Mental health in construction is no longer a taboo topic. Awareness campaigns, toolbox talks, posters, champions and wellbeing weeks are now common across sites and organisations. And yet, despite all of this activity, the industry continues to face stubbornly high levels of work-related stress, mental ill health, and people falling out of work entirely.
So what’s missing?
In this episode of Build & Thrive, host Jennie Armstrong is joined by Jo Yarker, Professor of Occupational Psychology and Co-Managing Partner at Affinity Health at Work, to explore why so many wellbeing efforts stall at awareness – and what it actually takes to move into prevention.
Drawing on decades of research and practical experience working with organisations across construction and beyond, Jo offers a clear message: good intentions are not enough. If the industry wants real change, it needs to apply the same discipline to mental health that it already applies to physical safety.
Why Awareness Alone Isn’t Shifting the Dial
There is no shortage of commitment in construction when it comes to mental health. Many organisations genuinely care and want to do the right thing. But Jo explains that awareness is only the starting point – not the solution.
“We’ve done a lot of work to help people understand that mental health is a challenge,” Jo Yarker explains. “But understanding the problem is not the same as knowing what to do about it.”
Construction has invested heavily in raising awareness, encouraging conversations, and supporting people in crisis. While this is vital, it does not stop harm from occurring in the first place. Prevention requires a different mindset – one that looks at how work itself is designed, managed, and experienced day to day.
This gap between awareness and prevention is not unique to construction, but the sector’s structure, pressure, and delivery models make it particularly challenging to bridge.
Psychosocial Risk: Treating Mental Health Like Any Other Risk
One of the central themes of the episode is psychosocial risk – the aspects of work that can cause harm to mental health if left unmanaged. These include workload, lack of control, poor relationships, unclear roles, job insecurity, and organisational change.
Jo highlights a key issue: construction is excellent at managing physical risk, but far less confident when it comes to psychological and psychosocial risk.
“Health and safety professionals are very good at identifying risk,” she says. “But when it comes to psychosocial risk, they often have responsibility for the assessment – without control over the solutions.”
Unlike physical hazards, psychosocial risks cannot be ‘fixed’ with a guardrail or piece of PPE. The controls often sit in management behaviour, work planning, leadership decisions, and organisational culture. This makes collaboration essential – between health and safety, HR, occupational health, and senior leaders.
Without that joined-up approach, organisations can find themselves completing risk assessments that raise expectations but lead to little meaningful action, eroding trust in the process.
The Line Manager Effect: Where Prevention Really Happens
One of the strongest evidence-based insights shared in the episode is the role of the line manager. Across sectors, countries, and job roles, Jo’s research shows that what people want from their manager is remarkably consistent.
“The behaviours that protect mental health are broadly the same whether you work on a construction site, in a hospital, or in an office,” Jo Yarker explains.
Key behaviours include managing workload fairly, being available and approachable, taking responsibility when things go wrong, and treating people with consistency and respect. These behaviours don’t just help when someone is struggling – they reduce the likelihood of problems developing in the first place.
Jo also highlights an important and often overlooked finding: inconsistency can be more damaging than poor management.
“Managers who are supportive some of the time, but unpredictable at others, can be more stressful than managers who are consistently average,” she notes.
For construction, where supervisors and managers are under constant pressure to deliver programme and cost, this insight is particularly relevant. Prevention is not about being perfect – it is about being reliable, fair, and human.
Construction’s Unique Challenges Around Return to Work
The episode also explores why returning to work after ill health can be particularly difficult in construction. Unlike many sectors, people often return to find that their role or project has moved on without them.
As Jennie reflects in the conversation, construction workers may lose not just a job, but a team, relationships, and informal support networks they had built over months or years.
Jo expands on this point, explaining that successful return to work is strongly influenced by the relationship someone had with their manager before they became unwell.
“Our research shows that people who return to work successfully are much more likely to have had a supportive manager before their absence,” Jo Yarker says.
This reinforces the idea that prevention is not a separate activity – it is embedded in everyday management long before a crisis occurs.
The Hidden Cost of Poor Mental Health Management
Another critical theme is cost – not just financial, but human.
Jo explains that when mental health is poorly managed at work, the consequences often show up elsewhere: disciplinary processes, investigations, grievances, turnover, and lost productivity.
“These processes can be extraordinarily harmful,” she says, “not just for the individual, but for everyone involved – and they are incredibly time-consuming.”
For senior leaders, this is an important reframing. Mental health is not simply a wellbeing issue – it is a performance, risk, and sustainability issue. Organisations that fail to manage it effectively often pay the price in ways that are less visible, but no less significant.
Choosing Wellbeing Tools Without Wasting Time or Budget
With so many wellbeing apps, platforms and services on the market, it is easy for organisations to feel overwhelmed. Jo is clear that this is an area where many good intentions go astray.
“You have a choice,” she says. “You can invest in evidence or you can invest in gloss.”
The episode outlines a practical approach to selecting wellbeing tools and services:
- Start by clearly defining the problem you are trying to solve
- Review what you already have in place and identify duplication
- Balance prevention, capability-building, and support
- Ask whether the intervention is theory-led and logically designed
- Plan for implementation and sustainability, not just launch
- Decide upfront how you will evaluate impact
Jo stresses that evaluation does not have to be complex, but it does need to be intentional. Without it, organisations risk spending money without ever knowing whether anything has changed.
Evaluation: Proving What Works
Jo shares examples from Affinity’s work evaluating interventions, including return-to-work tools and wellbeing programmes. These evaluations combine quantitative measures (such as confidence, capability, or absence data) with qualitative insight from interviews and lived experience.
This mixed approach helps organisations understand not just whether something worked, but why and what got in the way.
As Jo explains, “Sometimes it’s not the intervention that failed – it’s what was happening around it.”
For construction, where projects, teams and pressures are constantly shifting, this learning-led approach is particularly valuable.
Moving Forward: A Whole-Project, Whole-System Approach
When asked what one change could make the biggest difference in construction, Jo points to the role of clients and commissioning organisations.
“If mental health and wellbeing were considered across the whole lifecycle of a project – from design through delivery – the impact could be enormous,” she says.
Rather than wellbeing being an afterthought, Jo argues for it to be embedded into how projects are planned, resourced and led, with consistent expectations across the supply chain.
This echoes a recurring message throughout Build & Thrive: prevention works best when it is built in, not bolted on.
Key Takeaways
- Awareness alone does not prevent harm – prevention requires changes to how work is designed and managed
• Psychosocial risks should be treated with the same seriousness as physical safety risks
• Line manager behaviour is one of the strongest predictors of mental health outcomes
• Inconsistent management can be more damaging than getting things wrong
• Construction faces unique challenges around return to work and job continuity
• Wellbeing tools should be chosen based on evidence, not appearance
• Evaluation is essential to understand what is actually making a difference
If you are serious about building healthier, happier construction workplaces, this episode is essential listening and a powerful reminder that prevention starts with how work really happens..
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Join the Conversation!
Do you have experiences or thoughts on addiction and recovery in construction?
Drop a comment below or share this post to help break the stigma. Together, we can make wellbeing part of the culture – not just the policy.
Thank you to GKR Scaffolding for sponsoring the Build & Thrive podcast and supporting our mission to improve health and wellbeing across the construction industry.
At Construction Health & Wellbeing, we help organisations create healthier, happier, and more sustainable workplaces.
Contact us today to learn how we can support your strategy.
Learn more about the people and organisations mentioned in this episode:
Jennie Armstrong: https://www.linkedin.com/in/jenniearmstrong/
Construction Health & Wellbeing: https://constructionhealth.co.uk/
Affinity Health at Work:
- Website: https://www.affinityhealthatwork.com/
- LinkedIn: https://www.linkedin.com/company/affinity-health-at-work-ltd/
Jo Yarker:
- LinkedIn: https://www.linkedin.com/in/joyarker/
GKR Scaffolding (sponsor): https://gkrscaffolding.co.uk/
