The topic of mental health and well-being has come to the fore within the construction industry in recent years, but has increased in prominence with the emergence of the COVID-19 pandemic. Steps have been taken by large organisations to develop and promote practices for mental health and well-being within the workplace; however, such focus is lacking in the micro and SME (m/SME) sector. Therefore, this study aims to address this shortcoming, to see how such practices could be implemented in m/SMEs in the Irish construction industry, and to promote better health and well-being practices as well as integrating the effect of COVID-19. Although this issue is being addressed year on year, the details are yet to be clearly defined, with not enough being done for the m/SMEs. To gather the necessary data, a mixed method approach was adopted with 12 industry interviews conducted plus 35 questionnaire responses analysed from respondents in the Irish construction sector. Thematic coding was used to decipher the core factors indicated by participants, while data reduction was applied to highlight the findings from the questionnaires. Key findings indicate that COVID-19 is increasing mental health and well-being issues within m/SMEs in the construction sector. This is exemplified by a lack of support, both internally due to a lack of time, money, and other internal resources, and externally due to limited support from government organisations. The value proposition of this research aims to identify the shortcomings that emerge in the management of mental health and well-being in m/SME organisations within the construction sector in Ireland, particularly with the emergence of the COVID-19 pandemic. Where such organisations acknowledge and address the findings, it is perceived that they will be better placed to address mental health and well-being within their workplace.