a quick Summary
All of our work, which represented approximately eighteen months of research, design and testing was designed to deliver the following outcomes:
The Integrated Framework and The Integrated Approach that sits within it, are evidence-based and can be backed with the confidence of demonstrated results
There is widespread investigation of and alignment with global models such as the Harvard Business School
The Integrated Approach has been tested on a pilot group and delivered the outcomes that it was designed to deliver
Hard data (statistics) and soft data (anecdotal evidence) speak to the value and success of the program
That the solution represents the voice of industry (WII Steering Committee and Working Group).
The Research that Made a Real Difference
In 2018, a research report written by Professors Luke Downey and Con Stough from Swinburne University measured the psychological impact of workplace stress and related occupational factors on the Australian infrastructure construction industry.
The report showed that the levels of depression, anxiety and stress in the construction industry exceeded Australian population norms by more than 37% and were twice that of comparison industries.
These alarming statistics stimulated meaningful discussion across the industry, particularly in the collaboration with the senior leaders of the eight major construction companies involved in the study.
This extended to representatives of Major Transport Infrastructure Australia (MTIA), Major Roads Projects Victoria (MRPV), Roads Australia and other key industry associations and together they formed the Wellness in Infrastructure Steering Committee (WII) and Working Groups.
These groups established a clear charter with agreement that there needed to be industry-wide focus on addressing the issues systematically by taking a top-down leader-led approach, supported by evidence-based solutions and with a clear view to advocate for sustainable improvements in wellness.
What became very clear early in consultation with industry was that for senior leaders to feel confident committing funds and other resources to wellness initiatives, there needed to be evidence that it would work.
Proof of ROI (Return on Investment) would elevate the discussion from “we should do this because it’s the right thing to do” to include “and here’s the evidence to show the investment made a real and measurable difference.”
This created an imperative to:
Ground what is provided in this Framework in solid research, both academic and applied
Base our design and development on methods and models proven both locally and globally
Test our approach in a pilot program
Measure and evaluate the results using empirical data.
1 | Grounding our work in solid research
Key to our approach was using existing research in combination with extensive consultation. The early part of the project was therefore dedicated to researching both the problem and the solution.
Phase Two of the 2018 research had provided the Six Hazards and Contributing Factors (discussed in the What are the Core Issues that Need to be Addressed section and included again in the grid below). These hazards were identified in consultation with industry through the Wellness in Infrastructure Working Group forums.
The Six Hazards and Contributing Factors were cross-referenced to WorkSafe’s work-related factors and to David Rock’s SCARF model of psychosocial hazards. Each of these pieces of work are backed by research. This research was key to ensuring that early thinking in relation to the solution would make it relevant to any worker in any industry while still maintaining a primary focus on construction.
Following this research, we then implemented a survey with the Wellness in Infrastructure Working Group to identify initiatives already undertaken to address the issues and ran a second series of focus group sessions to assess what was working and what was not.
This work gave us the following insights:
Early experimentation was certainly occurring on some sites, but not consistently over the industry
Issues were systemic and therefore overwhelming for safety and wellness representatives to address independently
Resources were rarely dedicated to wellness initiatives, so it was extremely difficult for advocates and safety professionals to get traction on what were often great ideas
The industry believed itself to be ‘incapable’ of significant change
Due to the highly competitive nature of the industry and subsequent low profit margins, proven Return On Investment (ROI) was important in the decision-making process in order to justify spend on wellness initiatives and this ROI was yet to be widespread
Even though there was awareness from senior leaders around the seriousness of the issues, there was reluctance to commit resources to change initiatives without evidence that it would return result
In a largely male-dominated industry, there was (and still is) a reluctance to talk about emotions and mental health
Leaders did not understand how they could make a difference, fearing that the pressure and stress that impacts the industry was driven by the competitive tendering process
A focus on culture was not high on the priority of many project teams, particularly in joint ventures and alliances where different players tended to be loyal to their own processes, systems and ways of working
Without a broader strategy for integration, activities that were being undertaken did not always achieve the widespread change they were developed for and had inconsistent take-up and isolated results.
All of this research was pivotal to feeling confident that the approach put forward to industry would make real change and help build confidence around the board room table that investment in the mental health of their people would have long-term sustainable results based on work that was addressing issues at their root.
2 | Base our design and development on proven methods and models
Having gained a deep understanding of the issues facing the Australian construction industry, we then went looking for existing solutions, models and methods that could be leveraged or adapted to address these issues, particularly work out of Canada and the UK, that are often considered to be world leaders in this space.
This included extensive desktop research, exploration of global case studies and approaches, discussions with other associations and groups doing similar work and continued consultation with industry through the Wellness in Infrastructure Steering Committee and Working Group.
One of the key articles that informed early thinking was:
Implementing an Integrated Approach - Weaving Worker Health, Safety and Well-being into the Fabric of your Organization from the Harvard T. H. Chan Center for Work, Health and Wellbeing
While not specific to construction and relevant to the US market, this article aligned closely to and supported the core principles around which this framework hangs. It validated our thinking and reinforced a top-down, preventative approach to address the systemic factors at the heart of the issue.
A bibliography of the more valuable reference material is provided here:
3 | Test our theory in a pilot program
The Integrated Approach to Wellness is the core approach around which the framework is built. This draws on a philosophy that effective leadership and the creation of a positive culture will deliver a mentally healthy workforce and broader organisational health and success.
The integrated part of the framework speaks to the way that leadership development, the articulation of a desired culture, consultation and participation from the workforce, and supporting systems and processes in the business are all interrelated and aligned.
Testing the design of The Integrated Approach to Wellness was conducted on the Mordialloc Freeway project, a joint venture between McConnell Dowell and DECMIL. At the centre of the program were 17 leaders, with Trevor Cruden from McConnell Dowell as Project Director and Michael Di Carlo from DECMIL as Operations Manager, and approximately 95 white collar professionals over the life of the program.
These leaders were from the core disciplines including HR, Communications, Health and Safety, Quality, Environment and Sustainability, Design, Finance and Adminstration and included key superintendents and supervisors.
Mordialloc faced the normal challenges of any project - high-risk night works, weather challenges, policy and process challenges associated with two companies coming together, pressure to stay on-time and on-budget, as well as the unexpected complications of COVID-19.
It was an excellent project to partner with and we are grateful to Grant Fuller for engaging senior leaders to undertake this pilot, to the Executive of McConnell Dowell and DECMIL for supporting it (particularly in relation to the time-costs) and particularly to the participants who engaged wholeheartedly with the process.
You can hear from Trevor and Grant about the impact of the program at Mordialloc in this video.
4 | Measure and evaluate the results using empirical data
To ensure that we were able to capture the results from the pilot program and show quantifiable improvement, Professor Luke Downey supervised the use of the same survey conducted in 2018 to expose the depth of the issue.
The 95 white-collar professionals at the Mordialloc Freeway Joint Venture (MCDDJV) were surveyed at the start of the implementation in June 2020, again in February 2021 and finally in June 2021. The objective was to survey the team prior to implementing the pilot program and then repeating the survey at a mid-point and again at the end of the implementation.
The findings of the benchmark survey at the start of the pilot implementation in June 2020 were consistent with those of 2018, even showing slightly elevated levels of stress, anxiety and depression. There were significant improvements in the mid-point survey and then in the final survey. You can see a summary of the results here under the heading ‘How We Know it Works.’
This survey included the following assessments:
Depression, Anxiety, Stress Survey (DASS)
The DASS-21 (Lovibond & Lovibond, 1995) is a short-form of the DASS in which each of the three subscales contain seven (rather than 14) items. The DASS-21 has high reliability, has a factor structure that is consistent with the allocation of the items to subscales, and exhibits high convergent validity with other measures of anxiety and depression (Henry & Crawford, 2005).
The Depression scale includes items that measure symptoms typically associated with dysphoric mood (e.g., sadness or worthlessness). The Anxiety scale includes items that are primarily related to symptoms of physical arousal, panic attacks, and fear (e.g., trembling or faintness). Finally, the Stress scale includes items that measure symptoms such as tension, irritability and a tendency to overreact to stressful events.
Profile of Mood States (POMS)
Important pre-cursors to clinically diagnosed levels of mental illness are alterations in one’s prevailing mood. Alterations in levels of anxiety, depression, and anger are commonly observed in stressed workers, and represent important indices of mental health.
The POMS (McNair, Lorr & Droppleman, 1971) is a self-report questionnaire designed to measure six dimensions of mood: tension-anxiety; depression-dejection; anger-hostility; vigour-activity; fatigue-inertia; and confusion-bewilderment.
The POMS consists of 65 adjectives describing feeling and mood which is answered on a five-point Likert-type scale ranging from ‘not at all’ to ‘extremely’.
Perceived Stress Scale
How people experience stress differs across industries and within people who work in the same environment. What is important is how they perceive the level of stress they are experiencing.
The Perceived Stress scale is a subjective measure of stress and assesses the degree to which life events are perceived as stressful. This questionnaire has 10 items and participants are asked to score on a scale of 0-5 how often they have felt a particular way over the past month, ranging from 0 (never), to 5 (very often).
Higher scores indicating a greater degree of perceived stress and lower scores indicating effective coping (Cohen, Kamarck & Mermelstein, 1983).
General Health Questionnaire (GHQ)
Stress can also manifest through physical symptoms, and affect one’s general levels of health. The GHQ comprises 12 items and assesses changes in the ability to carry out normal daily functions, or the appearance of new symptoms including somatic symptoms and insomnia, or feelings that may indicate psychological disorder such as anxious or depressed feelings.
Work-Life Balance
A single item was used to assess the respondent’s satisfaction with their work-life balance: How successful do you feel in balancing your paid work and family life? Responses on this item ranged from 1 Not at all satisfied, to 5 Very Satisfied.
Burnout
Burnout among physicians was measured using a two-item version of the Maslach Burnout Inventory (MBI), a validated questionnaire considered the criterion standard tool for measuring burnout.
Consistent with convention, we considered a high score on the depersonalisation and/or emotional exhaustion subscales of the MBI as having at least 1 manifestation of professional burnout per week or greater (Shanafelt, et al., 2015).
Demographics
Details concerning the age, gender, company, and ratings of job security, company support, job demands, job status, and job rewards were also collected.
where to now?
Source:
Beyond Blue & PricewaterhouseCoopers Australia 2014, Creating a mentally healthy workplace Return on investment analysis, viewed 31 May 2021, https://www.headsup.org.au/docs/default-source/default-document-library/research-by-pricewaterhouse-coopers.pdf?sfvrsn=3149534d_2