Crisis resources, which are staffed by mental health professionals on a 24/7 basis.
  • The phone number of your local crisis center.
 
When in doubt, trust your instincts and take immediate action; you could save a life. Remember to follow up with your co-worker and stay in touch, just as you would with any injury situation.
 
For more information on this topic, Dr. Sally Spencer-Thomas put together an excellent blog on asking someone about suicide. Click here to read.

November 2019 - Myths About Suicide
Download as a PDF

There are many myths regarding suicide. One of the most significant myths is that suicide cannot be prevented. This is false. Suicide is absolutely preventable! It is, however, often difficult to decipher the warning signs that someone is having suicidal thoughts and then take necessary lifesaving action.

I have discussed common warning signs in one of my previous blogs (June 2018), and I will discuss those in further detail in my next blog. Today, I would like to discuss some of the common myths regarding suicide.

Myth: Suicide only affects individuals with a mental health condition.

Fact: Many individuals living with a mental illness will not have suicidal thoughts and not all people who attempt or die by suicide live with a mental illness. Information from National Alliance on Mental Illness (NAMI) indicate that only 54 percent of those who died by suicide had been diagnosed with a mental health disorder.


Myth: Suicide happens most often during the holiday seasons of Thanksgiving and Christmas.

Fact: While the holiday seasons can be difficult for those living with mental illnesses and loss survivors, suicide is unfortunately a year-round event. Suicides tend to peak during spring. 


Myth: Most suicides happen suddenly without warning.

Fact: Verbal, behavioral and situational warning signs precede most suicides.


Myth: Asking someone if they are having suicidal thoughts will put the idea in their head.

Fact: Discussing suicidal thoughts reduces the stigma and shame and can help give the person an opportunity to get the help he or she needs.


Myth: A person talking about suicide is just seeking attention and won’t actually attempt suicide.

Fact: A person talking about suicide is crying for help and is thinking of ending their life.


Myth: People who die by suicide are selfish and want to die.

Fact: People die by suicide because they want their pain and suffering to end and suicide is the only path they see out. They don’t want their life to end; they don’t see any other option.


Myth: Only a trained professional can stop a person from attempting suicide.

Fact: We all have the capability to save someone during a mental crisis. Read on to learn how you can make a difference.


An Example of How to Make a Difference: Shortly after my retirement, I spoke at a company safety and health meeting about suicide prevention. Within months of that presentation, a supervisor of that company received a text warning from an employee. The text read, “I can’t do it anymore”. 

The supervisor and a company officer immediately took action to reach out to this person in crisis. They made contact and determined where the individual was. When they reached the individual, he was alone in his car with the means to end his life. The employee in crisis was able to get the medical help he needed, and a life was saved. Remember: all warning signs are serious and require immediate action. 


October 2019 - An Example of a Difference Made

Download as a PDF

According to the National Alliance on Mental Illness (NAMI), approximately 60 percent of individuals living with mental illness don’t receive the treatment they need. That is a staggering number of people in need who aren’t getting help, and there are a number of barriers that have contributed to this statistic. One of the largest barriers is the stigma and shame associated with mental illnesses. Other barriers include the lack of: mental health facilities, psychiatrists and psychologists and adequate insurance coverage (as I discussed in a previous blog).

Let's think about this. Is there any hesitation by anyone to tell their employer they need time off for a doctor's appointment? What about when an employee requests time off to see a psychiatrist or a therapist? In both instances, the request would hopefully be approved, but the second instance might provoke more lingering questions regarding the employee's long term well-being and dependability. It shouldn't, but that's where we still are as a society, and that's what we need to move away from.

We know that the stigma is alive and well in our industry, but it is also very prevalent in the world of sports. Last year I indicated that it took bizarre public behavior of a Minnesota Viking before medical help was sought. Thankfully that individual is now in recovery and contributing to the team. Another Minnesota athlete recently came forward with his story regarding his journey with serious depression, and there are lessons we can learn from it.

Robert Covington was traded unexpectedly last season from the Philadelphia 76ers to the Minnesota Timberwolves and suffered a season-ending injury shortly after being traded. The sudden trade and serious injury frustrated Robert. He went months without telling his family or team about his worsening mental state. He became angry and began missing rehabilitation sessions. At this point, it would have been easy to blame and admonish Robert. However, Minnesota head coach Ryan Saunders noticed the changes in Robert and instead approached him with his concerns.

The coach cared about Robert as a person and began a life-changing conversation, recommending he see a therapist. Robert now states he felt strongly that, “seeing a therapist was kind of weak.” He had to overcome his hesitation of “always being strong.” Through therapy and the support of his family, team and coach, Robert has stabilized from both his physical injury and his period of deep depression.

Remember you can make a difference! In this case, Ryan Saunders cared and took action to help a person in need. The way we beat this stigma and make a difference is by doing what Ryan Saunders did - don’t shame the individual, encourage them to get the help they need.


September 2019 - Mental Health Impacts Safety, Productivity and Quality

Download as a PDF

As a contractor, determining the skill level and experience of applicants during pre-hire interviews was essential. I would have the applicant tell me about their skills and experience. I would ask questions like, “How long have you been in the trade?” “Have you done commercial or industrial painting, or both?” “Are you comfortable using an aerial lift?” “Are you OSHA 10 or OSHA 30 certified?”

Why ask these questions? I needed to make sure the applicant had the required skills to perform the work in a safe, productive and high-quality manner before making an employment offer. Making a bad employment decision could possibly harm the individual, their fellow employees, company equipment and the company’s reputation.

After an employment offer was made and accepted, my focus shifted to placing the new employee where their skills met the required need. In my mind, it was a matter of putting the right person in the right place in order to get a project completed safely, productively, with high quality and on schedule. As job requirements changed, the use of labor remained a high focus.

One thing I didn’t always think about was the fact that there is much more to an employee than just technical skills. With continual pressure of getting a project done and staying on schedule, it was sometimes easy to forget the employee’s personal needs. If a job required overtime, I directed the crew to work overtime. If a job required the crew to work a different shift, I directed the crew to work a different shift. Sound familiar?

Regular readers of my blog may already see what’s wrong with that picture. By not addressing the personal needs of our employees working on a job, I put safety, productivity and quality at risk without even knowing it. Here’s an example. When I directed a crew to work a second shift, or 12 hour days, what impact did that have on an employee who met regularly with their therapist after their normal, eight hour shift? What impact did that have with employees needing a regular routine of eating and sleep to maintain their mental health? How did these directives impact the families of these employees?

Eventually, I learned it was beneficial for all parties to ask about the impact a change in job shift or job hours might have on each individual working the project. I also learned to give each employee permission to say they would not be able to meet the change in job schedule if it would have a negative impact on them or their family.

You might ask, “Who is running the business - you or the employees?” I was still running the business, I just discovered that employee morale, safety, work quality, productivity and company loyalty increased when I began focusing on the employees’ mental health.

We would never knowlingly want an employee to work in an aerial lift if they were afraid of heights, because we wouldn’t want them to be injured or injure someone else. In that same line of thought, we shouldn’t put an employee in a situation that will endanger their mental health. We need to ensure the safety and mental health of each employee is valued.


August 2019 - Hitting Lofty Goals: Lessons Learned from Changing our Safety Culture

Download as a PDF

If you’ve read any of my previous blog posts, you know that one of the key points I make is that mental health issues should be treated the same as physical issues. Our society is slowly but surely coming around to this viewpoint, but one need look no further than health benefits for an example of this issue.

Many of humanity’s greatest achievements began with a huge, audacious goal that seemed impossible. One of the most famous such goals was President Kennedy’s goal of landing a man safely on the moon in the span of 10 years. That goal was achieved with time to spare. Our own construction industry has also seen lofty goals set and reached.

The construction industry I entered in the 1960’s drastically changed over my 45-year career, especially in regards to safety. When I entered the industry, jobsite injuries and fatalities were considered a given due to the inherent hazards. By the 1980’s, jobsite fatalities were no longer considered acceptable and zero injury campaigns began. Fast forward to today: jobsite injuries are no longer considered acceptable, and the focus is now on zero near misses. There was a culture change; the cost and loss of valuable human resources became the focus of labor and management.

Initially there was an acknowledgement that the status quo was not acceptable and the well-being of employees and union members became a priority. Hazard analysis, the use of personal protective equipment and the use of other safety equipment became standard operating procedures. Today it is common for many companies to have zero injuries throughout a span of more than one year. Our industry set a lofty goal and attained it. 

What would happen if the same process was used to attain zero suicides in the construction industry? Out of all industries, construction has the most suicides and the highest suicide rate. Our industry’s suicide rate is four times greater than the general population. We should all be outraged by our industry’s suicide epidemic.

Last month I talked about the importance of all employees having access to mental health benefits. It is also important for you to promote the creation of a culture where employees can talk openly about mental illness, substance use and suicidal thoughts. As business owners, are you providing a climate where it’s okay to talk about these issues without judgement or negative consequences? Do you have a return to work program for these issues similar to that of physical ailments? 

As an industry let’s begin by stating that suicide deaths are unacceptable. September is Suicide Prevention Month and Sept. 10 is World Suicide Prevention Day. We changed the safety culture, now lets change the mental health culture. Everyone needs to know and believe it is acceptable to seek help, and everyone needs to be supported when they seek help.


July 2019 - What Health Benefits Do You Provide Your Employees?

Download as a PDF

If you’ve read any of my previous blog posts, you know that one of the key points I make is that mental health issues should be treated the same as physical issues. Our society is slowly but surely coming around to this viewpoint, but one need look no further than health benefits for an example of this issue.

Prior to 2008, healthcare benefits for mental health issues were rarely offered, and when they were, the benefits were far less than those provided for physical health issues. In 2008, Congress passed the Paul Wellstone and Peter Domenici Mental Health  Parity and Addiction Equity Act (MHPAEA). 

One of the law’s key provisions requires that when mental health benefits are included, they must be equal to the benefits provided for physical issues. This would include the inpatient and outpatient network of providers and services, residential treatment, prescription drugs, co-pays, deductibles, maxmimum out-of-pocket deductibles and provider reimbursement rates. 

While the law was a major step in the right direction, one of it’s biggest weaknesses is that the inclusion of mental health benefits in group insurance plans are optional. Unfortunately, many states don’t require the inclusion of mental health coverage or only allow for a limited degree of mental health coverage. That said, as signatory contractors, we understand the value in going above and beyond the minimum requirements.

What coverage do you provide for your employees? Are your employees provided full and equal coverage for both physical and mental health issues? If not, why? Unfortunately, there are generally cost savings in the premium when mental health coverage is not provided or is limited to certain mental illnesses. That gets back to the issue of mental health issues being perceived differently. I would ask you, why would an employees’ mental health issues be considered less important than a physical issue? They’re both health issues that arise from sort of illness or injury.

Even with good healthcare coverage, it is often difficult to receive adequate and readily available mental health services due to a general lack of psychiatrists, psychologists, substance use facilities and mental health facilities. A new patient will often wait up to two months to get an appointment with a psychiatrist; in rural areas, the access to these services can be even more difficult. These barriers combined with the stigma and shame regarding mental illnesses often lead to a person not getting the help he or she needs. 

The next thing I’d like you to consider regarding health benefits your company provides is how your company accomodates and supports employees with mental health issues. Is it the same as those with a physical illness? For example, you would give someone time off to go see a doctor about a broken arm. Would your company do the same for someone needing to go to a therapy appointment? How does your company accomodate individuals and their duties under the care of medical providers? Many companies have a light duty return to work protocol for physical injuiries; does your company have a similar protocal for an employee returning from an in-patient substance use program? I would argue they both are the results of illnesses, and thus, they should receive the same level of support.

Comprehensive health coverage is a foundation that enables all employees to be productive in the workplace. A skilled and trained work force is essential for any company to be successful, but it is also essential for employees to receive the care and support they need as mental and physical health issues arise. We all have a role in ensuring the overall wellness of those who work in our industries.


June 2019 - Help is on the Way

Download as a PDF

With untreated or undertreated mental illnesses, opioid and suicide deaths increasing, it’s easy to become disheartened. Don’t be. This is a big problem in our industry, but we can make progress towards change. Change can be accomplished when we: 1.) Acknowledge that opioid and suicide deaths are a problem for our industry. 2.) Become better informed on this problem. 3.) Collectively address the problem as an industry. Our industry has slowly acknowledging there is a problem (the construction industry has the highest rate of suicide and the most suicide deaths of any industry.) Our next step is to become better informed.

To that end, two unique programs have recently been initiated in the finishing industry. The first is www.iupathelpinghand.com, an educational and outreach website created by the IUPAT. The second initiative is a Train the Trainer Class developed by the FTI titled Changing the Culture of Construction. This is a two-day course being conducted at the FTI’s training center in Hanover, Maryland. This initiative was the result of a work group consisting of FCA contractors and IUPAT members. The initial class was conducted in November 2018, and the most recent class was conducted this month. There have been a total of 35 attendees, including apprenticeship instructors, local training directors and local IUPAT representatives from 13 District Councils throughout the United States.

The class is being conducted by representatives of a well-established Allied Trades Assistance Program and myself. Attendees receive an overview of numerous topics, including a review of: how an Employee Assistance Program (EAP) works, the disease of alcoholism, substance use disorder and common drugs used, and treatment options. Attendees also receive an overview on mental illness and suicide prevention. After completing the course, attendees return to their local areas equipped to conduct training in their local training centers. Attendees are also able to better identify and reach out to an apprentice or union member who might need individual support.

The next class is scheduled for Sept. 24 and 25. To date, the following District Councils have had representatives attend this course: DC 4, DC 5, DC 16, DC 21, DC 35, DC 36, DC 39, DC 51, DC 58, DC 77, DC 78 and DC 82.

Please encourage a representative to attend if your area has not previously had an attendee. Contractors and their employees are welcome, reach out to your local BM/ST to learn more. Also, encourage training to be initiated at your local level. This is an industry issue and not solely the responsibility of either labor or management.


May 2019 - Living with a Mental Illness
Download as a PDF

As I’ve said in the past, all illnesses (including mental illnesses) are on a continuum of severity.  All illnesses will exhibit improvement and decline, often without any noticeable reason. Illnesses are no one’s fault, and the person living with the illness does not want it. A distinction with mental illnesses is that the afflicted person doesn’t exhibit any visible signs and usually masks their illness in shame.

A few months ago, I received an anonymous email through a friend providing a description of what it is like living with a mental illness. The email is lengthy, so I’m only providing selected portions to provide some insight. The email’s writer uses mounting and continuous snow as a means to describe what it feels like to live with a mental illness in the following words:

“Some days it’s only a couple of inches. It’s a pain and you still make it to work; but it is still snowing and who knows how bad it might get tonight, so you leave work early, and head home.

Some days it snows a foot. You spend an hour shoveling out your driveway and you’re late to work. Your back and hands hurt from all of the shoveling. You leave work early again because it is really snowing.

Some days it snows four feet, and you shovel all morning but your street never gets plowed. You are not making it to work, or anywhere else for that matter. You are so sore and tired, so you just go back to bed. By the time you wake up, all of your shoveling has filled back in with snow. People have called from work, but you don’t feel like calling them back because you’re too tired from all of the shoveling. Plus they don’t get this much snow at their house so they don’t understand why you are still stuck at home. They just think that you are lazy or weak, although they rarely come out and say it.

When it snows all of the time, you get worn all the way down. You get tired of hurting all of the time from shoveling, but if you don’t shovel on the light days, it builds up to something unmanageable on the heavy days. The snow continues unconcerned if it buries you or the whole world.”

The message to everyone is grab a shovel, and help your neighbor in need. “Depression is blind chemistry and physics, like snow. Like the weather, it is a mindless process, powerful and unpredictable with great potential for harm.” That said, we are not helpless. If we take action at every level, we can stop losing so many people to these illnesess.

 

Let’s end the silence, and open the door to having open dialogue about mental illness without any judgement. IT’S AN ILLNESS!

 


April 2019 - How is your Mental Health Today?

Download as a PDF

Prior to meeting with a doctor, you often have to fill out a brief questionnaire asking you to assess your overall mental and physical health on a scale of one to 10. If we did this every day, it would be clear that our mental and physical health fluctuate; this is quite natural. The events and environment of any day can greatly impact how we feel physically and mentally. Have you ever noticed you can feel better on a warm, sunny day rather than a cold, cloudy day? Do you feel better on a Friday afternoon rather than a Monday morning? Our physical health is about our body, and our mental health is about how we think and feel. They are obviously interrelated.

With May being Mental Health Awareness Month, I want to discuss mental health further. First of all, mental health and mental illnesses are two different phenomenon. Let’s first describe mental health. Mental health includes our emotional, psychological, and social well-being. It affects how we handle stress, relate to others and make choices. Mental health is something that everyone has, it is intrinsically related to our physical health, it’s changeable and we need to pay attention to it. Our overall mental health is impacted by sleep quality, diet, exercise and stress. You may notice that the same items are key to our overall physical health. 

How does a mental illness differ from our overall mental health? A mental illness is a disease of the brain that causes mild to severe disturbance in thought or behavior that results in an inability to cope with life’s ordinary demands and routines. Like all physical illnesses, mental illnesses are on a continuum of severity. People with a mental illness are able to function quite well with the proper care. The term for that condition is “being in recovery.” 

During the month of May, I challenge you to examine your company’s culture. Is the overall mental health of each employee a top priority each day? Is it safe and ok for employees to discuss their health concerns? If not, why? Are resources readily available for employees to address their mental health concerns?

A beginning step every company can take to protect its employees’ mental health is to cultivate an environment that encourages and allows employees to talk about their mental health. Let me close with a highly relevant quote from Mr. Rogers, “Anything that’s human is mentionable, and anything that is mentionable can be manageable. When we can talk about our feelings, they become less over-whelming, less upsetting and less scary.” 


March 2019 - Protecting Our Youth from Suicide
Download as a PDF

The competition during March Madness is intense, and there is only one champion. In life, while the competition can be intense, we all have the opportunity to be successful. During a recent presentation to a group of construction union members and their families, I was reminded about an all too often negative consequence of this intense competition in life.

A young middle school male approached me after my presentation to tell me he had very strong suicidal thoughts recently due to persistent bullying at school. He assured me he is now getting the support he needs. I reminded him he is a valuable young man, and he doesn’t need the approval of anyone else.

After this experience, I began to wonder how many of our youth are impacted by strong verbal and electronic messages from bullies and other messages giving them the perception that they are not valuable. I decided to look into it, and here’s what I found.

Suicide was the second leading cause of death among people ages 10 to 24 in 2016. A study conducted by the National Center for Injury Prevention and Control found: in 2013, 17 percent of the students surveyed for grades 9-12 seriously considered attempting suicide over the previous 12 months (22.4 percent for females and 11.6 percent for males). Additionally, 13.6 percent of the students made a plan on how they would attempt suicide over the previous 12 months, and 8 percent of students attempted suicide one or more times during that same period (10.6 percent for females and 5.4 percent for males).

I bring these sobering statistics to your attention, because while we often focus on adult suicides, our youth can also be the ones in danger. In this information age, we are inundated with many disturbing images that can give our youth the perception that the future is bleak.

Adults understand life is full of challenges, and through our experiences, we realize they can be overcome. Our youth, on the other hand, aren’t able to rely on this wealth of experience. We have all had extensive mentors including family members, and supporters from work, school, church, etc. to guide us along. We all have an opportunity to have a positive impact in the guidance of our youth. Remember it takes a village to raise a child.

 


February 2019 - You Can Make a Difference

Download as a PDF

In today’s information age, it’s easy to get overwhelmed by the vast extent of national and global issues. We are bombarded with so much information that it can often be difficult to comprehend how we can impact any of these issues. As a result, we can have a tendency to retreat to a flight scenario and just focus on our own individual and personal issues.

Suicide deaths are one such example where it can be easy to get overwhelmed by all the information and think there’s nothing we can personally do about it. In 2017, U.S. suicide deaths exceeded 47,000, which is a 33 percent increase since 1999. While that number is astronomical, the good news is that each of us has the ability to impact this crisis and save a life.

With so many of us having been impacted by the suicide death of a family member, friend, neighbor or fellow employee, I would invite you to consider how you can have a positive impact. What are some of the simple steps you can take?

  1. End the silence. Create an atmosphere where it is acceptable and safe to talk about mental illnesses as an illness of the brain. Silence creates a heavy burden for the person living with the illness and their family members.

  2. End the stigma and shame that surrounds mental illnesses and suicide. Due to shame, many individuals with mental illnesses either don't receive the treatment they need, or their treatment is delayed.

  3. Refrain from references of blame. It is not someone's fault if they have a mental illness.

  4. Use appropriate terminology regarding mental illness and suicide. The words we use have a powerful impact in shaping our attitude toward mental illness and suicide. Treat mental illness like the diseases they are and refer to them as such. Instead of saying, "he's bipolar," say "he lives with bipolar disorder." Instead of saying, "she committed suicide," say she "died by suicide."

  5. Show compassion and flexibility for someone living with a mental illness in the same manner you would for someone living with a physical illness. Remember that due to stigma and shame, an individual living with a mental illness will often disguise the pain he or she is experiencing.

  6. Understand there is a continuum with all illnesses from being a minor ailment to being a serious affliction. There is also a cycle to most illnesses - they are not static.

Now let’s think about some real life work situations and how we approach them. Often in the work environment when someone is away from work due to an illness or injury, a period of light duty or a flexible work schedule is implemented until the person returns to being 100 percent. In addition, fellow employees are usually supportive in assisting their fellow employee’s return to their normal work level. 

Understand the unique difficulties with being out of work for a mental illness such as anxiety disorder versus being out of work for cancer treatment. Both cases will require compassion and flexibility. In neither situation is the person pleased with their illness and the impact that it is having on their work performance. In which instance will fellow employees and the company typically exhibit more support and compassion? Why are they not the same? Hopefully by adopting the action steps listed above, the level of support for both of these employees will be the same.Now let’s think about some real life work situations and how we approach them. Often in the work environment when someone is away from work due to an illness or injury, a period of light duty or a flexible work schedule is implemented until the person returns to being 100 percent. In addition, fellow employees are usually supportive in assisting their fellow employee’s return to their normal work level. 

 

As Smokey Bear used to say, only you can prevent forest fires. Prevention of forest fires is the responsibility of each of us. The same applies to the prevention of suicide. Each of us has the ability and responsibility to prevent suicides. Take the time to save a life.

 


December 2018 - The Impact of Suicide on Loss Survivors

Download as a PDF

During the first few moments of most of my presentations, I ask the members of the audience to reflect on if and how have they been impacted by the suicide death of a family member, friend, neighbor, fellow employee, etc. Without exception, nearly 100 percent of the audience will acknowledge that they have been impacted by a suicide death. Many of us are suicide loss survivors.

During the past month, I have had three telephone conversations with members of our industry who are having difficulty coping with the suicide death of a friend or family member. Each of these instances highlight that the grieving process of a suicide death is unique. In addition to the normal stages of grieving which include denial, anger, bargaining, depression and acceptance, a suicide death often includes strong feelings of guilt. These feelings often are long term, and they may become a barrier to the normal grieving process.

On many occasions the non-physical issues later become public only after law enforcement personnel become involved. At that point the individual is typically blamed for their behavior without analysis of what prompted the behavior. There is a hesitancy to ask if the behavior was caused by a mental health issue, especially in male-dominated industries such as sports and construction.

I can use my own experience as an example of the effect suicide has on the grieving process. I have not experienced any guilt from my parents’ deaths. In each case, medical benchmarks indicated life could not be sustained. However, with my oldest son, I still face periodic uncertainty as to what else could have been done. My faith in a loving God has allowed me to move on, but even after nearly ten years, feelings of guilt occassionally occurs.

As we consider mental health and the impacts of suicide deaths, it is paramount that we also remember how a suicide affects those around the individual that was lost. It’s important to remember that the effects on loss survivors, whether they are family, a friend or a coworker, can be devastating and long lasting. The pain and guilt is not easy to get past, but we can help by offering our understanding and a friendly ear.


September 2018 - The Differing Perceptions of Physical and Mental Illness
Download as a PDF

The NFL season has begun, and every Monday morning each team reports any new injuries and players physically unable to practice. On the other hand, in the event of non-physical issues, teams typically state that the player is unable to practice for non-specified reasons. Why are physical and non-physical issues treated differently?

On many occasions the non-physical issues later become public only after law enforcement personnel become involved. At that point the individual is typically blamed for their behavior without analysis of what prompted the behavior. There is a hesitancy to ask if the behavior was caused by a mental health issue, especially in male-dominated industries such as sports and construction.

Recently, the Minnesota Vikings excluded Everson Griffin from practicing because of his behavior. As his behavior became more serious, law enforcement personnel became involved. Thankfully, Everson is now getting the medical care that he needs. I am very relieved that this situation didn’t result in a suicide attempt.

In my opinion, Everson’s unusual behavior was a cry for help. Rather than being excluded from practicing with his team, he needed medical care. Two years ago a quarterback for the Minnesota Vikings, by the name of Teddy Bridgewater, tore his ACL in practice and he was immediately transported to a hospital. Everson’s medical condition required the same immediate medical care. Unfortunately, the stigma and shame of mental illness continues to hold back impacted individuals from getting the care they need.

When an employee exhibits warning signs of a mental crisis (such as what I’ve discussed in previous blogs), treat it in the same manner as if it were a serious physical injury. It is critical to stay with the individual until trained personnel are contacted and available to assess the situation, and determine the care required.


August 2018 - What to do After a Mental Crisis is Averted
Download as a PDF

Last month I discussed how to respond to someone having a mental crisis; let’s discuss this matter a little further. How should you respond to a fellow employee once the crisis has been addressed? The same way you would if he or she had passed out and medical personnel were required. In both instances, the employee’s care and well being is the primary concern along with their personal privacy.

It is critical that the employee is treated in the same manner as if they had a physical incident. This might include things such as financial and non-financial support until the employee can return to work; and flexibility in work schedule or light duty upon the employee's return to work. Remember that with physical ailments, the issue is visible; this is not the case with mental ailments.

You may have heard the saying that we may forget what someone says or does, but we will never forget how someone makes us feel. I have a prime example of that regarding a workplace injury I incurred in the early 1970's. At the time, I was teaching painting and decorating at a vocational school when I had lacquer splashed in my left eye. I couldn't see clearly out of my left eye for a few days. When I returned to work, the school Superintendent took the time to visit with me and find out how I was doing. While I don't remember what exactly he said, I will never forget how he made me feel. To the Superintendent, I was more than just an employee. He genuinely cared about my well-being.

In today's high tech world, it is easy to forget that we all yearn for that personal contact. This is especially true after a mental health incident. As with any safety and health incident, there shouldn't be any judgement. The priority is to restore the employee to full health and well being.

Author's Note/Request
It is hard to believe, but this is the 12th blog since this venture began last September. Now I have some questions for you. What have you found most helpful so far? What other mental health topics would you like discussed? How have you used this information, and how can this blog be more beneficial for you? Your input and comments are welcome and will be helpful in writing future blogs, and they can be sent to 
rswanson@finishingcontractors.org.



July 2018 - How to Respond to Someone in a Mental Crisis

Download as a PDF

Last month, I discussed common warning signs of someone having a mental crisis and possibly being suicidal. There are two important things to keep in mind: due to shame and stigma, individuals having suicidal thoughts often appear quite normal. Additionally, unlike physical illnesses, the warning signs that an individual is having suicidal thoughts may not always be clear and visible.

If you’ve noticed any verbal, behavioral or situational clues, take them seriously. It is important to remember that your positive and caring action may save a life. If you are concerned about someone’s well being and personal safety, don’t ignore that impulse; act on it. Now you may be asking yourself... What should I do if I pick up on these signs and clues? How can I help someone who is having a mental crisis?

For starters, have a private one-on-one conversation. In an ideal world, a mental health problem would be viewed no differently than a physical one. Unfortunately, that is not often the case. Once you get the individual alone, you can start the conversation by saying, 

“I’m concerned about the recent changes in your behavior and some of the statements you’ve made recently. I care about you, and I’m here to listen and help.”

Often, this is all it takes for the individual to open up and talk. Make sure the conversation isn’t rushed, and that you are really listening. There should be no judgement based on what is said. If the individual is reluctant to talk, patience and persistance are your allies. Once trust is established, it is imperative to ask some critical and difficult questions, such as: “Are you having suicidal thoughts,” “Are you thinking of killing yourself,” or “Are you thinking of ending your life?”

There are a few questions and statements you should not ask, since they imply judgement and increase shame. These would include the following: “You’re not suicidal are you,” or “I hope that you aren’t planning to do anything stupid like ending your life.” Also do not ask, “Are you thinking of hurting yourself?” A person in this situation is not thinking of hurting themselves. They want to end their pain; their remedy to end the pain is suicide.

If at this point you are convinced that the person is having suicidal thoughts and is a possible danger to themselves, do not leave them alone. Ask if they are willing to get some help, and stress that you are there for them. Since you are likely not trained as a mental health professional, getting additional help is critical. 

It is essential to have the person’s approval for getting outside help.

How things proceed from here depends on each situation. For a moment compare this to a person bleeding.  For a minor cut, only first aid is required. However, for major bleeding, immediate medical care is required. If the person has indicated having suicidal thoughts, contact the national suicide prevention line at 800-273-TALK. 

The Suicide Prevention Line is a 24/7 resource staffed by trained professionals. If a lethal device is present and imminent physical harm is possible, call 911 and ask for a Crisis Intervention Team (CIT). They have been trained to handle these type of situations.

Identifying the warning signs of suicide is difficult, but knowing how to respond when you spot them in someone is extremely important. You can save a life by having a non-judgemental conversation with someone and helping them get help.



June 2018 - The Warning Signs of Suicide

Download as a PDF

It is estimated there are well over 1 million attempted suicides in the United States each year. There are nearly 700,000 visits to hospital emergency rooms each year due to a suicide attempt. As a result of the stigma and shame of suicide, many attempts are unreported or misreported. Approximately 90 percent of those who attempt suicide will not make a further attempt. Attempted suicides, however, do have a lasting impact on the person involved, their family, friends and coworkers.

There are many clues of an impending suicide, and all of these clues should be taken very seriously. Some clues are subtle cries for help, and others are more obvious. A subtle clue might be the statement, “Who cares if I’m dead anyway,” or “I’m tired of life and I just can’t go on.” A more direct clue might be the statement, “I wish I were dead,” or “I’ve decided to kill myself.”

In addition to statements such as these, many times there are noticeable changes in a person’s behavior such as the following:

  • Increased use of alcohol or drugs
  • Acting anxious, agitated or reckless
  • Sleeping too little or too much
  • Withdrawing from family or friends
  • Decreased productivity
  • Decreased problem solving ability

All of these clues exhibit a loss of hope in the future. In addition, a recent report from the Center for Disease Control (CDC) indicated that 29.4 percent of suicides in 2015 took place within two weeks of a life-changing event relating to a partner relationship, a health issue, a financial issue or a job-related issue. These type of events exhibit not only a loss of hope in the future but also a loss of individual control.

When we notice a person is bleeding or having difficulty breathing, it is obvious they are having a crisis and immediate action is required. Unfortunately, signs of a mental crisis are not as noticeable, but immediate action is still required. Hopefully you will now be more aware of some warning signs of a potential suicide. In next month’s blog, I will discuss possible action steps for you to take.


May 2018 - Suicide is Preventable

Download as a PDF

Suicides are having a major impact on our society and our industry. Here are a few facts to consider:

  • In 2016 there were 44,965 suicide deaths in the United States. That is nearly the combined total of homicide and traffic accident deaths in that same year.
  • Males are 78 percent of the total suicide deaths, and it is the second leading cause of death among males 25 to 54. This age group is a major portion of our workforce.
  • As I’ve stated before, the construction industry has more suicides than any other industry.

In order to address the issue of suicide, we need to dispel two common myths. The first myth is that a person talking about ending their life isn’t serious, or they are just trying to get attention. If someone is talking in that manner, they are thinking of ending their life, and they should be taken very seriously.

The second myth is that once a person has decided to end their life, nothing can be done. If at this point, action by anyone can prevent a suicide and save a life. There are three elements to a suicide: ideation, plan and action. 

  1. Ideation is having the idea. 
  2. Plan is developing a plan. 
  3. Action is implementing the plan. 

The action step can often be triggered quickly (minutes, hours or a few days). However, any individual who is aware of the warning signs of a suicide can intercede before the action step occurs. 

Remember suicides are preventable!

In next month’s blog I will discuss common clues and warning signs of a possible suicide.


April 2018 - Training Saves Lives
Download as a PDF

For many years, only medical personnel were capable of responding to someone who stopped breathing. That was before non-medical personnel were trained in cardiopulmonary resuscitation (CPR). Because of this training, many of us are now able to initiate CPR and possibly save a life before first responders arrive. In this case, knowledge and training provide non-medical personnel the ability to take immediate action in the event of a medical crisis and possibly save a life.

Regarding, suicide prevention, each of us can help save lives by being trained in Question, Persuade, Refer (QPR). QPR trains average people like you and me to take action prior to the arrival of first responders when someone is having a serious life and death mental crisis. QPR is a one-hour course provided by many local chapters of the National Alliance on Mental Illness (NAMI) and the QPR Institute.

I completed my certification to teach this course in May of 2016, and I have since had the opportunity to instruct hundreds of “gate keepers.” Gate keepers are individuals who have been trained to prevent someone with sucidal tendencies from acting on those thoughts before a crisis intervention team of specially trained first responders can arrive.

In future blogs, I will further explain some of the following key points included in QPR training:

  • Suicide myths and facts
  • Suicide clues and warning signs
  • Tips for asking the suicide question (and how not to ask)
  • How to persuade someone to stay alive
  • Resources for help

Remember: suicides are preventable. You may find yourself in a crisis situation some day, and QPR training could help save a life.


March 2018 - How Changing Your Culture Can Strengthen Your Company

Download as a PDF

To fully support employees who are living with a mental illness, addiction or suicidal thoughts, you need to change your company culture. How does one create a new company culture? First, management must be fully committed, and be willing to, “walk the walk,” not just “talk the talk.” Are your employees the most important part of your company? Do you care for your employees as only employees, or are they part of your company family?

Once you’ve initiated the culture change, the next step is to create a safe environment where it is not only okay to ask for help when there is a need, but it is considered a sign of strength. There should be no judgment from you or anyone else. The focus must be on listening and providing support and resources – not on telling someone what to do. Trust, honesty and confidentiality are absolutely required.

Next, provide educational opportunities regarding numerous topics such as mental illness, addiction, suicide prevention, financial management and planning, adolescent behavior, personal relations, etc. This could include payroll inserts, toolbox talks, and reference to your company and industry Employee Assistance Programs (EAP). Knowledge is powerful.

The old adage that “my personal problems don’t impact my work” is totally false. We are whole beings, and what happens outside of work impacts our work performance. Furthermore what happens at work impacts our personal lives.

After you have created a caring culture and a safe environment, you will find that employees will be more willing to let you know why they are struggling, and why their performance is not what both you and they desire. The net result is that performance issues get resolved, and you can avoid terminating a good employee who happens to be dealing with difficult issues. Not only will that employee be more productive, but the loyalty and dedication of that employee will be extensive.

In my previous work life of “old Bob,” it was common to address an employee performance problem by telling the employee to get their s*** together, or they would be terminated. I slowly discovered a much more effective way to address this issue by having a one-on-one discussion with the employee with genuine concern.

Here’s an example on how to start that conversation: “Lately, I’ve noticed a distinct change in your attitude, your behavior, and your performance, and I’m very concerned about this. You are a valuable employee, and it appears something is having a negative impact on you. Are you aware of anything that could have caused this change? Would you like to discuss this with me, or would you like to use our EAP program? How can I be of help?” Not only you, but all of your supervisors need to be able to interact in a similar manner.

You have safety programs to ensure that your employees return home each day without injury. A caring culture will ensure that your employees are at the top of their “A game” each day. As with a good safety program, this doesn’t ultimately cost money, but it saves money and lives.


February 2018 - Creating a Culture to Break the Silence

Download as a PDF

During the past three months, four FCA members have contacted me to discuss their daily journey with a family member living with a mental illness. In just the last month, two construction industry executives have contacted me regarding the suicide death of an employee. These calls are troubling, but I am encouraged that we are “breaking the silence.” A key to moving forward is providing an atmosphere in each of your companies where it is safe to talk about mental illness, addiction and suicide.

Employees living with a mental illness, addiction or suicidal thoughts need the full support of their employer. Over 60 percent of those who live with these illnesses never receive the treatment they deserve due to shame, stigma and fear of jeopardizing their employment. Would one of your employees have those same concerns if they had a serious physical illness? There shouldn’t be any difference in the support our employers and industry provides.

Mental illnesses don’t just impact the individual living with them, but those around them as well. Employees who are caregivers also require the full support of their employer. A caregiver of someone with a mental illness (including addiction) lives with a great deal of shame and guilt that a caregiver of someone with a physical illness doesn’t experience. It is therefore more difficult for such a caregiver to ask for help.

When tragedy strikes and an employee dies by suicide, that impact lingers for a long time. Fellow employees will often be troubled trying to understand what happened and why, and some employees may even be haunted by what they could have done to prevent it. Additionally, the immediate family of the deceased employee will be burdened by shame, blame and guilt in addition to the normal feelings of grief.

It has been my experience that our industry has a culture of “suck it up” and “get the job done.” This applies to both field and office employees, and to the boss. I spent much of my career impacted by this thinking.

Instead of solely observing individual performance, I suggest it is critical to ask why the performance of an employee is changing. A company culture that creates a safe environment for an employee to seek help, and a culture that encourages supervisors to address performance issues in a new way will increase productivity, work quality, safe work practices and employee loyalty. I will further discuss a new way for our industry to address this issue next month.


January 2018 - Why Are There So Many Suicides in the Construction Industry?

Download as a PDF

In 2016, there were nearly 45,000 suicide deaths in the United States. This is an increase of 35 percent in the past ten years. It is also estimated that there are up to 25 suicide attempts for each suicide death.

The construction industry has the second highest suicide rate per industry. The suicide rate of our industry is 53 per 100,000, which is four times the rate of the general population. However, with the total number of individuals in construction, our industry has more suicide deaths than any other industry.

What contributes to this high rate of suicide in our industry?

  • Our industry is customer driven, which means overnight travel, shift work, weekend work and long hours are often required. These factors all impact personal relationships, normal sleep and diet. They also affect the ability to maintain normal external support systems.
  • Seasonal work and project-specific employment creates financial insecurity and personal uncertainty.
  • Long-term, repetitive physical work often results in chronic pain, which can lead to the regular use of prescription medications and self medication. This can lead to an addiction to alcohol and/or drugs.
  • There is a general acceptance in our industry of the regular use of alcohol and/or drugs.
  • Use of a firearm is a common means of suicide, and many in our industry own firearms because they enjoy hunting and shooting.
  • An "old school, tough guy" persona is prevalent in our male-dominated industry. Due to this persona, employees are less likely to show any vulnerability or seek help.

It is essential for each of us to achieve a reasonable life balance of a healthy diet, adequate sleep, regular exercise and stable personal relationships. For a person living with a mental illness, a reasonable life balance is absolutely critical in preventing the onset of a mental crisis.

In the next few months, I will be suggesting industry practices you can adopt to help identify and assist a colleague who may be living with a mental illness or experiencing a mental crisis.

Remember that all mental illnesses are treatable and suicide is preventable!


December 2017 - Mental Illness vs. Physical Illness - Why Do We Perceive Differently?
Download as a PDF

Webster's New World College Dictionary defines an illness as, "The condition of being ill, or in poor health; sickness, disease." Note that the definition does not distinguish between mental or physical. Yet, still too often, we consider mental illnesses differently than physical illnesses. Why is that?

Part of the answer is that physical illnesses can generally be identified and measured. There are clear symptoms doctors are able to diagnose. Mental illnesses, on the other hand, are generally diagnosed by behavioral traits. There aren't consistent physical measurements that are readily identifiable, which often leads us to blaming the person living with the illness for not getting well. Believe it or not, individuals living with mental illness all too often embrace the blame for their condition. You rarely (if ever) see that in people with physical illnesses.

Mental illnesses are a result of a disruption to the normal function of the brain, and that's what makes them so hard to identify. The brain is one of the most important components of the body. We need to treat illnesses of the brain the same as we treat any other physical illness. Just like any other disease, there are varying ranges for the severity of a mental illness and treatment options. There are no cookie cutter solutions out there for these complicated diseases.

Our society has told us that people need to be stronger, they should be able to get past their problems and if they can't, it's a sign of mental weakness. That's why it's so easy to think of those living with mental illnesses differently. But that's the wrong line of thinking. It's time we start treating people living with mental and physical illnesses in the same manner.

Finally, one of the most important things to remember is this: not one person has chosen to live with a mental illness; it is not their fault.


November 2017 - Happy Holidays for Some, Not All

Download as a PDF

The traditional holidays of Thanksgiving, Hanukkah, Christmas and New Years will soon be upon us. The general expectation is these holidays will be festive family and friend gatherings. However, for those living with mental illnesses this is not always the case. Holidays can bring increased anxiety and depression. Instead of feeling joy, those living with mental illnesses may feel dread.

This will also be a challenging time for those who are in recovery for substance abuse. Those who live with a mental illness require a unique balance of diet, exercise and sleep. As we all know, the holidays can disrupt normal routines and bring added stress.

The holidays are also a time of reflection and a feeling of loneliness for those who have lost loved ones, especially in the instances of suicide and drug overdose. Guilt and shame can be a recurring dark cloud during this time.

During the busyness of these holidays, pay special attention to those who are having difficulty. A caring word will penetrate the lonely journey that mental illness and substance abuse involves.

When we typically ask someone, “How are you doing?” have we created the condition for an honest response?

Remember that a person living with mental illness or substance abuse often hides their pain and shame by physically looking okay, and verbally saying that they are okay.

Enjoy these holidays, and realize that these are difficult times for many people.


October 2017 - Updating Our Terminology for Those Hidden in Plain Sight

Most people who live with a mental health condition are active and productive members of our society. Due to a lack of visible, physical signs of a health condition, we are often not aware that a family member, friend or colleague is living with a mental health condition. Furthermore, because of stigma and shame, the person will often deny the presence of any mental health condition when asked; and therefore not seek the care they need.

A starting point in addressing the issues of mental health and suicide is to change our terminology. A change in terminology enables us to see these issues differently. Three examples are listed below:

Common Language Preferred Language
"He's bipolar." "He lives with bipolar disorder."
"She has a mental illness." "She lives with a mental health condition."
"He committed suicide." "He died by suicide." or "His death was caused by a brain disease."


What changes when using different terminology? When we say "he’s bipolar" or "she has a mental illness," we imply that it is the individual's fault. This affirms stigma and shame. With all physical illnesses, however, our terminology separates the person from the illness.

An example would be us typically saying "he has prostate cancer." Note how we don't say "he’s prostate cancer." This change in terminology places the blame on the disease instead of the individual for their health condition. Now let's examine the statement "she committed suicide." This statement places the blame on the individual, because they're the one who completed the act. However, the individual in this case had a mental health condition that caused her to lose all hope for continued life. We will reduce suicide deaths only when we focus on the root causes and stop laying the blame with the individual.

As with any change, the use of new terminology will seem awkward at first. However, it will change your perspective regarding mental health and suicide - give it a try.


September 2017 - Suicide Prevention Month

September is suicide prevention month, and it is also the beginning of my new monthly blog regarding mental health issues and suicide prevention. I am Bob Swanson, a retired commercial and industrial painting contractor from Minneapolis. I am also a loss survivor who lost our oldest son to suicide on March 13, 2009 at the age of 33. 

Besides my personal loss, why is this an important topic? First of all, suicide has impacted most of us. Secondly, more than 43,000 Americans will die by suicide this year, and the incidence of suicide in the construction industry is four times greater than the general population. In future blogs, I will be talking about many topics including the prevalence of mental illnesses such as depression and anxiety in our society, the shame of mental illnesses, the impact of negative terminology regarding mental illness, the impact of mental illness in the workplace and warning signs of suicide. 

Did you know that up to 25 percent of adults will experience a mental illness this year? In a recent webinar sponsored by Construction Financial Management Association (CFMA), 15 percent of the attendees indicated that they live with a mental illness, or they have experienced suicidal thoughts. In the same survey, 53 percent of the attendees indicated they have a family member living with a mental illness or a family member who has had suicidal thoughts. Because of the shame of mental illness, most people who live with a mental illness do not receive the care that they need. 

Knowledge regarding any problem is power. Please know that all mental illnesses are treatable, and suicide is preventable. Today is the time to accept nothing less than zero suicides in the construction industry.

©2020 FCA International. All Rights Reserved.