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Mental health in the construction industry – ON Series

Did you know that suicide rates in the construction industry for males are significantly higher than national and state averages for men generally?

Join the Office of Industrial Relations and MATES in Construction for a one hour webinar on mental health in the construction industry, and how to boost resilience on site through a program of training and support.

The session covers:

  • an industry snapshot of mental health in construction
  • the training programs developed by MATES in Construction to improve mental health awareness
  • identified trends when workers do not return to the workplace after a mental illness.

Download a copy of this film (ZIP/MP4, 9 MB)

Read transcript

ON Series: Mates helping mates

On series – by Office of Industrial Relations

Facilitator:

Good afternoon everyone. Welcome to today's ON Series session titled Mates Helping Mates. The topic and expert speaker is brought to you by the Office of Industrial Relations. As a Department we are committed to driving initiatives across the whole scheme that improve safety, wellbeing and return to work outcomes for both employers and workers.

My name is Allicia Bailey. I am the Manager of Engagement Services for OIR and I will be the Facilitator for today's session. Just to let you know that we anticipate today's session will go for approximately one hour and all participants will be emailed a copy of the presentation following the session.

Before I hand you over to our expert speaker for today I thought it would be valuable to provide you with some insight as to why the Office of Industrial Relations is focusing on improving the education available to support our stakeholders with the management of both mental health and psychological injuries in our Queensland workplaces. The Office of Industrial Relations is responsible for the administration of overall scheme performance data. This includes Work Cover and the 28 self insurers.

This data provides us with the opportunity to identify reoccurring and emerging trends within the Queensland Workers' Compensation Scheme.

So what we know based on the data from the 2015 to 2016 financial year is that there were 4,273 psychological and psychiatric injury claims lodged. These claims represent approximately 4.6 of the overall claim lodgements for that year. Now when you look at these statistics in a graphical representation like the graph on this current slide it is apparent that these injury types are not predominant when compared to other injuries more commonly experienced within the scheme.

However this slide shows a different perspective. In the last financial year the average finalised time lost claim cost for psychological or psychiatric injuries was just over $50,000. This is almost three times the average cost when compared to physical injury claims which was just short of $17,000.

We commonly hear through our engagement with stakeholders that many employers and rehab and return to work coordinators rely on statistics related to the average work days lost in terms of measuring their performance and outcomes for their particular organisation. So this may be of interest for many of you.

For psychological and psychiatric injury claims the average work days lost was 156.8 days compared to 49.4 for the overall scheme.

The comparisons in the latest data highlight the disparity in the impact that psychological and psychiatric claims have on an injured worker when compared to physical injury claims. We really hope that sessions like today provide you with practical and innovative strategies that you can implement in your own workplaces to help you influence successful return to work outcomes for any worker who has experienced a mental health issue or a psychological injury. Today's session is really an introduction to the issue of mental health in the construction industry.

MATES in Construction will be delivering a few follow up sessions in the coming weeks that will explore practical strategies that can be utilised in a rehabilitation and return to work context.

So with that being said I am pleased to hand you over to today's expert speaker. Jorgen is the Chief Executive Officer for MATES in Construction Queensland and we are extremely pleased to share his experience with you today. So thank you Jorgen.

Jorgen Gullestrup:

Thank you very much. The 'expert' bit sort of rattles me.

I'm really much more here to I suppose share my experiences and share some of the things we have learned in the construction industry in dealing with mental health and wellbeing and suicide prevention. So I'm absolutely thrilled to be here and I'm even more thrilled that you are where you are and you take the time to be part of this discussion.

I'm just going to work out how to actually…

No. Just a minute.

So it doesn't. Okay, yep. I apologise for that.

So this is the first of a few webinars we're going to do over the next few weeks and today I really want to start talking about what we know about suicide prevention and mental health and share with you a little bit about the model that we have used in the construction industry to deal with the issue.

So it might just be worthwhile just starting by having a bit of an overview about mental health. What we know is that about one in five Australians will experience a diagnosable mental health condition over a 12 month period and 45 per cent or more of us would experience a diagnosable condition at some times in our lives. So it means that mental health issues are generally out in the community. The OECD have estimated that poor mental health at work alone costs developed countries such as Australia 3 to 4 per cent of our GDP.

PricewaterhouseCoopers worked it out to be about $11 billion a year that we are losing in workplaces across Australia. They said about $4.7 billion due to absenteeism and $6.1 billion due to presenteeism.

About $146 million a year is paid out in workers' compensation claims for poor mental health. So it's certainly an issue.

Some research that was done in the coal industry found that 30 to 45 per cent of the absenteeism was in some way linked to poor mental health and they estimated about 1.5 per cent of their output overall was lost due to poor mental health at work. So it's a big issue.

Some industries have a higher incidence than others and we know some of it. We don't know all of it. The construction industry is one of the industries that have been identified as having higher rates of mental stress than other industries. There were some studies done by Burt Biggs at University of Queensland or QUT a few years ago that looked at for instance drug and alcohol use that worked out that about 58 per cent of the construction industry in that sample were consuming alcohol at hazardous levels and about 15 per cent of them were consuming alcohol at levels that was likely to cause significant physical harm. So all of these kind of things are obviously linked to mental health.

I want to talk a little bit about the most serious manifestation of poor mental health which is suicide because at cases poor mental health can be fatal.

In doing that I just want to put it out there because of course I don't know how your day has been so far. Some of us might not have had a good day. So if I can just sort of put a clock out here before we start the presentation that there's a phone number 1300 642 111. That's a 24/7 help line and I'll give you the number at the end as well. So just in case if some of the stuff we are talking about here sort of hits a little bit too close to home it's always nice to have someone to have a chat to about it.

So, in Australia we lose about 6,800 people to suicide each year. That's a suicide every three and a half hours. That's a fair bit and when we look at the World Health Organisation's estimations we can extrapolate that to say that we have about 7,100 people who are permanently disabled following a suicide attempt each year.

So we are talking fairly high numbers and of course suicide is not equally prevalent everywhere. For instance we know that three out of four suicides are by men. That's not to say that all men are doing it hard because women are actually more likely to attempt suicide than men. But when men are suicidal unfortunately it's more likely that the outcome could be fatal. So it's a quite serious thing.

I just want to break that down a little bit and just sort of try to see how relevant is that actually and how relevant is that to us in our own organisation, our own industries and workplaces as an issue we need to be concerned about.

When we do the math and we have 23 million people in Australia, we can work out that roughly 1 in 8,000 people would die by suicide each year and when you look at that to me, I don't see 8,000 people over a year. That's not really that much at first.

But a few years ago I went and saw a football game and it was real football, it was soccer and it was a grand final and the Brisbane Roar was playing. Of course there was 55,000 people there and that told me that there would be about you know, five or six or seven people who watched that game with me that day who wouldn't share the despair of the following year's season with me. So it sort of started making it a bigger issue than you first think.

We know that suicide is under reported. Coroner's actually have a presumption against suicide. Suicide is a reason for dying, it's not a cause of death and coroners are really looking for the cause of death more so than the reason. So, quite often unless it's very clear from the circumstances we won't put something down as a suicide. Some people say it's about 20 per cent under reported. Other people say it might be up to 50 per cent under reported.

There's also other reasons for that and we do that sort of out of consideration for the family and people around because there's a lot of stigma around suicide. We talk about committing suicide like we commit fraud or we commit crime or we commit a sin. It actually harks back to times when suicide was illegal. If somebody died by suicide a few hundred years ago the family wouldn't actually inherit the property. That would go to the state because they couldn't benefit from the proceeds of a crime.

So, we've actually had a period where – and our language skills reflect that thing, that suicide is wrong and is sinful and stuff like that. So that makes it really difficult for people who are doing it tough and could be suicidal to actually talk about it when that sort of fits in the way we talk and think about the issue.

We know from research that about one in 500 would attempt suicide each year and would need medical treatment following a suicide attempt.

So when we look at that, if we have a sort of medium to large size workplace we should actually statistically expect that we have a suicide attempt every year. Again that makes it something that we actually need to relate to as a place where people gather, as a workplace is.

The other thing that was highlighted - Suicide Prevention Australia put a position statement out about workplace suicide prevention a few years ago. They highlighted that research had shown that up to 17 per cent of the suicides were actually work related. So when I apply that to construction that's about 30 suicides a year that is somehow work related.

The other thing we know is that thoughts of suicide is quite common. Research has shown that when we go out to ask large populations 'Can you recall having thought about suicide over the last 12 months?' roughly one in 20 will actually be able to recall having had suicidal thoughts over the last 12 month period. So if we put that into context, half of us might experience – about one in 5 of us might experience a diagnosable mental health condition but one in 20 of us could actually be so stressed that suicide becomes one of the options we consider.

Luckily most people who think about suicide don't attempt suicide and even less of them die from suicide. That's a really good thing. But I suppose the thoughts of suicide is a little bit like the oil lamp in your car. You're driving along and the oil lamp starts flickering. That's not a good thing because it tells you there is something seriously wrong with your car. But it actually gives you some options. So you can choose to stop your car and top up the oil, get it serviced and so on. Thoughts of suicide are very similar to that. It's a sign to us that we need to stop and take stock and look at what's going on in our life and start dealing with it before it becomes any worse.

Now the last bit is that poor mental health is a safety issue and it's a safety issue for a number of reasons. It's a safety issue because if we're struggling with mental health issues like a crane driver I was talking to once – we did a presentation and he showed signs of being a bit stressed about it. I pulled him aside afterwards and I said 'What's going on mate?' He said he lost his son to suicide only five or six months before that and the stress of it had sort of caused his relationship with his wife to break up. So he was sitting in this one bedroom bedsitter. They started the lawyer's game, so he was actually broke. He said 'Every time I sit alone all I see in front of me is pictures of my son and what sort of mess I'm in.'

This guy being the crane driver was actually responsible for picking up tonnes of steel and moving it around the site while he was not all there. I would say every single worker on that site had a vital interest in this guy looking after his own mental health and wellbeing. So we know that people who are mentally stressed are actually more likely to have physical injuries and physical accidents than people who are doing well. We also know that people who are mentally stressed, it takes longer to recover from physical injuries than people who are in a better mental space.

We also know, so as I said before, 17 per cent of the suicides were somehow work related. We also know of course that work can affect our mental health. We know that some industries have higher stress levels. We know that some industries have higher suicide rates. So that tells us that there's some sort of link between work and mental health (inaudible) as well which of course puts on us some responsibilities in terms of our duty of care to the workforces we are dealing with.

This is a little bit about what got us into what we were doing in the construction industry. This is a study we released earlier this year with Professor Chris Doran from the Hunter Medical Research Institute that looked at suicides in the industry. They identified that suicide rates in the industry was about 32 per cent above the national average for men in Australia, remembering already three out of four suicides were done by men.

So shocking. The good thing is it's getting better. One of the things I always try to point to is when we look at the stats and we look at Queensland, we're even pegged now with the male suicide rates. It wasn't like that 10 years ago. Ten years ago we were 30 per cent above as well. So what we have done as an industry have actually shown that as a workplace we can have a real impact on saving lives in terms of suicide and suicide prevention.

But still this equates to 191 suicides in the construction industry each year. That is one every second day. We also know that we lose about 30 workers to accidents at work each year in the construction industry. So in context, we lose six workers to suicide for every worker we lose to an accident and we all know when you work in the industry, that the industry is a dangerous industry where we need to take safety really, really seriously. Guess what? We need to take mental health safety seriously as well and when we apply that 17 per cent statistic, if we apply that we actually end up with 30 suicides which are potentially work related which is the same number of people as we lose to physical accidents. So certainly something that's worthwhile considering.

This might be a little bit of a (inaudible) we're looking at. We know from the research we did that suicidal behaviour in the construction industry costs the community $1.5 billion per year. But it costs businesses more than $25 million a year in terms of lost productivity and things like that. That's all well and true but if you talk to a workplace 'We have lost a workmate to suicide', if you talk to somebody who lost somebody else to suicide, you'll know that this money just doesn't even go to actually describing the real cost of a workplace suicide or a community suicide.

So I suppose that is a little bit of painting the scene for the issue we are trying to deal with. So what we are dealing with. We are trying to deal with suicide because we know that we can't deal with suicide without also dealing with mental health. Mental health is the bottom of the iceberg. Suicide is the top of the iceberg, but we have designed our program specifically to be suitable to the workforce we are dealing with.

So let's talk a little bit about the workforce and then we can talk a bit about what we know and how we dealt with it. So when I'm talking about the construction industry I'm sure that you get pictures in your mind a bit like this, of hard working men toiling away. If you're a little bit more realistic the picture might be like that.

A lot of the time we work together really well as an industry and we are really good because building is a collaborative process.

But at the same time we're also an industry that have conflict where we often play it pretty hard between each other.

Sometimes our work sites are small building sites where we just work with a small crew just putting a house up here, a house up there or repairing a bathroom and other times we work on really large scale industrial projects.

So we had to work out if we were going to interact with our industry and make a difference, what is actually the core principles, what are the things that sort of tie together, how can we design a program that is acceptable to everybody in the industry and works with it?

So considering all of that we worked out about four key principles.

One of them was that we had to be independent. So we had to be an independent charity, we had to have the unions liking us, we had to have the employers liking us. We had to have the workforce liking us. So we had to work out that we didn't step on anyone's toes and that we respected everyone in the process. So we were designed specifically as an independent charity. So with that in mind we never sell our services. An employer can't pay MATES in Construction to do the program on the side. We only give it away for free.

We then like when people like us enough to give us money because that then supports the program we are running and so far the industry has been generous enough to keep the organisation going.

We use the industry structures. We thought that going out to a bunch of men and start talking about mental health would be hard enough. So we on top of that then had completely different structures and different ideas where the task would be just about impossible. So we aligned the program very closely to the safety structure and you will probably recognise that as we go through the program so that every step of it we actually know already. We know it works and we generally accept that it might not be perfect but it's the best we've got.

We target men. That's not to say that we don't have women in the industry but we do have the blue collar workforce which is the workforce within our industry which is at particularly high risk of suicide. They are 98 per cent male. So we devised our communication so they were specifically acceptable to men but still accessible to women. So we talk about suicide as a tangible problem because as men we like to fix problems. That's the gift we've been given. I come home from work and my wife will tell me about the door that I need to fix and all the kind of things that need to be fixed. I would (inaudible) try and 'try' is probably the operative word, to fix it. So that's what we actually do.

So when we get to a point where our life needs fixing and we can't fix it, that's actually quite a hard realisation to come to as a man.

So we deliberately talk about suicide because that is a very tangible problem whereas if we start talking about mental health we might get mental pictures of sitting around in circles without shoes on and things like that. That doesn't come natural to us.

We don't ask men to seek help because we're not very good at it. It's not what we naturally do and everybody would tell us that, that most doctors are – this is by women, most counsellors (inaudible). Women are much better at asking for help than we are.

So we decided 'Let's not target it. Let's target what we are good at instead', and we are good at offering help. So we have this ethos of mateship in Australia where you sort of a cultural duty to look out for your mates and have their back. So we put into that to say 'What does it actually look like when somebody is struggling?' and then 'How might we help them?' We find that we're much, much better at that. So it's really about mates helping mates when we boil it down.

Allicia Bailey:

Can I just interrupt you there?

Jorgen Gullestrup:

Yeah.

Allicia Bailey:

We hear quite regularly from our stakeholders that initiating conversations about return to work when they're suffering or have suffered from a mental health issue or a psychological issue is a huge barrier. People don't feel empowered to have that conversation.

Would you say based on the model and how you've changed this approach for males which is different to the approach for females, is it just a language difference in the way that you sell the program and you sell the concept of mental health and the concept of suicide? Or is it the actual physical approach that you adapt? Is it the way you go out to males and speak to them physically or remotely or however you do it? What's the main difference between the male and female cohorts?

Jorgen Gullestrup:

I think that men like to appear soft. Particularly blue collar men, we might have a healthy disrespect for professions. So we like to speak to other men.

I also think and I will probably want to talk a little bit more about that in the next webinar, sometimes when we find discussions around mental health difficult it's actually much more about ourselves than it is about the person we are talking to. So it's often much more about how we feel about mental health that is a blockage for us having effective communications with other people about mental health. So that's probably some of the things we just want to touch a little bit on next seminar. So how do we actually have an effective conversation about somebody who is experiencing poor mental health? I think the starting point is actually looking at ourselves rather than the other person.

Did that answer your question? Okay, thanks a lot.

So to come back to that idea about – so firstly we started. We saw in our industry that it appeared that we had a high suicide rate. We saw that through our redundancy trust. We saw that through our super schemes where a lot of the death payment appears to be suicide related.

So we then engaged with an organisation called Australian Institute of Suicide Research and Prevention out of Griffith University to do the biggest occupational study that had been done at the time into suicide within the industry to find out what we actually saw, whether that was true and then at the same time giving us some indications about what the right thing to do about it would actually be.

So we got that research done and I just want to share with you a little bit of some of the things that came out of that. But particularly what we are really doing in the MATES in Construction program, we are taking the recommendation of that report and saying 'That is what a bunch of people who know a lot about suicide prevention think we should be doing, so we'd better do that, but we'd better do it our way so that we do it in a way that we actually buy into and we accept.'

So the study found similar to what I reported to you earlier, that our suicide rates were much higher than average and that particularly our young workers were of higher risk of suicide.

It also found that of the people who died by suicide in our industry half of them had actually told somebody about their struggle and about the difficulty they were facing.

A quarter of them had actually attempted suicide before.

So there was actually people out there waving flags and saying 'I'm struggling, but I don't quite know what to do about it', and still they died by suicide.

So we say 'Well if we could actually do something about it, if we can change that a bit', because what we found is of the people who died from suicide, only seven out of 100 had actually sought professional help.

So if we could increase that seven to 50 or 30 even, we guessed that we would actually have a significant impact on the suicide rates within our industry.

So if we just think about it, half of them had actually thought about suicide, a quarter of them had attempted suicide before. So they had clearly tried to tell us that things weren't good, but only seven out of 100 had actually attempted suicide – had actually got professional help.

We also out of that – at the time I was a Trade Union official at the time. So we asked the union 'Can you just tell us what's wrong because then we can put a ban on it and we can fix it?' except the type of issues we got back wasn't the issues that was easy to fix for us.

This slide here sort of recommended – that's the type of issues that was identified by workers in the industry who died by suicide. So life events, these were the most significant event that happened in people's lives just before they took their own life. So relationship problems and legal matters and financial problems – all those kind of things, but they were not particularly construction related. So it wasn't actually something we could really do something about with them.

We also went to the workforce and said 'What are the type of issues that you feel are the strongest barriers for your quality of life?' and they highlighted issues like longer working hours, a culture of alcohol use, bullying behaviour and suddenly we got a lot closer to the workplace issues. When we actually then started putting those together we could then see there's a strong link between them. So relationship problems rarely comes – we often say 'It would be great if I could just say this week I'm having my relationship problems and I'm having my drug and alcohol problem next week and my financial problem the week after that.' It's not like that. It's one thing on top of another on top of another and suddenly people tip over and they can't deal with their stressors.

So it was much more those kind of issues we had to address. Yes?

Allicia Bailey:

I guess I just wanted to build on that point. I think it's a fantastic point that you raise that even though these particular triggers may not be specifically because of work itself, I guess you've come to the realisation that we are always managing individuals in a workplace who actually are experiencing these life events. So there has to be some awareness of the life outside of the desk that we sit in or the truck that we sit in day to day to actually manage these triggers and accept some onus of control that it is part of our duty of looking after our workers from a safety perspective but also managing how they actually respond to these triggers even coming back to the workplace as well and the implication that injury can have in actually causing some triggers like this for an individual.

Jorgen Gullestrup:

Absolutely. Absolutely. I think we come to work as whole human beings. We don't come as the work part or the private part and we are not that easy to – and of course the things interact. If you have had a tough day at home you're going to be less patient with your supervisor when you go to work and vice versa. So all of those kind of things completely interact and we can't separate it. People do come as whole people and it does influence each other.

So that was why we said 'We're not going to look at it whether it's a workplace issue or whether it's a home issue. We are going to be completely blind to that. What we are just looking at is people doing it tough. If we can actually identify people who are doing it tough we can then start dealing with the issues one by one and trying to separate it out so we get it into manageable chunks before suicide becomes one of the issues.'

So if I can just talk a little bit about the model we chose to use when we say 'How do we actually engage with the workforce around this?' and 'How do we actually get people on board with looking after mental health and looking after each other?'

This sort of is a bit like the contract we had at work. For a long time we had this idea that if I go to work and I don't tell you then you don't have to tell me and then we don't actually have to do anything about it. That sort of worked for us except it didn't because it showed up in our suicide rates.

So if we imagine here is Fred and Fred is going to work and he's having a tough time, a bit of troubles at home, he might be drinking a bit more, there might be the issues with the job, might be running out of finances – all the types of bits and pieces, it all adds up, one thing on top of another. He'll go to work and everybody's going to say 'Well you're a bit odd today but on we go.' We are trying to break that down.

So the way we do that is we start by we go into a workplace and we have a discussion with everybody in the workplace from the project manager to the builder's labourer, from the subcontractors to the employees and the principal contractors. We only do it if everybody comes together and it takes about an hour. We talk about suicide as a preventable problem. We all have a role to play in dealing with it. We talk about the tip over point and the type of issues we talked about before, how one thing on top of another on top of another can lead us to tip over.

Then we say 'What does it actually look like when one of your mates are tipping over?', 'How might you pick it up?' and 'How can you connect somebody up to help?'

So once we've done that everybody gets a white sticker because stickers are really important in the construction industry. You need to have hard hat stickers. So we get a white hard hat sticker and we put that on our hard hat and that shows all of us that on this site here we actually look after mental health. This site we have this sort of collective contract that mental health is one of the things we're looking after.

Now the sites look like this. That means that Fred is still going to work and his life is no better than it was before, but chances are now that one of the people around him might pick up that not all is well. Of course we only need one to pick something up but if we have everybody aware, chances are that somebody's going to pick it up.

So when we do this general awareness training one of the things we ask people to say is 'There's an issue we need to face as an industry. Do you want to be a volunteer with MATES in Construction? Do you want to be a connection point on your site where somebody can go to if they are concerned about one of their mates?' On average we get 20 to 30 per cent of the workforce volunteering to become connectors.

With those lists we then go back to management and we say to them 'Here are the people who are volunteers. How do we make sure that we get a good coverage of the workforce?' We need to make sure there is an apprentice there. We need to make sure there is a supervisor there. We need to make sure there is a union guy there. We need to make sure there is a project manager or an office person there so everybody has somebody that we can actually relate to ourselves.

We often say when the project manager is going through a separation he is not very likely to go to one of the apprentices and say 'My wife has left me.' Similar, the apprentice is not going to go the project manager and say 'I can't actually handle my drug and alcohol.' So people are more likely to go to somebody that they find at their own level.

So we then make sure that we have connectors distributed across the site so everyone has access to one. So we try to get about one in 20. So out of those 20 per cent we get about 5 per cent that we then train. We are not concerned at all about getting the wrong connectors. We have plenty of the wrong connectors all over the industry. That's not important at all because workers are smart enough to work out who to go to and who not to go to. What is really important is we need to have enough of the right ones. So by getting one in 20 we will have the right connectors on site that people can actually then find.

In that we're using a Canadian model called Living Worksto do that so that we actually could use something that other people had already developed which made it a lot easier for us, and test it. We come back to site and we give the connectors the connector training which is about a four hour training session. We talk about 'What is your role? So how do you actually manage your role as a connector?' and you might have conflicting roles because you might also have a role as a supervisor or as a safety guy or whatever. How do we actually manage those conflicts when those roles are in conflict and how do we deal with that? How do you look after yourself because often the people who volunteer are the people who are the carers, the people who people normally go to anyway. So if you are the type of person that people would normally use it's actually important that we look after ourselves in an open and honest way.

We give them this safe talk which is a module that deals with 'How do we actually approach people around suicide?', 'How do we ask them about suicide?', 'How do we have a conversation around it?' and 'How do we connect people up to help?' Then we induct them in to what actually happens when they connect up with us because they're part of us now. Once they become volunteers they're actually part of MATES in Construction. They do this as MATES in Construction volunteers rather than employees of their employer at that particular time.

Of course that means in our industry where people change jobs all the time and they go from one employer to another, they take their hard hat and they take their role with them. That means that the program automatically moves from site to site with the workforce organically. Again, the sticker is important. You get a green sticker. So that means everybody with a white sticker knows that 'If I've got doubts about one of my mates I just have to find a guy with a green sticker.'

So now the workplace looks like this. An important part of that is that I might have a white sticker and I notice that my mate is not doing too well. But if I don't feel that I'm comfortable in dealing with it, if I don't feel I'm right to have the conversation I might then actually choose to ignore it or walk past it. But if it's really easy for me to actually do something about it, I'm more likely to do something about it. So therefore having connectors in the workplace makes it really easy because all I have to do is just go and talk to a connector. So that's a part of it.

Allicia Bailey:

I particularly like this model because I think in a rehab and return to work context Jorgen, a lot of organisations have a dedicated Rehab Return to Work Coordinator which I'm sure you're familiar with. They are often seen as that conduit between all parties involved with managing this person to successfully get them back to work.

I think the value in this model that you've presented today shows that there's a lot of power in expanding outside of that role in terms of support. So that employers particularly might actually consider adopting this type of multi support person or multipronged, I guess approach just outside of the Rehab Coordinator so they still fulfil their duties and requirements in managing the return to work. But the worker has this visual and I guess quite transparent support network around them as well to give them more options on how to talk or where to go if that particular Rehab and Return to Work Coordinator is not the one that's maybe suited for their needs to help them overcome whatever barrier.

So I think there's a lot of I guess, impact and there's a lot of value in having such a huge network like that. A sticker is so easy. It's I guess quite funny to see how trivial a sticker could be in influencing this change in a workplace.

Jorgen Gullestrup:

Absolutely and I think it's important to that thing that people need to have choices because there might be some issues that I am 100 per cent comfortable going to my workplace coordinator and my Return to Work Coordinator or my supervisor and there might be other issues I would desperately not want to do that with.

The choice we're having is we can't force people to go to any specific person. So the alternative is that people are in the workplace unsupported. So it's much better that they are supported by some external source so that they continue at work and we maintain their mental health going forward.

The last bit of this model is what we call 'assist worker'. Remember how we talked about using the safety structures? When we look at the general awareness training that's not too far from the site induction. In our industry you will not get on a site until you have done the site-specific inductions and we do site inductions one, two, three, four, five times a year.

Every time you start a new site we go on, 'There's the toilet' and 'This is what we do on this site' and all that. Sometimes we do it hundreds of times but we just know that this is part of doing business in our industry and general awareness training is really the same. People do it on site one, two, three, four, five, six times and each time we do it it's just about actually getting this commitment that 'This is actually what we do on our site here. Together we look after mental health and wellbeing.'

The connectors are not completely dissimilar to our safety committee. Particularly in construction where things change all the time, handrails are missing, walls are going up, walls are coming down. It's not a static workplace. We know that we have safety people we can go to when the handrails are missing and connectors are no different to that in practice. So culturally it's quite clear, that it's simple.

The last bit of this is of course the assist workers which is our interveners, the first aiders. Assist - you can best compare that to physical first aid. It's a really good comparison. I go on site and if you could see me, you would see that I would be a fair risk of a heart attack. I go on site, I have a heart attack and I trust the builder's labourer to give me CPR here now and if he doesn't, chances are that I won't survive. I prefer if he didn't do the open heart surgery and that's what doctors are doing but if we don't have that on site I won't make it, I won't get the second chance. Mental health is no different to that. For some people getting that help where they are at the time can be life saving.

So having assist workers, again they're our first helpers, first aiders. It's a two day workshop where we talk to people about 'How do we actually talk to somebody who is suicidal?', 'How do we make a judgement about whether they just need a Band-Aid or whether they need to call the ambulance and go to hospital or whether they need to go and see the doctor?' The same assessments are made quite safely within the assist framework.

'How do we support them ongoing?' So we encourage work sites, particularly larger work sites and remote work sites to have assist workers. So within that framework we then have a self-contained model on site. This site can do their own thing or they can use us. We are totally happy with both sides. It's about actually building resilience into the workplace.

One of the things we said when we started was 'We didn't actually want industry to become reliant on a charity like us because one day we might lose our funding.' Then people say 'Where are they?' We actually want the place to be a better place because we've been here. So it's about building resilience rather than dependence.

So once we've done that then the site looks like this. So Fred is still doing it tough. Somebody noticed it. We can actually deal with something, a connector go and see him, say 'Mate, you're not doing too well. Let's go up to the first aid officer and have a talk to the assist worker' or whatever. They can make him safe. They then refer onto the services as is required.

We provide case management. So people who feel that that's the best resource for them can actually go with a case manager. Then say 'How do we actually cut this down into smaller bits?' and then we hook people up to existing resources where that might be the case managers say 'Has your employer got an employee assistance program?' 'Yep.' 'Well why don't we talk to them and get some counselling?' or 'If you're going through a separation why don't we go and find legal aid?' or whatever we might be able to do to help change the situation to take a bit of pressure out of it so people can manage their stress at that time.

We also operate a 24/7 hotline which was the number I gave you earlier where volunteers, our connectors and assist workers can call in and get support but also individual workers can call in and get support with it.

The last bit is that sites who meet our minimum standards, so that is that everybody on site has received the general awareness training, one in 20 have been trained as connectors and there's access to a suicide first aid resource, we then accredit that site. So that means the site gets a certificate, they get a (inaudible) sign to put on the front gate and a little thing they can do in inductions. That sort of means that 'On this site we've done our bit. We're committed' and of course that's not too far from safety audits and safety policies and all that. A number of the companies have actually adopted that internally to say 'We want all our sites to be accredited' and now the local management then have to work with us to get to that level and we are sort of keen to do that.

So that's sort of the model.

Another way and I want to do this relatively fast because we want to go through another way of looking at the model and that is from the person's point of view, from the person who's talking, particularly men. But I think all of us actually.

Going to work. We are struggling. Work is one of the last things we give up because that's where our finances sit, that's where so much of our hope and all the stresses we have sit in our work. So we are likely to actually continue working right up until we can't stick together in one piece.

In Australia we actually have lots and lots of good resources. So there's lots of help out there both through our employer, through the system, through the state, all those kinds of things. We have lots of good things happening out there, but it's not necessarily, what do you call it? You know, when people go home from work we don't normally Google 'Psychology'. There's lots of things that goes into the search engine. So the distance to the help becomes almost insurmountable.

Having people inducted means that there's somebody around you that you know personally that can actually pick up and say 'Mate, you don't look right.' Having a connector means there's somebody who can actually start the conversation. Having assist worker, there's actually somebody who can connect you up.

So what we have done is we have effectively built a bridge between the person who's talking and the help, whatever it is, and we find that that is actually what people are using.

Allicia Bailey:

Jorgen can I just ask you a question based on your experience and I don't know if you even have you know, a story that you could relate to this, but we hear quite frequently from rehab and return to work coordinators, 'We know that our stakeholders are quite proactive and committed to getting workers back.' One of the main barriers that they often experience is that the worker themselves doesn't want to connect with the services or the support or the resources that is readily available to them.

So I guess this model shows that you have quite an in-depth level of support or different avenues, but have you ever experienced when a construction worker or someone in the industry is struggling, it's known that they're struggling but they're just not willing to engage with the help that the program and that the organisation is offering, how you've overcome that or if that even happens?

Jorgen Gullestrup:

All the time. All the time. That's not uncommon. We'd probably call them 'frequent flyers'. We have people who keep coming back to the program time and time again and we talk to them about the need to deal with the drug and alcohol. We talk to them and they come again and that's frustrating but it's also great. I can't make people change. I can only be there to pick them up when they fall and if I'm there then I might be ready for when they are prepared to change.

That's not a similar situation to someone who is doing a return to work but quite often the question is 'Why?', 'Why is somebody not prepared?' because people want to do well mentally healthy. People want to recover from their injury. Nobody wants to be injured. So the question is really 'Why are people not engaging?' and that's probably the question we need to look at.

I have spoken a lot and that means that I've spoken over time which is not uncommon either. That means I won't bore you with any of the statistics. So what I will do is any of you who are statistical nerds I'm quite happy – that would be part of this presentation anyway.

Really what I much rather want to do is to see whether there's any questions and most importantly I want to, if any of you have sleep deprivation there is a bit of a list there of resources if you want to read more about it.

Not about sleep deprivation, but about us, and the help number I talked about before.

Thank you Jorgen. While we give our participants just a couple of minutes to put your questions through, everyone listening feel free to put your questions on the Q&A box in the bottom right hand side of your screen.

Just while they come through I think I might just take this opportunity to let everyone know that the Office of Industrial Relations has developed some other webinars and resources in the mental health space that you may find of interest. There's a couple that are found on that url in the screen and the topics are listed below. So over the coming months – October and November – we will be expanding on the topics in psychological and mental health and how to manage them successfully in a return to work space.

I'll also take the opportunity to let you know of the Injury Prevention and Return to Work Conference which is on the 19th of October this year. The details are on the screen.

But of interest to you are three particular topics that we've made sure specifically focus on mental health, wellbeing or psychological injury management. So they're on the screen as well. So feel free to jump on and to have a look at those.

We're getting quite a few questions come through. So Jorgen if you're happy I might just shoot these over to you.

Q:  Are you aware of any particular career pathway programs that integrate this awareness as part of their training such as apprenticeships or traineeships?

Jorgen Gullestrup:

What we are doing is we're doing what we call Life Skills Toolbox specifically for apprentices where we (inaudible) as part of their apprenticeship. So that's a 24 hour toolbox specifically designed towards young workers. But I want to make it clear that what we actually do with this, we look at this as a community development program rather than training. So then one thing is actually what people do with the training and also with the training itself. So we actually think it's important at this time in the workplace, in our workplace rather than (inaudible).

Allicia Bailey:

Great.

Q: Based on your experience are many of the suicides that you've particularly seen in this industry presented by Indigenous workers?

Jorgen Gullestrup:

Our industry have a relatively small proportion of Indigenous workers. So statistically I can't actually tell you. I can tell you that we have Indigenous clients and we obviously know that suicide rates are very, very high in the Indigenous community.

But I can't actually give you any statistics. We haven't got it broken down to that level where we've been able to give you anything on that.

Allicia Bailey:

One of the participants has identified that the Northern Territory has a zero construction suicide rate. Now I know that you're within the Queensland jurisdiction, but do you have any knowledge of what's happening in the NT space in regards to suicide in workers?

Jorgen Gullestrup:

Yes, I have and we would release a report next week. So here's a scoop for you, but it's not actually true. Northern Territory have high suicide rates in the construction industry and Northern Territory have high suicide rates generally. So that would be watch this space. That will be a report released next week on our website that looks at suicide rates in the construction industry between 2001 and now, broken down state by state compared to the male average.

So that is statistically I hate to say, but there is suicide within the construction industry in the Northern Territory and it's quite high.

Allicia Bailey:

Can you advise participants if they were interested in engaging the MATES in Construction program, how do they actually go about doing that? Is it simply a matter of contacting you directly? Or what's the best method?

Jorgen Gullestrup:

Within the construction industry it's a simple phone call and we'll just come out and do it. Outside the construction industry it's a little more complicated.

In the mining industry we are currently running a pilot program but because we're an industry based organisation we're happy to give our program to any other industry who want to run it. But our qualification in doing this is that we are a bunch of construction workers. So when we go into an office environment we just won't fit in. So it's about actually finding something that's suitable to that industry. But we are more than happy to help and we're more than happy to share any of the knowledge we have in this space.

Allicia Bailey:

Fantastic. I'm sure a lot of people will be very pleased to hear that.

Now I think we had a difficulty with your microphone for the first question, so I'm just going to ask it again just to I guess, pick your brain about if you had any awareness if these types of programs have been integrated into career pathways such as traineeships or apprenticeships?

Jorgen Gullestrup:

As I said, we are running what we call the Life Skills Toolbox and that is a program that is available not only through the construction industry but to any young worker within the state. That integrates the connector and that training with a number of other life skills as well.

Generally we don't look at the program as a training program. We look at the program as a community development program. So we actually think that that needs to be delivered as a package on site rather than through with the training program as it is now because it gives us power from being something we do together as a community.

Allicia Bailey:

Q: Based on your awareness of the rate of suicide are you able to give any comment if there's a particular subgroup within the construction industry that this is likely to affect such as trade or ethnicity or socioeconomic status?

Jorgen Gullestrup:

Yes. Actually we have some really good data on that that comes from Deakin University and looks at skill levels. It tells us there are particularly high suicide rates amongst the labourers and the operators, so the lower skilled occupation within the industry.

When we come to the trade side - plumbing and electrical - the rates are actually relatively low, possibly even below average and when we go to the more senior - the engineering occupations - there's a slight kick up in suicide rates as well.

So if we actually want to focus on where the rates are highest we need to focus on labourers and operators and the lower skilled occupations.

Allicia Bailey:

I guess that's great you can drill down that far actually, so you can target your program and actually develop strategies that are relevant to that particular cohort which is good to know.

Q: Are you aware of any particular program similar to MATES in Construction for the manufacturing industry?

I guess the impact that MATES in Construction has had is quite evident in a positive way. So do you know if there's anything similar for employees in manufacturing that they could access?

Jorgen Gullestrup:

There is a number of organisations that work in the same space, one of them called OzHelp, the other one called ConNetica.

They are different programs. They run a program called Life Boat which has the different components but in terms of an industry approach there's only been about two or three other examples in the world where we have actually taken an industry approach like we have in the construction industry, to a level where we've actually been able to provide evidence that we're effective. So there's good tools out there but without any force (inaudible) there's not a lot of places where we've actually been able to tie it all together on the industry basis that we have in construction.

Allicia Bailey:

Now the facts you've presented today I guess are overwhelmingly, I guess a lot bigger than probably most of us expect in terms of incident rates.

Q: Do you have any insight as to why this particular issue isn't heavily public in media and those types of avenues?

Jorgen Gullestrup:

Yes. I think it's the same reason why we call it 'committed suicide'. There is still a lot of stigma around it. We lose two and a half times more people to suicide in Australia than we lose to traffic accidents. That wasn't always so. It used to be opposite in the 1970s.

Traffic accidents have come down dramatically. We've got better cars. We've got better driver education. We've got better policing, better paramedics. All of those kinds of things have actually driven it down.

Suicide has remained (inaudible) high all the way through and it's by choice. It is because we have chosen not to deal with it, because in the instances where we have done something, so for instance when we limited the access to guns following the Port Arthur massacre the suicide rate dropped. When we implemented the National Suicide Prevention Strategy the suicide rate dropped.

In the construction industry suicide rates have dropped quite dramatically when we did it. So the reason we have high suicide rates is because we've chosen to, not because we have to.

Allicia Bailey:

So I guess that really highlights the need for the community to work collaboratively at all levels to actually influence change in this space. I guess I'm proud to announce that later in the year the Office of Industrial Relations is engaging a Mental Health Ambassador I guess, to help in this space as well.

So we're looking forward to hopefully having some positive influence over the coming months and over the next year.

Now I am aware that it's 1:00 o'clock and we don't like to keep people longer than we should. So we might have to leave it there.

All participants will be sent a copy of the presentation and a recording will also be made available on the Work Safe Queensland website. So keep an eye out for that.

We are extremely interested in getting your feedback on these types of sessions and as Jorgen mentioned, he will be back in the coming weeks with some follow up sessions. So stay tuned for the invitation for those.

So we will leave you now. Thank you for participating and if you have two minutes to complete a survey we'd love your comments and your feedback.

Thanks very much.

[End of Transcript]

Last updated
13 October 2016

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