CAIRDE - Suicide Prevention in the Construction Industry

International research shows that construction workers may be at higher risk of mental health issues and suicide compared to the general population. However, there is limited information about this phenomenon in Ireland.

The Men’s Health Forum in Ireland (MHFI) has been commissioned by the Health Service Executive’s (HSE) National Office for Suicide Prevention (NOSP) to investigate this issue in the Republic of Ireland, and to develop suicide prevention training and resources for the Irish construction industry. This project is known as CAIRDE (Construction Alliance to Reduce Suicide).

This initiative aims to reduce suicide stigma, enhance knowledge of suicide and mental health issues, and increase help-seeking and help-offering in the construction industry. Critically, it recognises the needs of key gatekeepers / sign-posters on building sites, and the crucial role that they can play in reducing suicide in their workplace.

In order to do this, the CAIRDE project began by seeking to understand the current issues in the Irish construction industry and what needs to change. This was done through interviews, questionnaires, workshops and focus groups with employees and employers across this sector. The insights gained were used to inform the shape and content of a number of workshops, which have been piloted on sites and extensively evaluated. These interventions are, currently, being scaled-up, and construction companies / sites in the Republic of Ireland are invited to apply to host these workshops.

If you or your company are interested in getting involved with the project, please email: This email address is being protected from spambots. You need JavaScript enabled to view it.

If you would like to find out more about CAIRDE, click on the links below …

Why men in the construction industry are being targeted
Aims and objectives of CAIRDE
Funders
Stakeholder Group
Research elements
CAIRDE workshops being offered
Articles published in international journals
Where to find help with mental health issues

Why men in the construction industry are being targeted

Research within the occupational health sphere has indicated stark differences in suicide rates across industries (Boxer, Burnett and Swanson, 1995), with the construction industry being of particular concern. Elevated risk of suicide within male-dominated industries has been observed in several countries, including the United States of America, the United Kingdom, Canada and Australia (Milner, Niven and LaMontagne, 2014). Indeed, it has been shown that males in the construction industry are at higher risk of suicide in comparison to the general male population (Boxer at al., 1995; Kposowa, 1999). While data is limited, it appears Ireland is not immune to this phenomenon - with men in the construction industry accounting for 1,039 recorded deaths by suicide between 2008 and 2012 (Construction Industry Federation, 2016).

Several risk factors have been identified as potentially contributing to elevated suicide risk within the construction sector, such as transient working conditions (Peterson and Zwerling, 1998) and job instability (Berkman et al., 2004). Suicide risk among construction workers has also been linked to substance misuse, relationship problems and a lack of help-seeking (Heller, Hawgood and De Leo, 2007). Moreover, gender norms, workplace culture and stigma have been identified as precipitating factors (Milner et al., 2014).

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Aims and objectives of CAIRDE

In high-income countries, construction workers have elevated mental health issues and suicide rates compared to the general population. However, such data is unavailable for Ireland, and few workplace suicide prevention programmes have been implemented in the Irish construction industry.

‘MATES in Construction’ is an Australian suicide prevention programme that has demonstrated evidence of effectiveness in positively impacting suicide stigma, suicide literacy (knowledge about suicide risk / protective factors) and intention to seek / offer help.

MATES was the inspiration for the CAIRDE initiative in Ireland, which AIMS to:

1. Develop a workplace suicide prevention programme to reduce suicide stigma, improve suicide literacy and enhance intention to seek / offer help among construction workers in Ireland through General Awareness Training (GAT).
2. Explore the factors underpinning elevated suicide risk among men in the construction industry in Ireland, and to assess the acceptability of ‘Selective’ suicide prevention interventions targeting key gatekeepers ('Connectors') in the construction sector.

The OBJECTIVES for each aim were …

Aim 1:

- Conduct a systematic review to establish evidence of effectiveness for mental health promotion and suicide prevention workplace programmes in male-dominated industries.
- Use co-design methodologies to develop general awareness training in order to: (i) improve knowledge of suicide risk / protective factors and where / how to seek help (suicide literacy); (ii) reduce stigma associated with suicide / help-seeking; and (iii) improve intention to seek / offer help.
- Assess the impact of the General Awareness Training on suicide literacy, stigma of suicide and intention to seek help using a pre / post-test design.
- Use qualitative methodologies to assess the overall acceptability of the intervention, and the impact on intention to offer help and awareness of available mental health supports.

Aim 2:

- Conduct a systematic review to examine the ‘active ingredients’ of suicide prevention programmes in male-dominated industries.
- Conduct interviews and focus groups with key stakeholders in the construction industry to explore the factors that contribute to psychological distress and suicide risk within this sector.
- Utilise co-design methodologies to develop specific ‘selective’ suicide prevention interventions (gatekeeper ‘Connector’ training) to support construction workers’ mental health and to increase help-seeking and help-offering behaviours.
- Conduct focus groups with ‘Connectors’, supervisors, and construction workers to explore the acceptability of selective approaches to suicide prevention in the construction industry in Ireland.

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Funders

The Men’s Health Forum in Ireland (MHFI) has been commissioned by the Health Service Executive’s National Office for Suicide Prevention (NOSP) to develop a similar model to MATES in Construction that is specific to the Irish construction industry (i.e. the CAIRDE project).

CAIRDE’s work is funded by NOSP, the Department of Health in the Republic of Ireland and the Irish Research Council.

Two PhD students (Emilie Roche Culleton and Jack Sweeney) from the National Centre for Men’s Health in South East Technological University (SETU) are hosted by MHFI under the Irish Research Council’s Employment-Based Postgraduate Programme to undertake the research and evaluation elements of this initiative. They are supervised by Dr Noel Richardson from the National Centre for Men's Health.

Additional input was provided by Dr Shane O’Donnell - a postdoctoral researcher who had responsibility for: scoping the overall study outline and methodologies; formative research; and oversight of intervention development.

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Stakeholder Group

An inter-agency Stakeholder Group is convened quarterly to inform developments within the CAIRDE project. This is comprised of representatives from the Construction Industry Federation, the Construction Safety Partnership Advisory Committee, the Lighthouse Club, Solas, the SIPTU Trade Union, MHFI, NOSP, HSE Health and Wellbeing, Department of Health and the National Centre for Men’s Health in SETU.

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Research elements

The aim of CAIRDE is to reduce suicide stigma, enhance knowledge around suicide, and encourage help-seeking and help-offering in the construction industry.

The CAIRDE project has developed relevant and acceptable training for the Irish construction industry through the use of evidence-based approaches informed by systematic reviews and existing theory. Two systematic reviews were undertaken to examine the global evidence in this area. The first review focused on elements of effectiveness in existing mental health promotion programmes in male-dominated industries, while the second review explored the active replicable components of interventions.

The use of surveys, qualitative interviews and focus groups with key stakeholders in the construction industry throughout the design process provided information pertaining to some of the current issues, how the CAIRDE project can address these issues and what needs to change.

The co-design phase of the research - which aimed to develop training and resources - linked with construction workers to ensure that the needs of the industry are being met.

Finally, evaluation data was collected following the pilot intervention to explore feedback, changes, and suggestions for the training.

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CAIRDE workshops being offered

There are two primary interventions (workshops) within CAIRDE:

1. General Awareness Training (GAT) - targeting the whole of the construction worker population. This is a relatively short - approximately 90 minute - programme.

2. Connector Training - targeting anyone on building sites who has a health, safety or managerial responsibility. This is a full day programme.

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