Tips for Construction Managers on Mental Health and Substance Abuse

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Logo: Travelers. Text: Construction in Crisis, Develop an Action Plan to Address Mental Health and Substance Use Disorder. Steve Beals appears in the upper right corner of the slide.

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STEVE BEALS: Hello. And welcome to today's webinar, Construction in Crisis -- Developing an Action Plan to Address Mental Health and Substance Use Disorders in the Industry. My name is Steve Beals. I'm a National Director, Large Construction Accounts at Travelers. And I'll be your host as we look at this critical issue.

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Text: This material does not amend, or otherwise affect, the provisions or coverages of any insurance policy or bond issued by Travelers. It is not a representation that coverage does or does not exist for any particular claim or loss under any such policy or bond. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy or bond provisions, and any applicable law. Availability of coverage referenced in this material can depend on underwriting qualifications and state regulations. The information provided in this material is intended as informational and is not intended as, nor does it constitute, legal, medical or professional advice or an endorsement or testimonial by Travelers for a particular product, service or company. Travelers does not warrant that adherence to, or compliance with, any recommendations, testimonials, best practices or guidelines will result in a particular outcome. In no event will Travelers, or any of its subsidiaries or affiliates, be liable in tort or in contract to anyone who has access to or uses this information for any purpose. Unless otherwise specified, no sponsorship, affiliation or endorsement relationship exists as between Travelers and any of the entities referenced in this presentation. © 2024 The Travelers Indemnity Company. All rights reserved. Travelers and the Travelers Umbrella logo are registered trademarks of The Travelers Indemnity Company in the U.S. and other countries. All other registered trademarks are the property of their respective owners. CONSTRUCTION IN CRISIS: MENTAL HEALTH AND SUBSTANCE USE DISORDER IN THE INDUSTRY.

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First, a little on our disclaimer. The information provided in this material is intended as informational and does not amend coverages or constitute legal or medical advice. Unless otherwise specified, no sponsorship, affiliation or endorsement exists between Travelers and any of the entities referenced in the presentation.

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Our Panel.

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I'm joined by a group of experts today who will share their experience and work around mental health challenges in the construction industry, including substance use disorders.

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Moderator Steve Beals, National Director, Large Construction, Accounts at Travelers. Panelist Michael Sharpe, Divisional Safety Director at Gilbane Building Company. Panelist Rob Labbe, Vice President, Risk Engineering at American Global, LLC. Panelist Doctor Marcos Iglesias, Vice President, Chief Medical Director at Travelers.

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We have joining us today Dr. Marcos Iglesias, Vice President and Chief Medical Director at Travelers.

We have Rob Labbe, Vice President, Risk Engineering, American Global. And we also have Michael Sharpe, Divisional Safety Director, Gilbane Building Company. Welcome to each of you.

We're here today to discuss the state of mental health in the construction industry, but even more importantly, to help destigmatize mental health conditions. We also want to share success stories and the programs and decisions that can lead to improved well-being for the people that are building our homes, our manufacturing plants, our infrastructure and our office buildings.

I also wanted to mention that today is World Mental Health Day, and there's an organization out there called WHO. And I would encourage everyone to learn more about this organization. If you have any questions, feel free to put them in the chat. We'll do our best to answer them at the end of the presentation.

Also, it will be recorded. So let's jump right into some of the questions for our panelists. And Dr. Iglesias, I'd like to begin with you. Can you share with us a quick look at the state of mental health and substance use disorder in the construction industry today?

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Doctor Marcos Iglesias.

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MARCOS IGLESIAS: Sure, Steve. Thanks for the honor of being here with this panel. It's an important topic. So let me start with the general population in the United States. And I have to say that right off the bat, the data are grim.

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The Current State.

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The 2022 National Survey on Drug Use and Health reports that 23% of adults in the United States experienced mental illness in that year.

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23% of the general population experienced a mental illness. Footnote 1.

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And just over 5% -- 5.5% of adults in the United States experienced a serious mental illness.

Now, a serious mental illness is a mental, behavioral or emotional disorder that results in serious functional impairment and limits major life activities. So think, for example, of how they function in the community, in the workplace or at home.

And not all demographics are affected equally.

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12% of those with a serious mental illness, adults age 18 to 25, were most likely to be affected. Footnote 2.

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Almost 12% of adults aged 18 to 25 and 8% of individuals 26 to 49 have a serious mental illness. In that same year in 2022, there were over 49,000 deaths by suicide in this country.

We also know that drug misuse, whether it's opioids, marijuana or alcohol, is common.

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48 plus million people aged 12 or older had a substance use disorder. Footnote 3. Footnotes 1, 2 and 3 Substance Abuse and Mental Health Services Administration, 2022 National Survey on Drug Use and Health.

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And there are almost 49 million individuals aged 12 or older -- that's 17% of that population -- with a substance use disorder.

I don't know how many of you caught this summer. But in the United States, we now have more daily marijuana users than daily alcohol users. That's significant. There's also a grave problem with drug overdose deaths. In 2022, we had almost 108,000 drug overdose deaths, most of those from synthetic opioids like fentanyl.

Now, what's going on in the construction industry? Remember, this industry has very physically demanding work, which not only increases the risk of musculoskeletal disorders.

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A look at the construction industry. A man gives a presentation to workers wearing construction hats and reflective vests.

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And there are higher rates of these disorders than in other industries. But these may then lead to chronic pain and also higher utilization of opioids, whether they're prescribed or not. We see a higher opioid overdose rate in these workers.

A WCRI, Workers Compensation Research Institute, study that was published about six years ago now reported that after a work-related injury, construction and also mining workers may be more likely to be prescribed an opioid than other industry groups. And additionally, use of nonprescription opioids, binge drinking, heavy alcohol use, other drugs is more common in the construction industry than in other industries.

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Steve Beals.

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STEVE BEALS: Thank you, Dr. Iglesias. Obviously, some alarming statistics there. Why is it so critical to address it here and now?

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Doctor Iglesias. Text: The Impact. A graphic depicts many spheres and planks precariously stacked on a base made of a cylinder, cube and cone.

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MARCOS IGLESIAS: Yeah, I think there are several reasons, Steve. Obviously, the human toll of mental illness, of substance misuse and suicide is significant not only for the sufferer but for the immediate family, for the community, for coworkers.

There are emotional costs as well, in addition to social, financial, occupational ones. We know, for example, that the cost to the U.S. economy every year for mental health issues has been estimated to be about $282 billion.

For an employer, for a contractor, these costs are not just for medical care. But they're seen also in higher absenteeism, decreased productivity, higher turnover. For example, a recent study showed that the number one reported case for missing work was mental health challenges, such as stress, anxiety and depression.

And additionally, mental health and well-being are part of our health. You really can't separate them. And many physical conditions, so think, for example, heart disease, chronic pain, fatigue, even things like diabetes, may be the result of or at least aggravated by stress, by depression, by poor sleep. And the relationship is bidirectional. Stress can cause these conditions, make them worse, but these physical conditions can also result in poor mental health. So it's important to look at the whole individual.

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Steve Beals.

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STEVE BEALS: Thank you, Dr. Iglesias, for that. Michael, is there anything that you would like to add?

MICHAEL SHARPE:

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Michael Sharpe.

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I would love to add something, Steve. First, I would just like to thank Travelers for the opportunity. But we are seeing the impacts firsthand within the construction industry.

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Text: Questions to Consider. How can we build connections and an empathic culture that empower employees to seek resources if they need it? How are these mental health resources shared? What is the 'tone' behind how these are shared? Who is leading the Mental Health conversation within our organizations? Are there actionable steps in place to help support a mental health program?

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There's been a lot of great progress and advancing the conversations with mental health and construction. But construction still stays atop in the suicide rates and substance misuse.

The challenges still ahead of us include a very male-dominated industry. There are a lot of amazing women within the industry. But men experiencing higher suicide rates affect that greatly.

There's a macho mentality. Toughness and strength are valued. Mental health conditions or seeking help may be signs of weakness. But I would like to challenge that. I think the macho mentality should be looked at as you're looking out for the people that you love, the people that you care about, the people that impact you every single day. So why wouldn't you want to share some challenges that you've had and how you've overcome them? I see that as macho, personally.

And then the stigma, shame, and fear judgment of seeking help. There can be a lot of shame around a death by suicide or an attempt, with the families, the person in general, and the people that are connected to it. Also, with the opioid epidemic, there's a lot of shame with that as well, with the people using, as well as the families.

There's a lot of impact on the families that there's a lot of shame, people saying things to you like, how could this happen? There's a lot of that that is really hurtful. And sometimes people just don't know how to respond.

And then support being vulnerable, share parts of ourselves to be relatable. I always think about, what public figures do you look up to? At least for me personally, I can't help but to talk about myself, is I look up to people that share themselves, that have -- want to make connections with people and have an understanding that their challenges could help someone else.

So when we're looking at these questions, how can we build connections and empathetic culture that empower employees to seek resources if they need it? So a few other questions onto that are, are we doing the best we can to support our employees? Do we know what our employees need? How are we showing them that we care?

Then the next question, how are these mental health resources shared? What is the tone behind how these are shared? Is there any shame or stigmatized language in these? Do they even know that it's available? We want people to find comfort in reaching out for help. And we want people to feel not alone, not broken, and that it is OK to ask for help, if needed.

Next one, who is leading the mental health conversation? Someone leading it, it should be someone that people trust, respect and look up to. It should start from the top down. Leaders need to support the company's journey. Be involved.

There are many ways to do this. And we'll discuss that further on in this webinar. Are there actionable steps in place to help support the mental health program. If there was a situation in your organization, is there internal support that can help your employees? Who is reviewing this program?

And be proactive. Don't wait to be reactionary. Just like any construction project, this will be constantly evolving. And then the goal, just to close this page, is to offer help and comfort people. We want to make people feel not so alone. Steve, back to you.

STEVE BEALS: Yes, some great points, Michael, and really being able to connect your people to your resources. Absolutely critical, so thank you for that. Marcos, a question for you. How are these issues impacted by the different generations all working in the workforce together?

MARCOS IGLESIAS: Yeah, that's a great question. And there really are two sides to the coin.

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Generational Differences. Three young workers in construction hats sit in a sunlit building under construction.

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First of all, younger adults are more likely to experience serious mental illness. And I referenced that 2022 study that points out that, especially those under the age of 49, but really the 18 to 25 age group, have a lot higher prevalence of serious mental illness.

I also mentioned the statistic about marijuana. And I'm very, very concerned about the negative health impact of increasing marijuana use, especially for that population, those individuals under the age of 25.

This age group, for example, is vaping marijuana at a much higher rate than older individuals. They're essentially inhaling much higher doses of THC. And these individuals are also at the highest risk for mental health challenges as a result.

We all know that the human brain doesn't really develop fully until the age of 25, so THC exposure to the brain may have serious consequences not only in the immediate period but down the line as well. And so this is a huge concern for me.

On the other hand, Generation Z, those individuals that were born after the year 2000, is much more open to talking about mental health problems and talking about mental health issues in general but also in themselves than older generations.

They report less social stigma. And so that's good. Reducing social stigma around mental health is important for all of us. And so I see a positive sign here. As the baby boomer generation retires, younger workers come into the workforce and into their ranks, I think they're bringing with them a culture of mental health awareness and also an expectation that we as employers should be providing mental health resources for them. So, again, that's the positive sign. And I think it's good.

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Steve Beals.

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STEVE BEALS: And, Dr. Iglesias, so what do you think is the outlook?

MARCOS IGLESIAS: Yeah, I'm hopeful, Steve.

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Text: The Outlook. A paved road stretches across a vast field.

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We've seen some positive signs, such as what I've just mentioned, younger individuals seeking mental health help, talking about mental health services positively.

As an industry, we've seen big changes in the past several years. Twenty years ago, there was a lot of resistance to even talking about mental being. And that's been changing. So I think we're on a good trajectory.

A whole person approach is very helpful. Mental health is health, as I mentioned earlier. There aren't two health approaches, the physical and the mental. And looking at individuals from a whole health perspective is something that we're adopting. So I'm very, very encouraged by that.

I think that as industry leaders, day-to-day managers, we can effect change when given the chance to develop this culture, a culture of care and developing plans of action. And that's really what this webinar is about. And I'm really excited to hear from Michael and Rob, a lot of the things that they've done and that they are doing. And we can all learn from them.

Thank you, Dr. Iglesias, for leading us into our next round of questions centered around the importance of leadership. Let's just take a look at the responsibility that leaders and managers have in their organization and addressing these issues with their teams. And, Rob, I'll shoot that one over to you.

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Rob Labbe.

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ROB LABBE: Sure. Thank you, Steve. And again, I'd like to say that it's a privilege to be here today with the members of this panel.

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Text: A top-down strategy. An icon titled Resources includes a hand holding a profile, a gear and money. An icon titled Education includes a light bulb within an open book. An icon titled Empowerment includes a clenched fist, with six people icons attached to it. An icon titled Empathy includes reciprocal arrows traveling to and from two heads facing each other. Text: People are our greatest asset.

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But, yeah, I'd like to talk about a top-down strategy. Management is very important in setting the tone. And it's often said that our people are our greatest asset. And we often forget about some of our assets with the stresses that we deal with on our jobs.

And it should also be noted that our best -- that our greatest assets are best when they're properly maintained. And I say this, but we need to do a better job at that. We often neglect our own health. And I believe we're all guilty of that.

Construction companies, they're often doing more with less, just stretching everything. And many of us rose up through the ranks by being that yes person. Yes, we can do it. Yes, we can do it. But I'm also hopeful because when it comes to leaders, there are many leaders that are supporting their people.

And some of the support can include setting aside the resources, the time, the money and the effort, and having the education available to raise awareness, as well as having the training available at all levels of the organization, and pushing back at times.

Sometimes we are asked as an industry to do something that's either extremely difficult. It's not necessary. And sometimes those leaders pushing back by not taking on that project because they don't have the resources to do it. So that's encouraging.

We talk about the word "vulnerable" at times. But leaders being vulnerable and sharing examples of their own struggles, getting out there, whether it's at the beginning of a meeting on a stand-down, on a jobsite, at a conference.

But leaders, I have been so encouraged by seeing some of these leaders talk about their own struggles and how they've overcome them or how they're dealing with them. I believe leaders, also looking at their employee assistance program -- and we'll talk a little bit about that further down in this webinar.

But employee assistance programs, they're great when they're used properly, when people use them and get the resources to them. But I think it's extremely important for leaders to understand what's in an EAP and even to call it to understand the experience that an employee would face.

Destigmatizing mental health challenges. I think that's really what I'd like to just talk about for a few minutes here. But first and foremost, it's about changing the culture to destigmatize the mental health. And it should be done with the plan.

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Destigmatize mental health challenges. A man meets with a professional who takes notes on a clipboard.

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Mental health and suicide prevention, it's a very, very challenging topic. And not everybody is comfortable about speaking about this topic. And a lot of people aren't comfortable speaking in public.

Most of us get anxious before we speak in public, no matter how much practice we've had. But sometimes there's training to prepare people to speak about this topic. And sometimes it's better when people just speak right from the heart rather than speaking right off a sheet.

But I want people to think about that because we may have a toolbox talk that we say, hey, the superintendent needs to talk about this tomorrow morning, or the foreman needs to talk about this with their crew. What if they're not comfortable? What if they don't express exactly everything that we're expecting them to express?

So maybe if we just train them a little bit, or prepared them, or if they're not comfortable, then maybe we do it ourselves. And one thing I just wanted to say was that years ago when I was speaking on a project, I wouldn't even tell the group of people what I was going to talk about ahead of time, because I didn't want them to close their mind and say, wow, this is going to be depressing, or make some sort of joke. And I know that jokes can be coping mechanisms.

But anyway, I think it's extremely important that we blast the message out there that even if you see some hardhat stickers or some of these hope coins, I think that just keeps pushing that message. I typically like to put up the banners after people speak so that message can keep going.

But also, I mentioned these hope coins. And I think the AGC of America has done a tremendous job of creating those. And a lot of people, including myself, have stolen that idea. But we know, hey, there are no secrets in safety. But thank you, Steve.

STEVE BEALS: Yeah, thank you, Rob. So a great message there around what leaders and managers can do. Michael, anything that you would like to add?

MICHAEL SHARPE: I would love to add something. So you want to lead with an empathetic and caring culture. And you're probably thinking to yourself, Mike, what does that mean?

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Text: The Company's Journey. Among many blue paper airplanes in flight, a red airplane soars ahead of the rest.

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So a caring culture is one in which leaders reinforce the importance of workers taking care of their mental health and well-being, as well as their physical safety in reaching out for help when needed.

Listen and respond. Understand employees within your company and what they need. Just like Rob has been saying about employees being our greatest asset, we want to make sure that we're looking out for them and we're continuing to support them.

Be authentic. People understand when someone's being authentic, so be authentic to yourself. Change the culture to destigmatize mental health challenges. We'll talk about that in a little bit, in a little more. Make people feel comfortable about asking for help. We have to realize that it takes a lot of courage for someone to come forward and ask for help, especially in the work environment.

The battle against shame, to be vulnerable, be relatable. So I like a researcher, Brené Brown. She's also a Ph.D. in social work, as well as a bunch of other things that I'm not giving her enough credit for. But I'm a big fan. And she has a quote that talks about vulnerability. And it says, "Vulnerability is the last thing I want to see -- for you to see in me. But it's the first thing I want to see in you."

I don't want to share what's bothering me, but I would love to know what's bothering you, and hopefully we connect over it. The power of storytelling is huge with that. What was your journey to get to this point?

As a leader, we all have journeys to get to a certain point we're at. And they're not all the same. So having courage to talk about where you've come from, your journey, your story can make it contagious throughout the entire company. And then people are sharing themselves with each other.

Mental health is as important as physical safety, just like Dr. Iglesias said. But we need to make sure that that's in the front of our minds and we have a conversation. We need to acknowledge that everyone has things that they struggle with. And it's OK to ask for help.

And leadership, being able to voice their own struggles. I can't talk about that enough. And I'm going to be redundant about it, probably. But having trouble sleeping could be a topic, having a stressful week outside of work. Do you have history of troubles with alcohol? Or are you in recovery? How has that helped you? Or what has helped you?

How they can help themselves with stress. What are some healthy escapes that you have? What supports you during tough times? Personally, I love music. Music has always been my escape. I was never gifted with any talent, unfortunately. But I love seeing live music. And I also like moving my body. I need to break a sweat. I need to get my heart rate up every single day.

Those are some things that are easy things to talk about. But people can connect to that because we all have things in life that help us get through the day and help us get through challenges. And it's important to commit to real, actionable steps. Do not sweep under the rug. And we'll talk about this more. And, Steve, I know it's coming back to me.

STEVE BEALS: Yeah, I'd like to talk about some of those actionable steps. What are the action items to consider when looking at the plan for mental wellness and substance use disorder in your company?

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Michael Sharpe. Text: Actionable Steps.

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MICHAEL SHARPE: So some actionable steps. Leadership engagement. So having active continuous leadership engagement is essential, not just checking the box, but what are you actually doing? Are we talking about this in every single meeting? Within Gilbane, we have Gilbane Cares moments start every single meeting. And it can be personal. It can be something within work. But we're sharing, engaging our folks.

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An icon above leadership engagement demonstrates one person helping another to climb a mountain. Text: Active and continuous leadership engagement is essential in breaking down barriers in addressing mental health and worker well-being.

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Open conversations about how therapy has helped in times of struggle. I have had therapy for different types of reasons. And it's helped me. And the more conversations with leaders talking about how it's helped them will continue that. But that engagement is huge. We need to be on the front lines talking to people and having those open conversations.

And then we're looking to raise awareness, being proactive, weaving mental health conversations into the work environment.

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An icon above Raising Awareness depicts two people having a conversation. Text: Weave mental health conversations into the work environment and be proactive in sharing resources.

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We'll talk about some vehicles for that. But toolbox talks, like Rob talked about, it is a great avenue for that, tying in what we have going on the project site that day, but also bringing it back to the real world.

Understanding, hey, there are resource groups. We have Narcan on-site. I don't think that's talked about enough. There's a conversation about how, oh, we don't need that in my house. There's a shame thing with that. But wouldn't you want that to save a life? I know I would.

And then creating a culture, immensely healthy organizational culture, caring culture, one that reinforces taking care of themselves.

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An icon above Creating Culture depicts four puzzle pieces coming together to create a glowing light bulb. Text: Organizational culture starts at the top. Leaders must recognize their role in helping workers feel valued and appreciated.

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It's OK not to be OK. Assessing the current state of how mental health are perceived within your organization.

The thing about perception is you can try your hardest to have great perception. But there's always going to be a few people that might not get that perception. But we want to make sure that we're reaching people. We're trying.

And how are these resources shared? Are they shared in a stigmatized fashion? What is the tone? Is it talking about how something's wrong with me, or is there something wrong with you? We want to really stay away from that?

And enhancing access.

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An icon above Enhancing Access depicts a spoked wheel beside a globe symbol. Text: What resources do we have for our employees and how are they communicated? Have leaders actually experienced them?

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What is the ease of use? When I call, am I clicking a bunch of buttons just to get to someone that's going to help me? Or am I having the understanding that I'm pressing one for English, and then I'm rocking and rolling?

But just don't wait for an emergency to see how the resources work. And we'll talk about what Gilbane has done in a little bit. But a thing that's been incredibly important to us is Gilbane has vetted all the resources, including the EAP.

And we have documents that we share with all of our employees to make sure that they know what is available to them. And if there's any ever questions about what's available to them, we have resources and groups within the company that will be able to help. And, Rob, do you have any other things to add on the stages of support?

ROB LABBE: Sure, absolutely. Yeah. And I'll pick up right there where you're talking about employee assistance programs.

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Stages of Support. A circle on the left titled Support has three off-shoots labeled Prevention, Intervention and Post-vention.

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And I think the first thing to say is that not all EAPs are created equally, and they're often expensive and underutilized.

And if your EAP is underutilized, it could be because the message just isn't out there. And when somebody needs something, they may be struggling with their current problems. They may not be able to really dig in and to find something.

So just like Michael says, the easier something is to use, the more likely people are going to use it. And it's going to be successful. I've spoken with many company leaders at different organizations that didn't really know much about their own EAPs. And it's important to know what they offer before you need them. It's important to know what they offer for your employees.

So you want to know that when your employee is struggling with something, and you have a benefit for them, that they can go right to that resource. And so one thing that I often do is I challenge managers from companies that have EAPs to look into their resources.

I challenge those managers to pick up the phone and call that EAP hotline so that they have a better understanding of what their employee would experience. We've already talked about some action steps regarding mental health and substance misuse and substance use disorder.

And I think we want to look at some of the different times that people would be looking for help. So we talk about prevention, intervention and postvention. And prevention would occur -- as far as a suicide attempt, it would occur prior to that. So that's prevention.

Raising awareness is part of the prevention process. And we can focus on those different types of resources that are out there. So they don't lead to an intervention or a postvention.

But an intervention would be the opportunity to contact a person that has a plan to die by suicide or somebody that's contemplating that. So that's where the intervention comes in to stop that process from happening.

And unfortunately, the next is a postvention. So postvention is the support that's provided after the suicide. Colleagues and family members and friends are often shocked during this time. And they need the resources to help them cope.

And some of these action steps in regard to substance use disorder in the workplace could be, well, promoting a sober workplace, educating workers on the associated risks, supporting those in recovery or those in need of recovery.

Some companies drug test. And drug tests can help identify people that are in need of recovery. And it helps provide resources. All right, not everybody who fails a drug test is getting fired. I think that was always what people thought years ago.

There are plenty of companies out there that if somebody fails a drug test, they want to get them the resources. Because the reality is for a lot of employers, it's tough to find new employees, so we got to take care of the ones that we have. It's extremely important. And Michael said this a couple of times here. But it's creating that culture, that culture of care, that culture that supports each other. Thank you.

STEVE BEALS: Thank you so much for that, Rob. Michael, back over to you for this question. Once you've gathered the information, what are ways to implement a plan of action?

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Implementation.

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MICHAEL SHARPE: Thank you, Steve. So it's a safety -- it's not a safety issue. It's a human issue. So the first thing that we want to do is create a committee, form a task force that includes stakeholders from all areas of the organization. It's not just a safety mission. Like I said, it's a human mission.

We need a group that understands what our employees need around the organization and the importance of having different perspectives, having someone within the leadership team, having safety employees, having people that are on-site, project executives, that really have a passion for helping people and understand what our people need. It's important that we have different perspectives within this group.

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An icon above Create a Committee depicts three people. Text: Form a mental health task force/committee that includes stakeholders from all areas of the organization.

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And then gather feedback. Sometimes you might not like the feedback that you get. But how is the mental health program perceived within the organization? Does the organization do everything that they can to support the employees' mental health? What is the company's culture around mental health?

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An icon above Gather Feedback includes arrows circling speech bubbles. Text: Get feedback from employees. How is mental health perceived within the organization and how is it supported?

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And remember, it's important to know that it takes courage for people to ask for help and to be vulnerable about their challenges. And we want to support them the best we can. So getting surveys out there, getting that feedback, and following up with those employees that, hey, we appreciate the feedback. This is what we're doing moving forward.

Education.

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An icon above Training and Education includes spokes emanating out from a teacher on a laptop screen. Text: Conduct formal training. Bring in experts and consultants that can educate employees. Add plans to the 'toolkit.'

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Mental health training, bringing in experts is incredibly important. And I know we're going to go deeper into what Gilbane has done. But just an example, Gilbane has used vital cog through the University of Colorado Helen and Arthur E. Johnson Depression Center.

We have resources for everybody. So we have had folks go through from CEO level, VP, HR, safety, and now we're working on our field staff. We've also partnered with Dr. Sally Spencer-Thomas, who's a psychologist and President and co-founder of the United Suicide Survivors International. She's also an author. She's also a podcast. Again, not giving her enough credit, I'm sure, but I'm a big fan as well.

And having that training, having those train the trainer sessions. Dr. Sally does an amazing job training our staff over 25 to 30 employees around the company that has this vital cog basic suicide prevention training, and making sure that it is available to everybody.

And then being able to add tools to your employees toolkit. It's the same concept as first-aid CPR training, in my opinion. They say that you're going to use it with a loved one before you use it in the work environment. More tools in the toolkit, the better you're going to be prepared to do so.

And you want to make sure that you're able to respond. So giving employees the ways that they can care for themselves but also the ones that they work with and the ones that they love at home.

And then scale your plan.

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We need to make sure that we have an understanding of what the plan is going to be. But how are we going to reach everyone? We want to make sure that we show that we care, have resources available and take feedback.

If we're doing one thing and it's not really well received, how can we make it better? Getting comments and ideas from other folks are incredibly important, and we'll talk about it in a little bit. We've been on this journey at Gilbane for three-plus years now.

And things change all the time. It's constantly evolving. Different things come up, different conversations as new ideas. And you want to make sure that we're getting feedback from the folks that it's actually impacting. And, Rob, would you like to add something, please?

ROB LABBE: Yeah, absolutely. Thank you, Michael. When developing a plan, just like Michael said on a lot of these points, but the first question I have is, can it actually be implemented? You might have this grand plan. But can it actually be implemented? Will it connect with the workforce, or the office staff, or whoever's in your organization?

And are we speaking their language? If we're speaking a different language, technical terms that doesn't connect with them, they may not get anything out of it. And action plans from company to company will vary, depending on the organization structure and the resources that you have.

Leadership commitment must be there for any organization to develop a plan that works. And a few important items for organizations of all sizes. But that leadership commitment, first and foremost, if they're not going to provide the resources, it's not going to get off the ground.

You need to have time. You need to have money. Education needs to be in place, those different training resources. Just like Michael said, we could probably talk for a long time just on training that's out there. And making sure that people who want the training can get it.

And support. A lot of our organizations may have employee assistance programs, some may not. And also 988. 988 has a lot of resources to it. They have trained operators. But it's not about telling somebody to call 988 and leaving them behind.

So again, it's about knowing what the resources are, connecting people. It's about letting our people know that they're supported. All right. And with all these resources, again, if you can broadcast them throughout your organization, your meetings, your walls and so forth, and then it goes right back to what we've talked about earlier. But it's about creating that culture, that culture of care.

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Steve Beals.

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STEVE BEALS: Thank you both, Rob and Michael. Some great suggestions there for the implementation stage. Let me switch over to you, Dr. Iglesias. What can be done to mitigate the potential for such problems resulting in death by suicide?

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MARCOS IGLESIAS: Steve, in 2021, which is the year -- the most recent year for which we have data, the CDC reported that the construction industry had the second-highest rate of suicide among its workers, only surpassed by mining, quarrying, oil and gas extraction workers.

So how do we approach prevention of this disaster? And I think my colleagues have been doing a really good job of laying down the foundation for a mental health action plan. The way that I would summarize it is in four different areas.

The first one is destigmatization. The second one is showing vulnerability in the workplace, then training, and then finally, providing resources. Let's very briefly talk about each one of these.

With respect to destigmatization, for the construction industry, I think this needs to include having open and frank conversations to destigmatize mental health conditions and to create the supportive environment that we keep talking about. It's an environment in which a worker is going to feel free not only to seek help but also to give help. And I think that's important to emphasize.

When it comes to showing vulnerability, I'm going to challenge you to ask yourself a question. How comfortable are you talking about physical health and recommending physical screening for your employees, for your workers, things like cholesterol screening, things like high blood pressure screening, or diabetes screening? And I think most of us are fairly comfortable doing that.

Now, let me ask you this. How comfortable are you asking your employees or telling your employees about mental health screening, screening around depression or other mood disorders? How comfortable are you or am I in talking about mental health in the same way that I talk about physical health?

Hey, Steve, how are you feeling today? Are you OK? Have you been having issues at home? How can I help you? That's a lot harder. But I think we need to get to that place. And we do that by showing vulnerability.

I haven't been feeling that great, or I've had challenges in these areas. We've talked about training, and obviously, that's so important -- training supervisors, training all our workers on the subject and how to recognize risk factors in order to be able to offer help, how to make it more likely that those around us can get the help that they need.

And of course, that comes to the fourth area, which is having those appropriate resources available at our fingertips to point others towards a path towards better mental health, and of course, the prevention of suicide.

I've also found the Construction Industry and Alliance for Suicide Prevention, CIASP, to provide very useful, relevant resources for our industry that helps us evaluate where we're at in terms of mental health and suicide prevention preparedness, and then what to do about it.

There's other associations out there -- the Workplace Suicide Prevention, the National Action Alliance. So I would recommend that you look at that. But at the end of the day, we need to feel supported.

Our managers or supervisors need to feel supported by giving them the information, the resources that they need, by training them in what warning signs to look for, and then be able to implement all these wonderful things that we're talking about.

STEVE BEALS: Thank you so much for that, Dr. Iglesias. Michael, it's one thing to create a plan. It's another to get that buy-in from employees to actually use it. But how can companies encourage their people to access their support systems out there?

MARCOS IGLESIAS: Thank you, Steve. So half the battle is really letting people know what's available to them. And the reality is a lot of people don't even know how to ask for help.

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A woman speaks into a megaphone beside text: Encouragement. Half the battle is letting people know what is available to them.

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So you got to think about providing different avenues to employees to help that access, to support them receiving that help.

So a few opportunities that we can talk about here is we've talked about the employee assistance program. But having what-to-expect document, calling them, having, hey, you're going to press 1 for English, you're going to wait a couple minutes for an operator, how does 988 work? What other opportunities and resources do you have? Have it be stress reduction. Have it be help sleeping.

There's a lot of different things that you can share. And again, we'll talk about what Gilbane did in a second. But that is employee assistance program. Vet them. Understand what exactly they're going to do to help your employees.

Toolbox talks. Again, we've talked about it. But how can we tie in mental health and physical health. It's through those conversations with the workforce. I'm telling you right now, those are the huge opportunities. And also, have it be union or nonunion. But talking to the subcontractor companies about what resources they have for their employees. So you can also bring that up, too, because they do vary.

And then emails on mental health awareness, just like how we kicked it off. Mental Health Awareness Month. Substance Abuse Prevention Month. International Overdose Awareness Day. Again, Narcan, Narcan, Narcan, so important to talk about. But the discussions on Narcan and highlighting those and celebrating those and understanding that these dates should be important to people because it could impact their lives.

Some did-you-know fact sheets as well within the email chains. And we've talked about employee-supervisor training. Formal training is incredibly important. We're going to talk about the fact that I am not a trained therapist. But I know resources and how I can get people to the proper resources. And that's what we really need to think about here.

And then wallet cards, hardhat stickers, mental health train, 988 awareness, Narcan awareness again, and then storytelling. Tying all that in with storytelling, being able to express your own story and how you have gotten to the point that you're at really can connect people to you. Steve, back to you.

STEVE BEALS: Yeah, I agree, Michael. So important for companies to make sure everybody understands their support structure out there and how to use them. Rob, over to you for this question. So once the plan is in motion, is there anything else that should be considered?

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ROB LABBE: Yeah, I think other things to be considered are issues that people may struggle with that are often overlooked. Financial literacy. I'm sure a lot of the people in our workforce are struggling to make ends meet. Some people don't know how to balance a checkbook. So just some companies offer things of that nature, which is hopefully helping them.

I think a lot of people struggle with technology, whether it's some of the programs that are already using on their phones, on their computers, their iPads. And for some people in our workforce, it's overwhelming.

And communication. I'm sure we all get a lot of emails every day. Some may say we get too many. There's email overload. We're not reading everything. But it's about the proper way to communicate with certain people and find out what works.

But as far as substance use disorder -- and I know that's a big part of what we want to talk about here today -- I want people to understand this, that it's not just about getting somebody treatment and stopping.

People who are using substances have other issues as well. And those underlying causes, if they're never addressed, then they may just go back to either that substance, or another substance, or there'll be something else that would be the problem.

So we need to think back. And we talked about this earlier. But people are our greatest assets. And we need to think about that. All right. We need to think about the people coming through the gate every day, just like Dr. Iglesias said before. But how are they doing?

Checking in with them as they're coming in, maybe at the beginning of the shift while some people are doing a stretch and flex, where we're taking a look around. And we're looking at some people's limitations while they're doing that. And maybe we're going up to them afterwards. And we're having a conversation with somebody. There's a lot we can get from a conversation.

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Steve Beals.

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STEVE BEALS: Yeah, I agree, Rob. Always good to ask people, how's it going today? How's it going for you? Michael, back over to you. Do you have any examples of how these solutions look in real life? Have you been able to effect change?

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MICHAEL SHARPE: Thank you, Steve. So after the 2022 Construction Working Minds Summit in Denver, a Gilbane task force committee -- however you want to call it -- was formed from leaders from different parts of the company.

We called this group the Life Savers to help support the mental health program within Gilbane. Want to shout out Ragu, who's been a great partner, Wes, Katherine Johnson, Drew. But this group meets biweekly with a bunch of folks that discuss action items to help the company's journey.

Sometimes it's just brainstorming. Sometimes there's action items that need to be completed. But we get together, we meet, and we have conversations about how we can not just impact our employees but the workforce as well on all of our projects.

Like I spoke about before, the partnership with Dr. Sally Spencer-Thomas has been incredible. She has, like I said, done train-the-trainer for a lot of our employees, as well as advanced training for managers, which we've done from the top down as well.

She is a great resource. She also helps us look at what we've done and make us better as well. So we're always trying, like we said, constantly evolving. The more impact that we can have on the communities that we have, the better.

And the first step that we had was we needed to understand all the resources that Gilbane offered. And that what-to-expect document, we did that. It's a front and back one-pager. And it goes through all of the mental health resources and what to expect underneath them.

Like we talked about, press 1 for English or whatever that is. But having employee assistance programs that have been vetted, that people can talk about and say, hey, I have called them. It has helped me. This is what you should expect. And if you have any troubles, please let me know.

I'm happy to get on a call with you to talk through it or even get on a call to help you get that help that you need. But that first step is vetting the resources. We don't want to send folks to resources that might not get the impact that we expect from them. I know Rob talked about not all EAPs are created equal. And we want to make sure that we have the right ones for our employees, for their needs.

Training available, like we talked about with Dr. Sally. And then a few employees volunteered to share their stories. I was one of them. So short of it is I lost my brother to a fentanyl overdose, October 1, 2019. Dude was my guy. I think about him every single day. I loved him, and I still love him. And that's how he died. But that's not who he was as a person.

I don't say that to make you feel bad for me. I know statistically for a fact, I am not the only one on this call right now that has had that impact your life. So I'm telling you right now that therapy has helped me.

Yoga has helped me incredibly. It's a great avenue for people that are not having a lot of impact or need to have that stretch and relaxation. But it's understanding these stories and being able to share them. And I understand that there's generational differences that might not be comfortable about talking about it.

But if we can have people come forward to talk about, even what I talked about, or if you have a trouble with alcohol or substances, or have had in the past or in recovery, how that has helped you is incredibly important. But that storytelling, find people that are able to share their stories to impact your employees.

And then last but not least, recognizing employees. So we set up the Eric Black Award. So in 2016, Gilbane lost one of our colleagues to a death by suicide. Eric was a loving husband and father to three children who were his pride and joy.

In honor of his legacy, the Life Savers group established the Eric A. Black award, which will recognize managers and employees who show compassionate support for the mental health and well-being of their direct reports and colleagues.

So we had our first award a few months back. There was a situation on a project site where there was a worker on-site that came into the medic trailer talking about self-harm. And we had a superintendent and our safety director in that region jump right in and support that individual, get them the resources they need. And that's that recognition that we want to have.

And safety, sometimes we're so caught up in the statistics, the incident rates, the injuries. But it's all about recognizing the positives, supporting what we're doing positively, and have that understanding that we all can make a difference. And I truly believe that we all can make a difference. And I'm sure Rob agrees with me as well. And he's going to talk about more solutions.

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Rob Labbe.

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ROB LABBE: Thank you. Yeah, Michael, as you say, for safety professionals, we tend to dwell on the negative things. Because that's what hurts people. But I think it's really important to talk about hope. And we use that word a lot, "hope." But I think it's important. I think there's plenty of hope out there.

I think there are plenty of success stories that shine light on what people are doing. We've been raising awareness for a while now. I think that's great. I think it's great seeing organizations work together and get better together.

I think it's great to see people open up now and reach out for assistance. There's just so much going on that I feel it's very hopeful. I mean, we have a long way to go. And there are plenty of success stories out there.

I could tell stories about workers helping a coworker save that worker that day. I could tell you stories about workers who have been working on a highway project and have helped the traveling public when they saw that broken down car in the lane.

But one thing I wanted to share on today is about substance abuse disorder. So I just want to tell a quick success story about substance use disorder. So there was an employee who was trained to see, to pick up on those differences and pick up on some of those red flags.

And so he received a phone call. He's the go-to person. He received a phone call and one of his fellow workers had a substance use disorder and was in a lot of trouble. He was losing his family. He was going to be losing his license and a whole bunch of things.

And at that time, he was actually drunk. And he was going to be headed into a courtroom. And his peer stopped him and said, you know what? Let me call the judge. Let me see. If you agree to go to rehab right now, I can hear the troubles you're having. You're losing your family. Are you ready for rehab? Are you ready to make some changes?

And it was just amazing to see that worker, that peer step in and help his fellow worker. And so to me, when we talk about hope, I see that there are plenty of people that are doing some tremendous work out there.

And I love to see what other people are doing. And I think it motivates other people and people feed off each other. So, again, I'm just going to leave it with hope right there. But there are plenty of stories. We could go on forever about the different stories.

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Steve Beals.

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STEVE BEALS: Move back to Marcos for this next question. In what ways can Travelers assist the company in its efforts to address mental health and substance use disorders?

MARCOS IGLESIAS: Thanks, Steve. Well, at Travelers, we provide educational opportunities like this one, this webinar.

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Text: Travelers Resources. An open laptop displays a Workplace Safety Resources window in which to enter one's ZIP code and find an agent.

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We also offer e-guides. When it comes to workers compensation claims, for example, our 550-plus nurses are involved in these claims, and especially when they may benefit from added medical management. And that's what they do.

And one of the things that they do is when they intake these individuals, they screen all of our lost time claims for psychosocial barriers. And then they offer at-risk individuals the use of a resilience-building app that helps them build skills, that helps them manage stress, helps them deal with sleep and a lot of other issues.

We also, of course, have access to mental health resources, mental health professionals around the country, whether it's in person or virtually, to help as appropriate during a workers compensation claim.

So there are a lot of resources that we use. I'm very, very proud of Travelers and what we do. We take mental health very seriously. It's part of our approach to the injured worker. We see them as a whole individual, so we care for their physical as well as their mental needs. And it's obviously part of what we do for our insureds and their injured employees.

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Steve Beals.

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STEVE BEALS: Well, Dr. Marcus, I'd like to also add that Travelers Risk Control is dedicated to providing risk control services to our construction customers. For example, we do our safety leadership training development, which really facilitates a culture of safety among frontline supervisors out there.

Our risk control people are out there every day, targeting fall protection and site safety and work zone practices, really to help prevent those severe injuries on a jobsite. Specific to substance use and doing the other things that we have out there or the e-guide, we developed an e-guide that includes information from a white paper that -- Dr. Iglesias, you wrote that paper. And it also has links to Travelers and the CIASP resources out there.

And Travelers is a proud sponsor of the CIASP and the work they do out there and to help the industry. So with that, I did want to say thanks to everybody in the panel. Do we have some time for questions? We've got a couple here. Dr. Iglesias, how about this one here? What are the signs of misuse of drugs?

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MARCOS IGLESIAS: Thanks, Steve. Well, signs of substance misuse, first of all, can vary quite a bit, depending on the substance that is being used and also the individual's tolerance, their physiology.

What I would say for observers, if we're actively listening and observing people around us, that's where we position ourselves in the best way to help that individual. Some of the things that I would be looking for are, from a behavioral perspective, are there any changes.

So, for example, in the workplace, are there unexplained absences? Is there tardiness? Is there decreased productivity? Are there change in work habits? So this isn't normal for that individual. That's a behavioral issue. Are there physical changes?

And that could be anywhere from severe weight loss or sometimes weight gain that's unexpected, changes in appearance. Somebody looking like they're physically declining. They're nervous all the time. They're fidgety and that's not normal for them.

So that's what I would look for from a physical perspective. From a personality perspective, I'm looking for mood swings, irritability, unusual behavior. That might be, for example, irrational fears. It could be anxiety. It could be paranoia.

Are there legal issues, troubles with the law that may be related to substance use? DUI, for example, would be one of those. Are there social problems? Social issues going on? Withdrawal from social situations? Strained relationships? Isolation? Financial difficulties?

And what I would remind all of us is that as a coworker or even as a friend, as a neighbor, as a family, we don't have to diagnose mental health issues. But we can detect behaviors or signs, like we just discussed, characteristics that may mean that individual needs our help, needs us to come alongside them, point them towards the help that they need. And that's really what we're here for.

STEVE BEALS: Got one more question out here. It says our leaders and workers aren't qualified to administer mental health care. When and how should we turn a budding crisis over to mental health professionals?

MARCOS IGLESIAS: Steve, I can answer that. So first of all, if it's a crisis situation, if somebody is at risk, our first approach is calling 911 if it's something where people are in danger. 988, as was mentioned earlier, is very helpful to help individuals in a crisis situation as well.

But what I just said earlier, too, I think is so important. We're not here to diagnose and treat mental health conditions. Let's just come alongside individuals. Let's be active listeners. Let's be an observing individual who can identify someone who's at risk and then point them to those right resources.

Those resources might be in our company, might be in an EAP, might be in the healthcare system, might be in a community system. It could be their church or religious group that we could plug them into.

The important thing here is to identify and to have those resources at our fingertips. But like I mentioned just now, if it's an emergency, obviously, our first approach is getting emergency care immediately.

STEVE BEALS: Thank you so much for that. Well, I'd just like to say thanks to everyone on the panel today and everyone who attended this webinar. There is a crisis of mental health and construction. And no one has to suffer alone with the resources and commitment to stay silent no longer, construction companies can make a difference. So thanks again for everybody, and thanks for the panel.

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