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Truck drivers sometimes bear the image of being “tough” and impervious to emotional stresses, a perception that doesn’t always lend itself to open discussions about mental health. But truckers and their employers are working to change that image and pay greater attention to mental health and how it influences workers’ overall well-being — as well as work performance.
A spate of trucker suicides last year shone a brighter light on the issue of drivers’ mental health and the importance of improving support for them. But stopping suicide is not the whole picture; it plays into the wider, complex topic of mental health.
More than 17 million American adults experience depression, making it one of the most common mental disorders, according to National Institute of Mental Health data.
“What we’re seeing in terms of truck drivers is that it’s almost double,” said Kirleen Neely, psychotherapist and CEO at San Antonio-based Logistics Mental Health. “That alone is alarming because depression is correlated to suicide, and suicide is a leading cause of death.”
Suicide is now among the 10 leading causes of death for adults in the United States, with the rate rising about 30% over the past 20 years, according to the U.S. Centers for Disease Control.
The suicide rate is higher among certain groups and within certain professions. By occupation, transportation has the fourth-highest rate among American working-age adults. Suicide is especially a concern for male-dominated industries such as trucking because nearly 70% of people who die by suicide are male, Neely said.
Suicide rarely occurs because of one issue, but mental health conditions are a factor, CDC reports. Depression and anxiety are top issues among truckers, closely followed by post-traumatic stress disorder.
“On the road, they’re seeing horrific things — accidents and things we don’t think about. We don’t always think how that translates to anxiety and fear,” especially when a driver doesn’t process their thoughts and emotions, Neely said. “They need to talk about it to move forward.”
Many factors unique to the transportation industry put drivers at a higher risk of depression or other mental health disorders. The amount of time that drivers are isolated in a cab and away from family and friends is a major element. Intense pressures to deliver on time and from traffic conditions are others. Inadequate restful sleep and poor access to healthy meal options and physical activity also can be contributing factors.
“It’s not a great environment for them. They have a really tough job,” said Duskee Kassing, director of operations at Dot Transportation Inc., the trucking subsidiary of food industry redistributor Dot Foods.
Common indicators correlated to mental health distress include increased fatigue, trouble focusing and increased risky behaviors such as substance use. These factors increase a driver’s probability of being involved in a preventable accident.
Although there are many common stressors and mental illness indicators, men and women exhibit some differences along gender lines.
Men are less likely to voluntarily talk about mental health and their emotions. They view it as a sign of weakness, believe they may be judged and are embarrassed by it. Bottling up emotions and issues contributes to poor mental hygiene, sources say, and the stigma is especially strong in trucking.
“There’s still a machismo in driving — not wanting to admit and deal with the stigma and discrimination with seeking care for mental health problems and mental distress,” said Mona Shattell, associate dean for faculty development at Johns Hopkins School of Nursing. “Truckers are a hardworking group, and mental illness in our country … is still seen as a weakness.”
Men often exhibit non-obvious indicators of mental health issues, such as anger, when they’re grappling with mental distress. “One of the clinical indicators of depression is irritability. … Anger is a surface emotion, the easiest one to show,” Neely said.
Anger can manifest in forms such as increased cursing, yelling, punching objects and walking out on conversations. Supervisors who recognize these characteristics should carefully consider an appropriate response or intervention.
“We need to train leaders to know that when they see this, instead of matching that emotion and reacting to anger, connect with [the employee] and see what can make this better,” Neely said.
Women’s gender-specific experiences that contribute to depression and anxiety include discrimination or negative comments about working in a male-dominated industry, feeling unsafe on the job and perceiving themselves as a subpar parent or caregiver while on the road.
Shattell has conducted several studies on truckers’ mental health. Much of the research examined only men because of their predominance in the industry, but she’s currently examining results from a study that includes women. Preliminary analyses suggest that women more frequently employ mindfulness techniques, and engaging in mindfulness could help to improve mental health for truckers as a whole.
In the past, business leaders may have viewed mental health as a personal issue and not one to discuss with employees. But the topic should not be ignored at work, for the worker’s, business’ and public’s sake.
“At the end of the day, this affects their bottom line,” Neely said. “If a driver is worked up about their marriage and can’t function, they’re not going to be a good worker. And it increases the possibility of a road accident.”
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The topic should be approached with care. Supervisors should find a way to connect with employees, even about problems that are solely related to their personal lives, sources said.
Connecting with drivers is important to Dot’s supervisors, Kassing said. It helps employees understand their value and have an outlet to talk about any issues. Supervisors can observe changes in the driver’s behavior that could indicate mental distress.
“Companies do a lot of communication electronically — messaging in the truck or by text or email. We try really hard to make more physical contact with our drivers,” Kassing said. “When you see them, you may recognize something … and you don’t get to see that with online communication.”
Managers can enlist help from a third party to address drivers’ mental health. One option is to incorporate driver counseling and supervisor training from mental health professionals. They could offer companywide training on coping and problem-solving skills. Neely, for example, works solely with logistics businesses, employees and family members to provide mental health care and conflict resolution specialized for the industry. And last year, the Nova Scotia Trucking Safety Association became the first Canadian transportation association to offer industry training for mental health and reducing the stigma in the workplace.
While large operators might offer insurance that covers mental health care, that’s not necessarily the case for all drivers, especially independent operators. This presents a barrier to receiving care.
Another barrier is the perception that admitting an issue — suicidal thoughts, for example — might render a driver unfit for duty.
“When your livelihood depends on getting a pass on the DOT exams, truckers might not be 100% forthright with what they’re experiencing because they need to keep driving,” Shattell said.
Mental health professionals say drivers’ apprehension is understandable, but they still should seek help to prevent mental distress from worsening and possibly leading to a catastrophic event.
The transient nature of trucking presents a challenge: Truckers have difficulty making and keeping therapy appointments. But efforts are underway to increase health care access. Telehealth is a growing way for drivers to connect with therapists while on the road.
“I think we need more of that,” Shattell said, noting that drivers could do it in their cab for ease and to ensure privacy. “We need to provide more health care services where truckers are — more clinics at truck stops and warehouses. It’s nearly impossible for them to come to us.”
A Dot Foods family health center. (Dot Foods)
Dot has on-site family health clinics at several of its distribution centers. Drivers can get an appointment on relatively short notice to address physical and mental health needs, Kassing said. Dispatch and supervisors do their best to work around drivers’ appointments.
Bringing a significant other or pet along on the road is growing in popularity and alleviates truckers’ isolation. Industry participants recommend improvements for other well-being aspects, such as sleep.
“I would love to see a focus on more options for places that drivers can sleep and get good rest,” Kassing said.
Truckers are stepping up to help each other with mental health outside of formal health care settings. The number of Facebook groups dedicated to providing a space for drivers to have an open dialogue with and offer support to their peers, especially in times of mental health crisis, is growing rapidly. The Facebook group “Truckers for Truckers” is one example.
“People are pouring their hearts out to Facebook groups. … Good drivers are supporting each other. That lets you know what a huge issue this is. They know they need help, and they want help,” Neely said. “Now, we need to get more companies on board.”
Although sources report seeing a small shift in attitudes about mental health — inside and outside of the trucking industry — there is far more to be done, they say. Working to revamp the way people look at mental health is a first step. It’s time to shift the focus to the concept of whole health.
“Without mental health, you can’t have physical health,” Shattell said. “We really shouldn’t even differentiate — we should just say ‘health’ and include ‘mental’ in that.”
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