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From Awareness to Action

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INTEGRATING MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION INTO WELLNESS PRACTICES
BY CHRISTIAN MORENO AND SALLY SPENCER-THOMAS
When people hear the term "wellness," they often think of physical wellness: sleeping eight hours a night, drinking 64 ounces of water a day and exercising for 30 minutes three times a week. Physical wellness is important, but it is only one dimension of overall wellness. Mental, social and emotional and spiritual conditions are key aspects of a person’s overall wellness.

Mental wellness involves always sharpening skills and committing to lifelong learning. It comes from a sense of inner responsibility to always finding ways to improve – increasing knowledge, asking critical questions, trying new things and advancing skill sets. social, emotional wellness focuses on keeping relationships and emotional well-being intact. It’s about conflict resolution, self-esteem and coping skills. Finally, spiritual wellness involves committing to something larger – participating in a faith community, volunteering to serve the common good, standing up for injustice or appreciating nature.

When implementing wellness into the construction industry, the conventional wisdom has been, "Don’t invest in it" or "It has little impact." These perceived challenges are exacerbated by the paradigm shared by American society: mental health issues are personal and taboo. Combine the cultural realities of the construction industry with the perceived financial challenges of investing in mental health and you get a recipe for disaster. It’s time to change the mindset.

As with any preventive maintenance process, wellness needs attention over the long haul. Unfortunately, when people are in crisis mode, wellness practices are often the first to go. And, just like when you neglect to change the oil in your car, the end cost is higher. When adversity hits, people will be in a much stronger position to maintain high performance, reframe disappointment and recover from trauma if they have reservoirs of resilience and mental health resources to rely on. Arguably, the preventive approach is the most effective way to save a greater number of lives from suicide.

Here are three case studies of employers who moved beyond awareness to action:

1. ENGAGE LEADERSHIP AND DEVELOP COMMUNICATION STRATEGIES IN SUICIDE PREVENTION
Case study by David James, CPA, CCIFP, CFO of FNF Construction, Inc.in Tempe, Arizona, a member of multiple AGC chapters.

"Make sure key executive positions are in support of the initiative.With the recent statistical data and the ‘zero accidents’ mentality of most construction executives, it is not a huge leap to ‘zero suicides.’ Safety and HR positions are key, as they represent the ‘front lines’ for communication. FNF began with posters and a newsletter article that was distributed to all employees to share resources and messages of hope, recovery and resilience. Just recently, two employees who were experiencing a personal crisis were identified and directed to resources that, prior to this initiative, very likely would never have been recognized."

2. ADVOCATE FOR MENTAL HEALTH SERVICES INCLUDING EAP
Case study by Steve C. Tenney, CPA, chief financial officer of Story Construction in Ames, Iowa, a Master Builders of Iowa member.

"I used our health insurance and benefit enrollment meetings as the platform to break the silence. At the beginning of each meeting, I led a discussion about mental health and suicide prevention and told the group that I was bringing up the topic because ‘I care.’ It was a captive audience; they had to listen and fortunately they paid attention. The reality is you don’t get to leave your personal problems at the door when you show up for work, and, as an employer, we are trying to do a better job of increasing our awareness of events that impact our employees. We ask compelling questions, and it makes a difference: Do you know anyone in your family or group of friends who has suffered from some type of mental health issue?

Do you know anyone who has been impacted by suicide? If you had a chance to save one person’s life, would you be willing to help? I haven’t had three no’s yet."

3. DEVELOP A PEER SUPPORT PROGRAM 
Case study by Kyle F. Zimmer, Jr., LAP-C, health & safety, director and member assistance program, director from IUOE Local 478 in Hamden, Connecticut.

The peer support efforts have to start at the top, but you don’t have to look that far to find people to help. Many who have lived through life’s challenges are willing to step up and share their lessons learned. People in recovery want to give back. Training and confidentiality are critical to the success of the program. Peer support helps remove the stigma for people who are struggling. The reality is co-workers spend more time with each other than they do with their families and they talk – about football, their families, their problems. Our brothers and sisters need to be ready."

WELLNESS PROGRAM DESIGN AND METRICS IN CONSTRUCTION
The demonstrated uniqueness of risk to the construction industry drives a need for specific and tailored metrics and program design. The standard wellness program metrics measure either biometric screening measures or "engagement" measures – or some blend of both. While the biometric screening measures of a cohort population can be extremely valuable in predicting future health risks and associated costs, these measures lack the insight to hidden risks of mental health issues for the construction industry. The construction industry’s unique risk profile demonstrates the clear need for the inclusion of mental health metrics and wellness program design innovation by the wellness vendor community.

Given the stakes, contractors can no longer afford to utilize the "standard" wellness program designs and litmus tests for efficacy. Rather, the construction industry must alter its approach to – and its expectations of – wellness program providers. Contractors like Barriere Construction in Metarie, Louisiana, a Louisiana AGC member, have led the way with changes to resources and configuration of their wellness program. "We have made significant changes and investments in our wellness program over the last several years," says Christopher Williams, Barriere’s director of administration and employee development. "We invested in on-site clinical resources (R.N.) for one reason: the health and wellness of our employees. While the impetus for the investment was initially the ‘physical health,’ we have come to realize the benefits of a front line resource in identifying mental health issues as well." Barriere relies on indicators such as "number of interactions per employee, per week/month with the on-site nurse. "In this way," says  illiams, "we are able to marry the data sets with the year-over-year biometric data to get a clearer picture of overall health – as opposed to strictly physical health."

Christian Moreno joined the Lockton Dunning Benefits team as vice president in 2011. With more than 16 years of experience, Christian specializes in designing health plans that are fully integrated with wellness solutions; helping employers manage the demand side of healthcare. As a clinical psychologist, mental health advocate, faculty member and survivor of her brother’s suicide, Dr. Sally Spencer-Thomas sees the issues of suicide prevention from many perspectives. Currently, she is the CEO and co-founder of the Carson J Spencer Foundation, a Denver-based organization leading innovation in suicide prevention. You may contact her at Sally@CarsonJSpencer.org.
 

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