Rules "are required" to tackle construction's mental health crisis

A MAJOR new white paper is calling for sweeping contractual, cultural and legislative reform to address what it describes as “unacceptable” levels of poor mental health across UK construction.

Unlocking the Action Plan for Better Mental Health in UK Construction sets out 28 specific, measurable recommendations aimed at transforming how the industry supports its workforce. 

Authored by chartered quantity surveyor and registered counsellor Marc Preston, the report argues that despite decades of discussion, construction has failed to convert research into meaningful action.

The scale of the problem is stark. According to the paper, more than 80% of construction workers report experiencing stress or anxiety, 26% have had suicidal thoughts, and suicide rates are nearly four times higher than the national average. 

The industry’s fragmentation — with 98% of firms employing fewer than 24 people — has made coordinated change difficult. 

Above: The construction sector, both in the UK and in markets around the world, struggles with poor mental health. 

Preston says his motivation for writing the paper stems from more than four decades in the sector.

“I have been in the industry for over 40 years and more frequently reflecting on the fact that there has not been the degree of change as seen in the development of society in general,” he says. “Construction is still predominately adversarial. Payment certainty is still lacking. The work force is not as well looked after as should be the case.

“Modern society has become increasingly aware and concerned about poor mental health but in construction we have not, as a whole industry, progressed beyond the talking about it, as opposed to taking active steps to change the landscape.”

The report is structured around four pillars: legislative and contractual reform; collaborative working; training and awareness; and culture shift. 

Among its headline proposals are the introduction of mandatory mental health clauses in standard construction contracts, the widespread appointment of specialist mental health managers on projects, reform of payment practices through expanded use of project bank accounts, and extending RIDDOR reporting to include mental health-related incidents. 

Above: The white paper calls for RIDDOR reporting to include mental health-related incidents on UK construction sites, among other measures.

Preston is clear that voluntary goodwill will not be enough.

“The most important part in the plan is creating an obligation in contract or through legislation,” he says. “We are a rules-based society, and rules are required in order to make the change.”

He points to previous regulatory interventions — including CDM 2015 and the Building Safety Act — as evidence that industry-wide change only follows formal obligation. 

The paper recommends aligning mental health protections with existing physical health and safety duties, including adoption of ISO 45003 and BS 30480 standards.

The industry is not starting from zero. Initiatives such as Get Construction Talking — founded by Fred Mills, The B1M and Procore — are already helping to drive action and lasting change. 

The campaign has raised more than $830,000 for construction mental health charities to date, held events across three continents, been featured on the BBC and published its own simple five-step action plan aimed at helping individuals and team leaders across the industry take the first steps toward change. 

Above: Get Construction Talking's Construction Mental Health Summit brought the global industry together at London's Gherkin in September 2025 and challenged it to drive change.

Beyond compliance, Preston's report makes a financial case for action. Citing research showing a £4.70 return for every £1 invested in workplace mental health, it argues that improved wellbeing would reduce presenteeism, absenteeism, defects and accidents — while strengthening ESG credentials.

“All industry leaders, C level decision makers and politicians, should read the paper in order to understand the business case,” Preston says. 

“Blue and white collar workers should read the paper so they can push, for simple but effective changes to make the difference to their everyday work experience.”

In the short term, he hopes the document will act as a catalyst.

“It is designed to be thought provoking and in some instances challenging,” he says. “There needs to be a realisation and acceptance that we have to do things differently to create change.”

The biggest barrier, he argues, is fragmentation — both across the supply chain and within leadership.

“Research is often duplicated, poorly communicated and the benefits are not properly explained.”

The white paper concludes with a direct call to action to government, contract writers, tier one contractors and representative bodies to move from rhetoric to implementation. 

Its central message is clear: construction cannot afford to keep having the same conversation.

You can download the white paper Unlocking the Action Plan for Better Mental Health in UK Construction for free.