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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

 


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

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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?

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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

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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
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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?

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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
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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

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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

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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
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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
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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

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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

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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

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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
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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

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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

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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?

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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?
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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

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.

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