Exploring Health, Safety, and Mental Health Practices in the Saudi Construction Sector—Knowledge, Awareness, and Interventions: A Semi-Structured Interview

Abstract

Background: Mental health is increasingly recognized as an integral component of occupational health and safety, particularly in high-risk industries such as construction. However, in Saudi Arabia, limited attention has been given to understanding mental health knowledge, beliefs, and workplace support mechanisms, especially among a diverse workforce that includes both migrant and national employees. Methods: This qualitative study employed semi-structured interviews with 30 construction sector participants occupying a range of professional roles. Thematic analysis was conducted using NVivo 15 software, guided by the COM-B model and Health Belief Model, to explore perceptions related to mental health, safety practices, and organizational interventions. Results: The findings highlight significant disparities between migrant and national workers. Migrant workers reported greater challenges related to language barriers, cultural stigma, and a lack of access to culturally appropriate mental health support. National workers described slightly better access to safety and health initiatives but still reported inadequate mental health training. Key barriers across the workforce included limited leadership engagement, stigma, resource constraints, and insufficient organizational training. Existing health and safety programmes were largely focused on physical safety, with minimal incorporation of mental health concerns. Conclusions: The study reveals a pressing need to integrate mental health into occupational safety frameworks in the Saudi construction sector. Culturally sensitive, leadership-supported mental health initiatives are essential to addressing disparities and promoting holistic workers’ well-being across both migrant and national populations.

1. Introduction

The construction sector is one of the most hazardous industries globally, with consistently high rates of occupational injuries and fatalities [1]. Alongside these physical dangers, a growing body of evidence highlights significant psychosocial stressors affecting construction workers, including long working hours, job insecurity, and exposure to extreme environmental conditions [2]. These stressors contribute to a wide range of mental health issues, such as depression, anxiety, and substance abuse, which negatively impact both individual well-being and workplace safety [3,4,5,6]. Although mental health is increasingly acknowledged as an essential part of occupational safety, the construction industry continues to prioritize physical safety, often neglecting psychological aspects [6,7,8]. In many cases, workers and managers lack adequate knowledge about mental health conditions and their workplace relevance, resulting in poor detection, limited access to support, and widespread stigma that discourages help-seeking behaviours [9,10,11,12,13,14,15].

This issue is particularly pressing in the Saudi Arabian construction sector, which plays a central role in the country’s Vision 2030 development strategy [16,17]. Despite this strategic importance, worker well-being, especially mental health, has received little formal attention in policy and practice. The workforce is largely composed of both Saudi nationals and migrant laborers, many of whom face cultural and linguistic barriers that increase their vulnerability to psychological distress [14,18,19]. Prevailing workplace norms, including masculine cultures and hierarchical management structures, further constrain open discussion of mental health [7,13]. Mental health interventions such as counselling, employee assistance programmes, or structured training are rare or inconsistently implemented [3,4,20]. The lack of culturally sensitive strategies and minimal integration of mental health into occupational safety frameworks leaves workers without meaningful support mechanisms [6,7,13].

This study addresses a significant research gap by examining how construction employees in Saudi Arabia including both national and migrant workers, and both front-line staff and top management understand and experience mental health within occupational safety practices. While international literature has identified mental health risks in construction, few studies have explored these issues in a Gulf context or through a culturally comparative lens. The aim of this study is to explore levels of knowledge, beliefs, and awareness regarding mental health and workplace safety, as well as the challenges and barriers to intervention access. The following questions guide this research: (1) How do employees, defined here to include both front-line staff and top management, perceive their understanding, beliefs, and awareness of health, safety, and mental health issues in the workplace? (2) How do they describe the effectiveness of existing workplace programmes and support systems? (3) What challenges do they face in accessing and benefiting from mental health interventions? (4) How are leadership and top management perceived in promoting and supporting mental health at work?

2. Literature Review

Research on occupational mental health in construction increasingly acknowledges the multifaceted origins of psychological distress, spanning individual, organizational, and systemic levels. High-risk work environments, long hours, job insecurity, and gendered workplace norms contribute to increased incidence of anxiety, depression, and substance use among construction workers [3,6,10]. While these concerns are universal, their severity and manifestation often vary across contexts, shaped by factors such as worker nationality, migration status, and cultural beliefs about mental illness [14,18,19]. Studies in Australia, the United Kingdom, and the United States have consistently identified stigma, poor leadership support, and lack of training as key obstacles to mental health engagement in the sector [6,7,12,14]. For instance, Eyllon et al. [12] found that U.S. construction workers who perceived higher mental health stigma reported lower psychological well-being and were less likely to seek support, while Shepherd et al. [21] showed that migrant workers in Europe experience disproportionate barriers due to cultural and language differences. Despite growing global awareness, these findings are rarely translated into actionable interventions in policy or practice, particularly in settings such as Saudi Arabia, where mental health remains socially sensitive and under-researched [16,17,22].

The theoretical framing of this study is grounded in the Health Belief Model (HBM), which links individual health behaviours to beliefs about vulnerability, consequences, and intervention value [15]. Applied to workplace mental health, the HBM helps explain why workers may avoid discussing psychological challenges, especially when perceived risk is low, stigma is high, or the value of intervention is unclear [7,13]. Empirical applications of the HBM in construction show that personal beliefs about mental health such as associating distress with weakness or viewing it as a private issue reduce the likelihood of help-seeking [9,12]. Moreover, such beliefs are often shaped by cultural norms, especially in male-dominated sectors where emotional disclosure may be discouraged [6,14].

Complementing the HBM is the Job Demand–Control (JDC) Model, which focuses on structural work-related stressors and posits that strain results from high job demands combined with low autonomy or decision-making power [23]. This model is well-suited for construction settings where hierarchical management, time pressures, and production targets frequently override worker participation in health-related decision-making [4,6,23]. Studies in the UK and Asia-Pacific have shown that JDC conditions are significantly associated with mental health decline and poor safety outcomes [10,18]. Leadership practices, such as supervisor communication and engagement in health promotion, play a pivotal role in moderating these effects [7,19]. For instance, Wu et al. [14] found that construction firms with supervisor-led mental health initiatives observed higher engagement with support programmes and lower psychological distress among workers.

These individual and organizational models are embedded within the broader WHO Healthy Workplace Framework, which emphasizes a comprehensive approach to occupational well-being encompassing the physical and psychosocial environment, personal health resources, and community engagement [24,25]. In low—and middle-income contexts, the WHO framework provides actionable guidelines for creating mental health-friendly workplaces, yet its operationalization remains uneven. Studies across sub-Saharan Africa, Southeast Asia, and the Gulf States show that structural weaknesses, such as poor access to training, absence of confidential services, and limited cultural competence, hinder full implementation [13,18,19]. This is particularly salient in Saudi Arabia, where rapid infrastructure development has not been matched with proportional attention to psychosocial health [16,22]. Cultural stigma, migrant–national worker divides, and weak institutional mechanisms further fragment efforts at integration [21,23].

To synthesize these models and guide the analysis, a conceptual framework has been developed for this study (Figure 1). The framework integrates individual-level perceptions (HBM), organizational-level structures (JDC), and system-level conditions (WHO Framework) to examine how knowledge, beliefs, work environment, and leadership intersect to shape mental health awareness and intervention engagement in the Saudi Arabian construction industry.

3. Materials and Methods

3.1. Study Design

A qualitative design based on semi-structured interviews was used, which assisted in the elicitation of deeper experiences and views about the health, safety, and mental health of Saudi construction professionals. This provided space for covering issues pertinent to participants’ understanding and giving space to enable mentioned themes relevant to safety and mental health to be addressed. The semi-structured interviews presented an open-ended avenue whereby participants had the chance to contextualize their experience and opinion; this has the potential to generate a deeper understanding of the nuances [26,27] that are implicated in integrating mental health within construction safety practice.

3.2. Participants

A total of 30 participants were recruited using purposive and snowball sampling strategies, ensuring representation across diverse roles in the Saudi construction sector, including both national and migrant workers. Eligibility required a minimum of three years’ professional experience to ensure familiarity with workplace safety practices and mental health concerns. The participant group included senior safety specialists, HSE advisers, safety officers, project and construction managers, engineers, and site workers, reflecting a broad spectrum of operational and managerial perspectives. This diversity allowed for exploration of variation in knowledge, beliefs, and access to mental health initiatives. The sample size was guided by the principle of data saturation, which was achieved prior to completing all interviews, confirming its adequacy for thematic analysis [26,27]. While not statistically representative, the sample supports analytical generalization and thematic richness, which are appropriate to qualitative inquiry [26,27].

3.3. Data Collection

Semi-structured interviews were conducted with recruited participants from Saudi Arabia’s private and public construction sectors; each interview lasted between 45 and 60 min. All interviews were audio-recorded and conducted by one researcher (MA). All interviews were conducted in English, as this was the common working language across the selected construction sites. However, recognizing that a significant portion of the workforce comprises migrant workers whose first language is not English, the study took deliberate steps to minimize language-related bias. Prior to participation, individuals were asked to confirm their comfort with English, and only those with demonstrated fluency sufficient for conversational engagement were included. During interviews, questions were phrased in clear, accessible terms, and participants were encouraged to request clarification at any point. When needed, participants were permitted to use familiar terms or brief phrases from their native languages, which the interviewer contextualized and recorded with care. Although language may have subtly influenced the depth of some responses, the consistency and clarity of the themes that emerged across interviews suggest that meaningful data were obtained.

The interview topics questions were developed using the Behavior Change Wheel and its Com-B model. The Behavior Change Wheel (BCW) and its COM-B model (Capability, Opportunity, and Motivation) are used in qualitative interviews to systematically explore factors influencing knowledge, beliefs, and behaviour [28]. The interview schedule in this study to examines the knowledge and beliefs about mental health and awareness of health and safety practice and mental health interventions in the Saudi Arabian construction industry. The questionnaire contained closed and open-ended questions to collect socio-demographic data as well as gaining further insight from each participant’s point of view. Two groups were interviewed: those who were managers and safety professionals, and those who were building construction workers. Furthermore, national and migrant workers were also interviewed within these two groups. These different groups were targeted to obtain different perceptions of mental well-being and viewpoints on what type of mental health interventions would be useful for construction workers. The interview questions were divided into five sections:

• Background: Focused on demographic and professional data.
• Knowledge: Participants’ understanding of mental health and safety measures to address RQ1. This theme aligns with the Capability component of the COM-B model
• Beliefs: Perceptions of mental health prevalence, potential reasons for these and attitudes toward interventions, addressing RQ1 and RQ3. This theme aligns with Motivation in the COM-B model.
• Awareness: Perceived awareness of mental health and safety and leadership efforts to address RQ1 and RQ4. This theme reflects Capability and Opportunity.
• Practices: Explored existing health and mental health programmes, initiatives, and resources within the organizations. It focused on identifying the protocols and routines in place to address both physical and mental well-being to address RQ2. This theme aligns with Capability and Opportunity.
• Intervention: Examined perceived barriers to implementing effective mental health interventions, such as stigma, lack of resources, or insufficient training. The interview questions also explored suggestions for improving support systems to address RQ3 and RQ4. This theme relates to Opportunity and Motivation.

This structure ensured that the data collection instrument directly reflected the central inquiries of the study. A full list of the interview domains and guiding questions is provided in Appendix B, where each section is explicitly mapped to its corresponding research question(s).

3.4. Data Analysis

All data were transcribed verbatim in English. Descriptive statistics were used to describe demographic information, and thematic analysis was undertaken for the interview data. The analysis employed a combined deductive and inductive approach. Initially, a deductive template was developed based on topics from the interview guide questions (i.e., 1–2 topics per primary interview question). Transcripts were attentively read, coded, and analyzed using NVivo 15 qualitative data analysis software. Thematic analysis was then extended inductively to identify emergent patterns and themes in line with established procedures [29].

Codes were continually refined and synthesized into themes through constant comparison, supported by iterative reading and team-based discussions [30,31]. The data were coded using the refined framework, and the lead researcher consulted with three co-authors to validate the analytic interpretations. To ensure reliability, a selection of the transcripts and their coding was reviewed collaboratively by the three co-authors to validate the analysis [32].

Higher-order coding procedures, such as axial coding, were applied to establish connections between initial codes and broader thematic categories. This facilitated the development of coherent themes that represented patterned meaning across the dataset. Themes were then summarized in matrix format, stratifying data by nationality (migrant vs. national workers) and by job type (e.g., managers, professionals, or construction workers), enabling comparative thematic exploration across subgroups.

Deductive thematic analysis, guided by the Behavior Change Wheel (BCW) and the COM-B model, further contextualized the findings. This process led to the identification of three overarching themes: (1) Health, Safety, and Mental Health Knowledge, Beliefs, and Awareness; (2) Practices Existing Health, Safety, and Mental Health Initiatives, Programmes, and Resource Availability; and (3) Interventions, Perceived Needs, and Acceptability. The inductive strand complemented this structure by highlighting additional cross-cutting factors, including stigma, cultural beliefs, trust in management, and accessibility of support services, especially for migrant workers.

The development of themes is further substantiated in Appendix A, which documents the analytical progression from individual codes to sub-themes and final thematic categories, with frequency counts and distribution across participant groups.

4. Results

The findings are presented in two sections including participants’ demographics (

Table 1. Demographics of the participants.

P	Age	Job Title	Highest Academic Qualification	Experience (Years)	Sector Type	Sector Size	Nationality	Method
P1	38	Senior Safety Specialist	Bachelor	15	Private	Large	Saudi	Direct
P2	40	Senior Executive Safety	Postgraduate	19	Public	Large	Saudi	Direct
P3	36	Health and Safety Inspector	Postgraduate	13	Private	Large	Saudi	Direct
P4	44	Chief Safety Officer	Postgraduate	17	Private	Large	Saudi	Snowball
P5	33	Health and Safety Adviser	Bachelor	10	Private	Large	Saudi	Snowball
P6	37	Safety Officer	Bachelor	15	Private	Large	Saudi	Direct
P7	39	Project Manager	Postgraduate	18	Public	Large	Saudi	Direct
P8	42	Senior Construction Manager	Bachelor	14	Private	Large	Saudi	Direct
P9	40	Construction Worker	Diploma	17	Private	Medium	migrant	Snowball
P10	48	Director of Occupational Health and Safety	Postgraduate	19	Public	Large	Saudi	Direct
P11	46	Senior Construction Manager	Postgraduate	19	Private	Medium	Saudi	Direct
P12	31	Civil Construction Engineer	Postgraduate	10	Public	Small	migrant	Snowball
P13	32	Safety Specialist	Bachelor	6	Public	Small	Saudi	Snowball
P14	33	Safety Manager	Bachelor	10	Private	Small	Saudi	Direct
P15	37	Construction Manager	Bachelor	12	Private	Large	Saudi	Snowball
P16	34	Construction Technician	Diploma	13	Private	Medium	migrant	Direct
P17	36	Safety Supervisor	Diploma	12	Public	Small	Saudi	Snowball
P18	42	Civil Construction Engineer	Bachelor	10	Public	Medium	migrant	Snowball
P19	45	Electronic Technician	Bachelor	6	Public	Small	migrant	Snowball
P20	32	Health and Safety Specialist	Bachelor	12	Public	Medium	Saudi	Direct
P21	39	Environmental Safety Specialist	Bachelor	12	Public	Small	Saudi	Direct
P22	34	Technician	Diploma	9	Private	Small	migrant	Direct
P23	36	Safety Manager	Bachelor	12	Private	Medium	migrant
P24	34	Safety Engineer	Bachelor	13	Private	Small	Saudi	Direct
P25	45	Construction Technician	Diploma	20	Public	Small	migrant	Direct
P26	49	Engineer	Bachelor	21	Public	Medium	Saudi	Direct
P27	26	Civil Engineer	Bachelor	4	Private	Medium	migrant	Snowball
P28	42	Technician	Bachelor	5	Public	Medium	migrant	Direct
P29	38	Civil Engineer	Bachelor	5	Public	Medium	Saudi	Snowball
P30	44	Construction Technician	Diploma	10	Public	Small	Saudi	Direct

Note: P: participant; Sector Size refers to the approximate number of employees in the participant’s organization: Small = fewer than 50 employees; Medium = 50–249 employees; Large = more than 250 employees.

) and qualitative data analysis results. As detailed in Appendix A, the thematic framework displays the major themes and subthemes identified through NVivo analysis. Each node represents a concept or issue raised by participants, with the frequency of coded references providing an indication of how commonly a given topic appeared across the dataset.

4.1. Participants’ Demographics

Thirty participants were interviewed, representing a mix of roles within the construction industry, including managers, safety specialists, and construction workers (Table 1). All the participants were male (n = 30), as the construction industry in Saudi Arabia is predominantly male: 10 were migrant workers and 20 were national workers. The distribution of age revealed that nearly all participants were above 30 years (n = 29), with a significant proportion of those in leadership and technical roles having more than 10 years of work experience (n = 24). Out of the total participants interviewed, six were migrant workers.

In terms of educational qualifications, the majority of participants held bachelor’s degrees (n = 17), including five migrant workers. A smaller group held postgraduate degrees (n = 7), with only one migrant among them. The remaining participants (n = 6) held vocational or technical diplomas, defined here as post-secondary qualifications below the bachelor’s level, typically awarded by technical colleges; all six of these were migrant workers. In addition, participants were classified into three role categories: management and executive roles (n = 7), with only one migrant participant; safety-related roles, including safety specialists, professionals, inspectors, and officers (n = 12), of which one was a migrant; and technical or site-based worker roles (n = 11), among whom eight were migrant workers.

4.2. Results of Qualitative Interviews

4.2.1. Health, Safety, and Mental Health: Knowledge, Beliefs, and Awareness

• Knowledge:

The findings from this study reveal a significant disparity in the understanding and prioritization of mental health compared to physical health and safety among migrant and national construction workers. While participants demonstrated a foundational awareness of mental health, their knowledge often lacked depth and practical applicability. “Mental health was broadly described by the participants as encompassing emotional, physiological, and social well-being, with one respondent stating that mental health is the person’s emotional, physiological, and social well-being” (P4, national, Safety officer). A different participant noted “Workers who suffer from mental health issues, life or work stress, or other mental problems affecting their personal or work life” (P9, migrant, construction worker). However, only a minority of participants identified specific strategies to address mental health challenges. A small group acknowledged the potential role of therapy, while others referred to medication as an effective intervention. Despite these insights, the overwhelming majority reported no formal training on mental health in their organizations. One worker reflected “As for the mental health training, my current construction company has not provided any specific education or training on this topic” (P10, national, OSH director). A migrant worker shared a similar concern, stating that “in my current company, doesn’t had any training or education on mental health” (P16, migrant, construction tech).

The lack of training extended manifested to an incomplete understanding of the practical implications of mental health challenges in the workplace. Some participants recognized that poor mental health could adversely affect employee performance and workplace safety; their responses suggested a need for further education. For example, one participant explained “Mental health could affect people physically and socially and result in making it difficult to do your own things and job duties” (P7, national, project manager). One interviewee shared the risk of unsafe acts stemming from stress or poor mental health, noting “If the person has poor mental health or stress, they could harm themselves or others by doing unsafe acts” (P25, migrant, construction tech). These findings underscore the importance of integrating mental health education into existing health and safety training frameworks.

Participants also demonstrated a strong awareness of heat stress as a workplace hazard, acknowledging its physical and emotional effects. The majority of participants were equally familiar with indoor and outdoor heat stress, and a substantial number recognized its impact on mental well-being. As one participant explained, “Physically, it will make them fatigue more, more fatigue. Yeah. Other than the normal working hours or other than their normal working there emotionally, I mean they will be. I mean easier to be nervous or be mad and be angry for any small thing.” (P22, migrant, technician). This finding suggests that while workers understand the physiological and emotional effects of heat stress, similar awareness about other psychological stressors such as anxiety and depression remains low.

In contrast to mental health, participants exhibited a strong and consistent understanding of workplace health and safety protocols for both national and migrant workers. A majority reported receiving comprehensive training. One respondent remarked “In my current position and previous roles, health and safety training focused primarily on basic safety protocols related to equipment operation and hazard awareness” (P15, national, construction manager). Another respondent commented “I have received comprehensive health and safety training from my current company and past construction companies” (P12, migrant, Civil Construction Engineer). This demonstrates the institutionalized emphasis on physical safety, which far surpasses the attention given to mental health in workplace training programmes.

Participants also recognized the pivotal role of management in promoting both physical health and safety and mental health. A substantial number highlighted the importance of managerial involvement in workplace safety. As noted by one participant, “Managers, of course, play a very important role in promoting health and safety” (P14, national, Safety Manager). Similarly, some participants emphasized the necessity of leadership in fostering supportive environments for mental health. According to one interviewee, “They play a significant role in promoting good mental health at the workplace by creating a supportive environment and offering training” (P4, National, Chief Safety Officer). One migrant respondent acknowledged the importance of management’s role by stating “Managers and supervisors have a significant role in promoting good mental health in the workplace” (P12, migrant, Civil Construction Engineer). These findings suggest that managerial leadership is perceived as essential for addressing both physical and mental health concerns effectively.

Meanwhile, Saudi workers generally reported better access to training and resources, with some acknowledging sporadic discussions on mental health within their organizations. In contrast, migrant workers often described limited or non-existent training opportunities, citing cultural and linguistic barriers as significant obstacles. One migrant respondent explained “We don’t talk about mental health; it’s not a priority in our culture” (P16, migrant, Construction Technician). This disparity highlights the need for culturally sensitive and inclusive training programmes that address the diverse needs of the workforce. By prioritizing equitable access to knowledge and resources, organizations can foster a more supportive and effective workplace environment for all employees.

• Beliefs:

The participants’ beliefs about mental health in their organizations revealed a growing acknowledgment of its prevalence and significance, albeit with persistent stigma and limited organizational efforts to address it. Many participants, including national and migrant workers, recognized mental health challenges as common among workers, often citing workplace pressures and personal issues as contributing factors. For example, one participant observed “I would say these days everyone has some form of poor mental health. In our company I have noticed so many cases that related to work and some from non-work issues like a family stuff” (P11, national, Senior Construction Manager). Another respondent stated “Many workers struggle with mental health, the tough working conditions, long hours, and being far from family can make it hard emotionally” (P16, migrant, Construction Technician). Migrants were frequently highlighted as facing unique challenges, including feelings of isolation and a lack of support systems. One participant emphasized this, stating “foreign workers who are away from their families and support systems, those without family or strong social networks may experience increased feelings of isolation or loneliness…” (P10, national, Director of Occupational Health and Safety).

Despite this recognition, participants reported significant gaps in how mental health is perceived and addressed within their organizations. Stigma surrounding mental health remained a recurring theme, with participants describing negative attitudes and misunderstandings about mental health issues. One respondent noted “People have a negative view of what mental health is about” (P3, national, Health and Safety Inspector), reflecting the enduring cultural and social barriers to addressing mental health openly.

National participants predominantly linked mental health challenges to work-related pressures, such as tight deadlines and high workloads, while migrant workers emphasized the emotional toll of isolation and cultural displacement. For instance, one migrant worker remarked “Especially for migrants or those without nearby family support, the lack of connection adds to the mental strain” (P16, migrant, Construction Technician). These contrasting perspectives underscore the need for tailored mental health initiatives that address the distinct challenges faced by diverse workforce groups.

• Awareness:

The findings reveal a stark contrast in the level of awareness regarding health and safety compared to mental health among national and migrant workers in the construction sector. Awareness of health and safety protocols was reported to be relatively high, with most participants rating it as robust and a smaller group considering it moderate for both types of workers. Participants frequently referenced mandatory health and safety programmes as key contributors to this high level of awareness. As one participant explained, “I think in rate, it is 7 as we have a health and safety programme which all workers must take, so they have an awareness about it” (P27, migrant, Civil Engineer). One national worker reported a similar experience, explaining that “I would rate the level of awareness on health and safety at a 7 out of 10. Because actually we did a lot of things, we provided the training to 95 percent of our employees” (P20, national, Health and Safety Specialist). This suggests that health and safety initiatives are well-integrated into workplace practices and are effectively communicated across employee groups (migrant and national).

In contrast, awareness of mental health was perceived to be significantly lower. A majority of participants expressed concerns about the lack of education and understanding surrounding mental health in their organizations. For example, one participant remarked “I would rate the level of awareness of mental health at a 3 out of 10. Mental health education is lacking, and many employees may not fully comprehend the significance of mental well-being at the workplace” (P15, national, Construction Manager). Likewise, one migrant worker rated the awareness of mental health at 3 out of 10, saying that “Awareness regarding mental health is notably low, with limited understanding and recognition of mental health issues among employees” (P19, migrant, Electronic Technician). This disparity highlights a critical gap in workplace initiatives, where the emphasis on physical safety far outweighs the attention given to mental health. While health and safety programmes are well-established, mental health remains an overlooked aspect of employee well-being.

4.2.2. Existing Health, Safety, and Mental Health Initiative, Programmes, and Resources

The practices related to health and safety, as well as mental health, within the construction sector varied significantly across organizations. Migrant and national workers generally attested to the presence of strong health and safety practices in their workplaces, with many acknowledging that their organizations had robust safety protocols and initiatives in place. These practices were often supported by structured programmes and resources. As one migrant participant noted, “Yes, there are health and safety programmes and initiatives in place within the organization. These include initial safety training during onboarding and safety protocols” (P19, migrant, Electronic Technician). One national worker said something similar, stating that “Yes, there are some health and safety programmes and imitative such as safety meetings, guidelines, and regular safety training” (P26, national, engineer). Also, the majority of participants confirmed the availability of health and safety resources, while only a small number reported the absence of such programmes. One national interviewee expressed that “Yes, there are some health and safety resources and support available for employees, including safety guidelines also posters around company” (P29, national, Civil Engineer). Similarly, another migrant worker indicated that “Yes we do have some resources on health and safety but only basic resources” (P28, migrant, technician).

In contrast, mental health practices were far less consistent, with considerable variation across organizations. While a minority of participants reported the availability of mental health, resources, and support, the majority indicated that their workplaces lacked formal mental health programmes. This disparity underscores the fragmented nature of mental health initiatives in the construction sector. Participants provided contrasting perspectives on these practices. For instance, one respondent explained “As I always say the needs of mental health programmes in our company and cross the country. So, there is no mental health or workshops in our construction company” (P14, national, Safety Manager). One migrant worker also noted that “No, we don’t have any of these, never heard about it, only things we know is the safety like PPE, safety training but not mental health” (P18, Migrant, Civil Construction Engineer).

In the context of the availability of mental health resources, the majority of workers expressed concern over their limited availability, with few acknowledging the presence of some support services. One national interviewee expressed that “Yes, somehow, we have communications, you know, through emails, but it’s not too much. Maybe once, twice a year, that’s it” (P20, Health and Safety Specialist), suggesting minimal and infrequent engagement with mental health issues. Conversely, another participant stated bluntly “No, there are no mental health resources or support available for employees within my company” (P21, national, Environmental Safety Specialist). One migrant worker also noted that “No, there are no specific mental health resources or support available for the employees in my organization” (P12, migrant, Civil Construction Engineer).

Health, Safety, and Mental Health Intervention: Barriers and Facilitators. The implementation of mental health interventions in the construction industry in Saudi Arabia is hindered by several systemic, cultural, and organizational barriers. These barriers, identified through participant responses, highlight the challenges that must be addressed to create a supportive and inclusive mental health environment.

Participants frequently cited resource limitations as a major barrier to implementing mental health interventions to stay updated. These constraints included a lack of trained mental health professionals, financial resources, and time allocated for mental health programmes. One participant observed “The focus is always on physical safety, but there is no mention of mental health” (P28, migrant, Technician). Another participant also stated “There is limited focus on staying updated regarding mental health intervention in my current workplace as we only focus on the time of project to be complete” (P26, national, Engineer). This prioritization of physical safety over mental well-being is indicative of the broader organizational challenges in allocating resources equitably.

Migrant workers face additional challenges due to linguistic and cultural differences, which exacerbate feelings of isolation and hinder their access to mental health resources. One migrant worker highlighted some key barriers: “Limited acknowledging mental health issues, culture differences, and difference of language” (P27, migrant, Civil Engineer). Another national worker acknowledged that the support and limited information about poor mental health as one of the barriers of intervention, saying that “I would say first barriers lack of support and knowledge that related to the poor mental health intervention…” (P11, national, Senior Construction Manager). Awareness of health, safety, and mental health barriers often makes it difficult for both migrant and national workers to communicate their mental health needs effectively or to understand the resources available to them. One participant noted “There are some barriers to addressing these working conditions may include lack of awareness and limited resources” (P14, Safety Manager, national). Migrant participants also noted the same: “The barriers, lack of awareness, fear of stigma, and culture not prioritizing mental well-being” (P19, migrant, Electronic Technician).

4.2.3. Health, Safety, and Mental Health Interventions

Participants highlighted three critical aspects of these interventions: management support, need for awareness, need for management training, and provision of interventions.

Management support emerged as a crucial determinant of the success of interventions. Many participants reported that their organizations demonstrated robust support for health and safety measures, often enforced through mandatory policies. One participant shared “Health and safety intervention, including training and toolbox talk, usually occur within the workplace during scheduled sessions” (P12, migrant, Civil Construction Engineer). However, this level of support was largely absent in the context of mental health. Participants noted that leadership engagement with mental health interventions was minimal, as reflected in comments such as the following: “Regarding mental health, leadership and management support for interventions is currently lacking” (P12 migrant, Civil Construction Engineer), and “Leadership and top management do not currently support any intervention related mental health but only health and safety” (P17, national, Safety Supervisor). This discrepancy highlights the broader organizational tendency to prioritize physical safety over mental well-being.

The need to bolster intervention awareness was another prominent theme, particularly regarding mental health. Many participants emphasized the importance of educating workers and fostering open communication about workplace stressors, including tight deadlines and long hours. As stated by a national participant “…in smaller sectors, raising awareness about both mental health and safety through open communication about stressors such as tight deadlines and long hours working…” (P30, national, Construction Technician). Raising awareness was seen as critical to reducing stigma, normalizing discussions about mental health, and encouraging workers to seek support when needed.

Participants emphasized the urgent need for management training to help leaders effectively address workplace mental health. Both national and migrant workers agreed that managers lacked adequate training in mental health interventions, limiting their ability to provide holistic support. As one respondent noted “Of course, everyone and managers need to have training on health, safety, and mental health intervention” (P13, national, Safety Specialist). Migrant participants also had same concern: “Must important the mangers need an additional training on safety and mental health issues to better support the workplace” (P27, migrant, Civil Engineer). This highlights a critical gap in leadership practices, where mental health remains overlooked in safety training programmes.

5. Discussion

This study highlights critical gaps in health, safety, and mental health awareness and intervention among migrant and national workers in the Saudi construction industry, particularly the prioritization of physical safety over psychological well-being. While companies have well-established safety protocols to mitigate physical risks, mental health remains largely overlooked, contributing to systemic challenges in the workplace well-being. The findings underscore the persistence of stigma, the need for leadership-driven mental health initiatives, and the disparity in access to support systems between migrant and national workers. This discussion focuses on five key areas: (1) the role of stigma and culture in mental health knowledge and beliefs, (2) the role of companies in addressing both safety and mental health, (3) the need for awareness campaigns, (4) integrating mental health into safety and resource access, and (5) the need for proactive and inclusive interventions. These areas will cover the five themes addressed (Knowledge, Beliefs, Awareness, Practices, and Intervention). Addressing these challenges requires structural changes in workplace policies and stronger leadership engagement in fostering a holistic approach to worker well-being.

5.1. Stigma and Cultural Barriers to Mental Health Knowledge and Beliefs

As reflected in our findings, one of the strongest barriers to effective mental health intervention in the Saudi construction sector is the stigma of mental health, which impacts national and migrant workers differently. Psychological distress has been regarded as an indicator of individual weakness, rather than a genuine occupational health problem [4]. This perception discourages workers from acknowledging their challenges or consulting professional advice due to fear of job insecurity, bias, or being stigmatized as incapable. The majority of migrant workers are subjected to more stigmatization based on deeply entrenched cultural assumptions in their countries of origin, where mental illness is generally viewed as taboo or poorly understood [14]. As such, they are unlikely to receive help and there are untreated mental illnesses that will likely lead to workplace accidents, decreased work performance, and deterioration in physical condition.

The HBM [15] helps explain why both migrant and national construction workers in this study avoid seeking mental health support. While both groups fear stigma, migrant workers face greater barriers due to cultural taboos, language issues, and limited access to support. The findings show that migrants are less likely to seek help, viewing disclosure as a serious risk. Literature reveals that peer support, mental health literacy training, and open forums run by senior management have the effect of reducing stigma and encouraging help-seeking behaviour among employees [6]. In addition, implementing anonymous mental health reporting programmes and confidential counselling services can provide employees with a channel through which they can report instances of mental health without the risk of stigmatization [6,20].

5.2. The Role of Companies in Addressing Both Safety and Mental Health

Building on our findings, although companies in Saudi Arabia’s construction sector have well-defined safety practice, mental health remains an overlooked aspect of workplace safety. Occupational health and safety laws and policies focus on tangible physical work environment, but they fail to account for psychosocial issues such as work-related stress, anxiety, and depression [10]. This imbalance is problematic because mental health issues can contribute to increased workplace accidents and reduced productivity. While both migrant and national workers are affected by this neglect, migrant workers are also disadvantaged by language barriers, unfamiliarity with workplace regulations, policy, and the absence of culturally appropriate support systems [19].

Companies need to recognize that mental health and physical safety go hand in hand and must be treated as a package. Overlooking mental health not only impacts employees’ health but also undermines workplace safety. Stress and burnout can hinder cognitive performance, resulting in increased error and increase accidents rate [30]. Studies have found that integrating mental health into workplace safety policies results in improved employee well-being, job satisfaction, and workplace effectiveness [7].

5.3. Need for Awareness Campaigns

The study has identified that mental health awareness in the Saudi construction industry is still poor, and most of the workers, especially migrant workers, are unaware of the general facts about mental health risks and interventions. The cause of such ignorance is more problematic given the fact that work in the construction sector is highly stressful and exposes employees to persistent stress, uncertain working conditions, and harsh environmental conditions. Without organized campaigns, workers are not made aware of the signs of mental distress and the facilities provided to them, and mental health issues remain untreated and worsen over time.

Evidence has shown that mental well-being awareness campaigns have been effective in reducing stigma and increasing help-seeking [19]. We suggest that awareness campaigns should be structured to consider workforce diversity, particularly among migrant workers, who need to overcome extra challenges such as language barriers and unfamiliarity with mental health services [14]. The literature highlights that companies that incorporate mental health education as part of their comprehensive occupational health efforts enjoy reduced workplace stress, enhanced worker engagement, and higher productivity [21].

5.4. Integrating Mental Health into Safety and Resource Access

One of the primary findings of this study is the sharp contrast in mental health and safety resources between migrant and national workers in recent years. The Saudi government has made tremendous strides toward improving physical safety, which benefits both migrant and national workers; however, their programmes have not yet addressed mental health [22]. National workers reported some access to mental health initiatives and resources, but most migrant workers had no access, primarily due to language barriers and exclusion from workplace initiatives.

This lack of support is compounded by weaker worker representation and advocacy for migrant employees, making it difficult for them to voice their concerns or demand equitable access to resources [21]. Research suggests that multilingual mental health programmes, culturally tailored counselling services, and specialized outreach efforts can significantly improve intervention access for migrant workers [19].

Mental health must be integrated into safety practices. Mental health issues such as stress, anxiety, and depression are just as risky to job safety as physical threats but are typically overlooked in standard safety measures [10]. The inclusion of mental health in occupational safety systems is necessary to ensure complete coverage to occupational health and safety. Traditionally, construction safety policy has predominantly been focused on avoidance of physical safety, with detailed guidelines provided on hazard evaluation and mitigation, and use of PPE. However, research indicates that mental health issues such as stress, anxiety, and depression are just as risky to job safety as physical threats but are typically overlooked in standard safety measures [10].

Our findings suggest that companies should include the Job Demand–Control Model [16], which explains how job demand and low control common in construction can lead to mental health issues, such as stress, especially without proper support [7]. Research indicates that mental health campaigns, when integrated into routine safety briefings and toolbox talks, have the ability to reduce stigma and improve help-seeking behaviours among workers [19]. Furthermore, companies must include mental health training and leadership-led initiatives as part of standard safety training. In being proactive in incorporating mental health into workplace safety policies, construction firms can establish a more durable and better-supported workforce, eventually leading to both improved employee wellness and increased overall workplace productivity.

5.5. The Need for Proactive and Inclusive Interventions

The findings show that most of the management (supervisors, managers, safety professionals) need training on how to implement workplace interventions in the Saudi construction sector. Migrant workers reported that leadership engagement and support for mental health interventions were limited. The construction sector has been mostly reactive toward mental health, responding only after workers show severe distress or reduced work performance due to mental health issues [25]. Research has shown that organizations that embrace proactive and vision strategies, whether these are routine stress management workshops, resilience training modules, and accessible mental health care providers, see a sudden reduction in absenteeism, job confrontation, and employee discontent [7].

Findings from the study indicated that migrant workers have extra sources of stress such as language barriers, cultural differences, and an absence of support from their family. These aspects led to increased vulnerability towards mental health issues; it was also noted that many migrant workers have no access to appropriate support services. Evidence has shown that culturally appropriate and linguistically tailored mental health interventions for workers are more effective in increasing participation and reducing psychological distress [19]. National workers, despite having more access to firm-provided mental health programmes, similarly face challenges with inconsistent mental health training and poor managerial support. A truly inclusive intervention strategy must span these gaps by offering equal opportunities for mental health treatment to every employee regardless of nationality or work status.

Leadership is critical in this process as supervisors and managers must be taught how to detect early warning signs of mental distress and act appropriately. Research indicates that organizations where leadership embraces mental health programmes report increased levels of employee trust, engagement, and overall job satisfaction [20]. Furthermore, organizations should implement flexible intervention strategies, such as open communication channels, mental health support systems, and expanded workplace outreach initiatives. These steps ensure that employees are provided with support at their convenience, regardless of work times or job locations.

6. Conclusions

This study reveals crucial gaps in mental health practice in Saudi Arabia’s construction sector—most notably, differences between migrant and national workers. Though there has been significant progress in the implementation of physical safety measures by the government, the exclusion of mental health continues to be an organizational issue. Low knowledge, poor awareness, and stigmatized views about mental health continue to block the development and use of effective workplace interventions. These problems are especially common among migrant workers, who also face barriers such as cultural differences, language challenges, and limited access to safety and mental health resources. National workers, while having better access to systems in their own workplaces, are still not immune to these structural gaps, showing that there is a general need for wider improvements in mental health support.

In order to address these disparities, an integrated and holistic approach must be adopted. The incorporation of mental health in health and safety policies is instrumental in developing a healthier and safer workplace. Measures like multilingual training sessions, culturally sensitive awareness campaigns, and flexible access to health, safety, and mental health resources can reduce the disparity between migrant and national workers. Leadership will need to be at the forefront in leading mental health discussions, fighting stigma, and ensuring equitable access to mental health treatment throughout the workforce.

Investing in mental health is an ethical responsibility and a call for intervention on the part of Saudi Arabia’s construction sector, especially with ambitious projects under Vision 2030. Whole-population mental health intervention can enhance the productivity of workers, reduce absenteeism, and increase job satisfaction more broadly, for workers and organizations alike [7,28]. Addressing the particular needs of national and migrant workers via fair and inclusive mental health strategies will transform Saudi Arabia’s construction industry into a model for the well-being and resilience of its workforce, supporting sustainable growth and development.

7. Limitations

The present study had some limitations, including that recognition of work-related mental health issues is still limited, which strongly affects how participants see these problems and their willingness to share information. Additionally, only 10 out of 30 participants were migrant workers, as language barriers limited their participation. Also, only one-third of participants were front-line employees, and differences in education and language may have influenced responses. This affects how well the findings can represent the wider migrant workforce. This reliance on self-reported qualitative data makes the participants’ responses subjective, as these responses might reflect socially desirable answers or a failure in trying to recall accurately. Moreover, the findings may be culturally specific to Saudi Arabia and cannot be assumed to generalize to other parts of the world. Lastly, the results reflect a snapshot of perceptions that may soon become outdated as mental health initiatives change; thus, ongoing research is required to keep up with current practices and new legislation. These limitations will, therefore, provide an avenue for future studies to further develop and improve this understanding and efficacy of mental health interventions within the construction industry.

8. Recommendation

The findings recommend a number of suggestions that will help raise safety and mental health awareness and interventions in Saudi Arabian construction. First, organizations should incorporate mental health education in their training programmes on safety, including how to notice problems with mental health, and ensure materials are accessible to workers with varying education levels and language background. Second, leadership needs to visibly be active in creating a supportive organizational culture through facilitating regular discussions and showing commitment to mental health, particularly for migrant workers. These should be awareness campaigns for stigma reduction by normalizing conversations about mental health and encouraging help-seeking behaviours. Third, companies should develop an overall support system that would provide Employee Assistance Programmes and counselling services to help employees manage stress effectively. Fourth, interventions must be culturally adapted to match local values and be in collaboration with mental health professionals to guarantee better acceptance. Finally, the continuous review of mental health initiatives and programmes, informed by employee insights, provides a good basis for determining effectiveness and realizing the need for further improvements. The application of these recommendations will facilitate a holistic interventions approach toward health and safety, realizing how very fundamental mental health is to the building of a productive workplace.