Safety training in the construction industry tends to focus on preventing physical harm — falls, electrocutions, repetitive motion injuries, heat stroke and the like.
But with a suicide rate that’s among the highest of any industry in the nation, the construction industry is increasingly recognizing mental health as an integral part of worker well-being and jobsite safety.
According to a 2023 report from the Centers for Disease Control, the overall suicide rate for men across all industries was 32.0 deaths per 100,000 workers. In construction, it’s 56.0 deaths/100,000 — 75% higher than the national average and second only to mining at 72.0
(Suicide among women is much less frequent — 8.0/100,000 across all industries, and 10.4 in construction. However, while the number of women in the industry is at an all-time high, they account for less than 11% of the total construction workforce and just 4% of laborers and tradespeople, according to federal data analyzed by the National Association of Home Builders. So the significant difference in suicide rates by gender doesn’t make a meaningful difference in the overall suicide rate for construction workers.)
Suicide is the extreme result of mental health concerns that go untreated, but it’s not the only area of concern. Opioid addiction and overdoses among construction personnel often begin with physical injuries on the job, but also relate to mental health — and far outweigh the deaths in either of those categories.
The kind of dangers that safety training typically focuses on — OSHA’s so-called Fatal Four — accounted for 982 construction jobsite fatalities in 2023, The Center for Construction Research and Training (CPWR) notes. By comparison, there were 5,095 suicides that year, and another 15,910 fatal drug overdoses among construction workers.
“Although construction workers are only about 7% of the entire workforce, they were 20% of on-the-job fatalities and 16% of opioid overdoses,” according to CPWR.
Why construction employees struggle
There are four main reasons construction has such alarming rates of suicide and drug overdose, according to a variety of experts.
1. Demographics and baseline risk: Across all U.S. residents, men die by suicide about four times more frequently than women, according to the CDC. Because construction is still one of the most male-dominated occupations in the country, the industry starts with elevated baseline risk.
The aging of the construction workforce is another factor, as suicide rates generally increase by age. And finally, veterans — who have higher-than-average suicide rates — constitute a slightly larger share of the construction workforce than for other industries, notes construction software company BuildOps.
2. Work-related stressors and physical conditions: The construction industry itself is tough on the bodies of its workers. And studies consistently link chronic pain to higher rates of depression and substance use — particularly opioids, which remain a significant contributor to suicide risk and accidental death.
Add irregular hours, seasonal layoffs, schedule compression, travel and daily jobsite dangers and the mental health risk becomes even more acute.
3. Cultural factors: Construction has a proud culture of toughness and self-reliance. But that same culture can make it hard to admit when someone is struggling. Jobsites are often isolated and may involve work at odd hours. Many workers lack ready access to mental healthcare — and there is still a stigma attached to that kind of help.
4. Industry fragmentation and financial stress: Finally, it’s no secret that working-class Americans have, for years, experienced increasing financial strain due to wages that aren’t keeping up with rising costs for everything from food to housing to education to healthcare.
Add tight deadlines, liquidated damages and operational stress, and even the bosses — owners, project managers and foremen — are under crushing pressure.
But the available support systems are wildly inconsistent because of the industry’s fragmented nature. On any given day, the people at a jobsite may be working for a general contractor, any of several subcontractors or a temporary labor agency. Each of these entities decides on its own what kind of training and support to offer workers.
How to help (without becoming a social worker)
1. Make mental health part of safety: OSHA now explicitly includes suicide prevention in worker well-being guidance, and the most successful companies treat mental health like any other safety risk. Add a 60-second check-in during weekly safety meetings; encourage foremen to notice changes in behavior; and emphasize that asking for help is part of staying safe.
2. Provide basic resources: Even modest resources matter, including Employee Assistance Programs (EAPs), one-page handouts listing crisis numbers, peer-support programs and simple training for supervisors to recognize signs of distress or crisis — and to know how to respond effectively.
3. Reduce avoidable stressors: Communicate early about manpower and overtime. Manage fatigue during heat waves. Allow modified duty without stigma for those who need extra time to take care of their mental or physical well-being. Check in with employees during injury recovery.
4. Track what you can: High turnover rates can point to issues with working conditions that affect employee mental health. Absenteeism records can identify employees who may be struggling, either temporarily or on a sustained basis.
If employee benefits include an EAP, track utilization of that program too. Employers aren’t entitled to know specifically who is using the EAP, but anonymized data that the vendor is permitted to provide can alert you to trends and changes across the team.
Anonymous surveys among workers — taken monthly or quarterly — can also help to gauge changes in the team’s emotional well-being. Review the surveys for patterns and trends as opposed to individual answers.
5. Resources: As a builder/contractor, you aren’t alone. Here are some resources:
- CDC Occupational Suicide Dashboard: Provides data by state, county, city or ZIP code on deaths from suicide, drug overdose or violence.
- OSHA Suicide Prevention: Workplace resources to support mental health.
- CPWR Resources to Prevent Opioid Deaths in Construction: Statistics, toolbox talks, infographics, a complete training program and other resources.
- CPWR Data Bulletin on Construction Worker Injuries, Overdoses and Suicides: Deeper insight about the intersecting issues around mental health.
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