Promoting positive mental health in an unequal world: a focus on young construction workers from the Global South – Part 1

Construction work has a significant negative impact on the mental health of young construction workers worldwide. However, promoting positive mental health among young construction workers from the Global South who work either in their home or foreign country is challenging at best. This is because of inequalities that emanate from approaches to mental healthcare and the state of current research. In the first of this two-part article, I address five important questions on this topic.

What is the Global South?

Global South countries have a non-Western cultural background and have likely suffered colonization and its attendant consequences of under-development, neo-imperialism, and cultural marginalization. Global South countries are often tagged using the labels “developing”, “Third World”, and “low and middle-income”. The term also covers indigenous cultures whose ancestors once dominated the currently “developed” world (e.g., North America and Australasia) before the advent of Western colonization. Taken broadly therefore, countries like Brazil, Mexico, Ghana, South Africa, India, and China are all part of the Global South. People like the Native Americans of the US, the Aborigines of Australia, and the Maoris of New Zealand are also considered Global South people.

What does it mean to be mentally healthy from a Global South perspective?

Despite the varying socio-cultural characteristics, the Global South has a common framework of healthcare conceptualization and methods which differ only in context. Humans are seen as “socially constructed” and so for a person to be healthy means that they are in a state of harmony with their natural (plants, animals), social (society, family, friends), and spiritual (God, ancestors, and spirits) environment. This is why despite all the modifications introduced by Christianity, science, and technology, a typical Global South person, including a medical doctor, has no problem at all attributing problems (e.g., physical injury, ill-health, social challenges, and death) to a person’s breach of traditions, conflict with neighbors, and disrespect of human elders, ancestors, and deities.

What is unique about young people from the Global South and for that matter young construction workers?

Almost 90% of young people under the age of 24 have a Global South background. Diverse work opportunities for these young people are often limited and so many find ready employment as construction workers both in and out of their home countries. In developed countries such as Australia and the US, young Global South migrants constitute a key source of construction labour. As a matter of fact, this group has been envisaged as crucial for boosting the post-COVID economic recovery of countries such as Australia.

What is the state of mental health in the Global South?

The Global South accounts for about 70% of the worldwide burden of mental ill-health. There is a wide gap between the mental health needs and the availability of resources for promoting positive mental health and prevention of mental illness in this region. As a result, many young people from the Global South lack access to proper mental healthcare.

What gives rise to inequalities?

It is a well-known fact that the provision of mental healthcare is always significantly influenced by where it is practiced and the background of healthcare recipients. This notwithstanding, the Western world has global dominance and has therefore influenced many Global South governments to back a Westernized healthcare approaches that employ a disease-based framework. This model dwells on negative mental health, focuses on the treatment of disease symptoms, and ignores the underlying healthcare philosophy of the Global South as discussed earlier. The has had two main effects on the promotion of positive mental health among young Global South construction workers.

The first is the lack of support, in the Global South construction industry, for formal interventions based on alternative approaches for promoting positive mental health. Furthermore, because it is typical for Global South people to migrate with their healthcare perspectives and practices, young migrant construction workers in developed countries have the tendency to consider conventional Western medicine, which is often the only available option to them, as “culturally insensitive, discriminatory or even racist”. This could explain their low patronage of workplace mental healthcare interventions.

The second is the lack of situation-specific research on young construction workers with Global South backgrounds. Most of the attention has been on developed countries such as Australia, the UK, and the US. Furthermore, much of the research available also adopts a disease-based conceptualization of mental health. Thus, the current research alone is not adequate for strategy development and policymaking for promoting positive mental health among young construction workers from the Global South.

To conclude, it is clear that the current situation is at odds with the fact that promoting the mental health of young people - including construction workers - from the Global South is a key issue on the global mental health agenda. What are the implications of ignoring healthcare inequalities and whose responsibility is it to address them? I will give attention to these and other key questions in part two of the article.

I found the following sources extremely informative in composing my write-up:

Alloh, F.T., Regmi, P., Onche, I., van Teijlingen, E., and Trenoweth, S., 2018. Mental health in low-and middle-income countries (LMICs): going beyond the need for funding health prospect. Journal of Public Health. DOI: 10.3126/hprospect. v17i1.20351.

Dados, N. and Connell, R., 2012. The Global South. Contexts, 11(1), pp. 12-13.

Fernando, S. and Moodley, R., 2018. Global Psychologies: Mental Health and the Global South. Palgrave Macmillan, London, United Kingdom.

Frimpong, S.Y., Antwi, A.B., Boateng, E.S., Hagan, J.A, and Mensah, P.A., 2021.?The state of youth health in Ghana’s construction industry. Ghana: Participatory Development Associates (PDA) Ltd.

Index Mundi, 2019. World Demographics Profile 2019. Available from: https://www.indexmundi.com/world/demographics_profile.html.

International Labour Organization [ILO] 2017. Global Employment Trends for Youth 2017: Paths to a better working future. Geneva: International Labour Office.

Kieling, C., Baker-Henning Ham, H., Belfer, M., Conti, G., Ertem, I., Omigbodun, O. et al., 2011. Child and adolescent mental health worldwide: evidence for action. Lancet, 22, 1515–1525.

Loosemore, M., Alkilani, S. Z., and Hammad, A. W. A., 2021. The job-seeking experiences of migrants and refugees in the Australian construction industry, Building Research & Information, DOI: 10.1080/09613218.2021.1926215

Oude Hengel, K.M., Blatter, B.M., van der Molen, H.F., Bongers, P.M. and van der Beek, A.J., 2013. The effectiveness of a construction worksite prevention program on work ability, health, and sick leave: results from a cluster randomized controlled trial. Scandinavian Journal of Work, Environment and Health, 39(5), pp.456-467.

Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., et al., 2018. The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553–1598.