Enablers and barriers to mental health initiatives in construction SMEs

Background Mental ill-health is prevalent in the construction industry, and workers in small- to medium-sized enterprises (SMEs) are at high risk. Knowledge about the implementation of mental health initiatives in construction SMEs is limited. Aims To explore enablers and barriers to implementing mental health initiatives within UK SME construction firms from the perspective of the business owners, directors and managers with responsibilities for workplace mental health. Methods Qualitative study involving semi-structured interviews conducted with company owners/managers with responsibilities for workforce mental health. Participants were sampled from construction SMEs in the UK. Results Eleven construction professionals were interviewed (10 men, 1 woman; aged 34-55 years, M = 40.6) representing UK SME construction firms that were micro (<10 employees, n = 8), small (<50 employees, n = 1) and medium (<250 employees, n = 2) sized organizations. Reflexive thematic analysis generated four themes: (i) traditional views and macho culture, identified as barriers to implementation; (ii) mental health awareness, knowledge and education; (iii) valuing good mental health and (iv) a reactive or proactive approach to mental health, which all served as both enablers and barriers depending on perspective and context. Conclusions This study sheds light on an under-researched but high-risk category of workers experiencing poor mental health. We provide recommendations for policy and practice with a 'call to action' for SME owners, industry and policymakers to embark on workplace mental health implementation projects in SME settings. Mental ill-health is prevalent in the construction industry with a high economic and societal burden. Small- to medium-sized enterprises (SMEs) are at particular risk for mental ill-health but are an under-researched setting. This study provides insights from the perspective of owners and managers on factors that help or hinder construction SMEs in implementing mental health initiatives. Recommendations for policy and practice are provided.