"I’m good, man.”

“Nothing’s wrong, just tired.”

“You don’t wanna know.”

In an industry historically characterized by its stoic nature, these are often the responses you get if you ask a construction employee how they’re doing. Hard workers in a grueling industry, they’ve been conditioned by the very nature of the job to tough it out and get it done—and that’s taking a toll on their mental health. The numbers don’t lie: Construction is already a dangerous occupation, with 1,008 work-related jobsite fatalities in 2020, but the industry’s suicide rate for the same year is a staggering four times greater, at 5,242 employees.

According to the American Foundation for Suicide Prevention, suicide “most often occurs when stress and health issues converge to create feelings of hopelessness and despair.” What specific risk factors are prevalent in construction, and how can companies and the broader industry work to combat this crisis? The discussion around construction workers’ mental health is gaining traction, and while no one has all the answers, one thing is clear: We need to talk about it.

Under the Hard Hat

Construction’s inherent risks make physical safety a top priority for companies, with toolbox talks, OSHA training and proper PPE being just a few preemptive measures they take to protect employees’ wellbeing. But what about what’s going on underneath that hard hat? Simple demographics lay the foundation for a predisposition to suicide risk: Construction workers are predominantly white males, and nearly 40% are between the ages of 45 and 64—all characteristics of the general population most at risk. Construction is also a natural transition for many military veterans who, due to the nature of their service, often carry heavy burdens of trauma and PTSD.

With its transitory nature, construction workers often have to follow the job, leaving them disconnected from family and friends for extended periods of time and contributing to feelings of isolation and loneliness. Long and irregular hours can affect sleep patterns and cause mental and physical exhaustion. Seasonal or economic-related layoffs can place added stress on employees and could also mean loss of medical benefits and access to employee assistance programs (EAPs).

Last but certainly not least, the physical demands of construction take a substantial toll on the body and can result in severe musculoskeletal injuries or even chronic pain, leading some workers to self-medicate with alcohol or drugs. Not that it always begins as self-medication—construction workers are prescribed opioids for pain relief at a rate more than twice the national average, often taking them for much longer than the recommended 60-day maximum. As length of use increases, so does the risk of addiction, causing feelings of shame that can further isolate workers who desperately need assistance.

How do companies and colleagues start to identify who might be struggling? “It may be the things that they bring up with you, it may be their demeanor, it may be things that I don’t see on a daily basis because I jump around to different jobs each day,” says Marty Alter, senior safety manager for Cincinnati-based Messer Construction Co. “It could be pain, it could be coming to work late every day or missing work. It could even be personal hygiene, a sign that someone isn’t taking basic care of himself.” Messer trains all safety personnel on the importance of recognizing these signs and addressing them when there may be an issue.

“The pandemic is really when we started talking [about mental health in construction],” says Zeke Smith, former director of people operations for Satterfield & Pontikes Construction in Houston. “We realized we were putting a lot of effort into keeping folks safe from COVID-19 on the jobsite, but we had to consider their mental and emotional health as well, because suddenly people were dealing with the stress of kids in virtual schooling, or spouses trying to manage that while working from home or having sick family members and potentially even the loss of family members due to the pandemic. It became really apparent that we needed to pay close attention to how our employees were doing and look out for the warning signs that they might be struggling.”

From the C-Suite on Down

To see real progress in improving mental-health outcomes, industry veterans say, companies need to change their cultures, so employees feel a sense of trust and openness to share their struggles and seek help. “I started in the construction industry out of high school in 1978, and at that time, I think there was an expectation that you leave your troubles on the front seat,” says Greg Sizemore, vice president of health, safety and environment for Associated Builders and Contractors. “You pick yourself up and you climb out of it, because you’ve got to come to work, shake your head out, give them the best you’ve got. Well, it wasn’t right then. And it’s not right now.”

“When we talk about care seeking, you have to teach the recipients to accept care and you have to teach people how to offer care,” says Cal Beyer, vice president of workforce risk and worker wellbeing for insurance brokerage Holmes Murphy & Associates. “Someone isn’t going to raise their hand and say, ‘Hey, I’ve got a problem. I need help.’ You have to teach peers to look after people—to share support, to offer kindness. You have to teach people how to access their employee benefits. When all these things are in play, it becomes a virtuous cycle of support that builds a caring culture.”

That cycle of support has to start with the C-suite and extend to field workers and everyone in between. “On a national level we can raise awareness, but the real work needs to take place in their company, on their projects, in their community. Right in their own ZIP code,” Sizemore says. “The vast majority of construction companies in America today are 50 people or less. And they’re very static. They don’t have a lot of turnover. If I’m the CEO, I ought to be able to have a one-on-one conversation with my people to say, ‘I just want you to know that I care, and I’m going to take action to build an organization based on a culture of making sure that not only you but your family has access to the things that are going to make you not just physically safe but mentally healthy, too.’”

The simplest action, according to Alter, is starting a conversation. “Simple,” he says, “but not easy. Some people are just really tough to have a conversation with. You know if you ask how they’re doing, they won’t pour their hearts out to you. But sometimes just asking the question is enough to get them thinking, and eventually, they might start talking.”

Messer has worked to create an environment where employees are educated on the resources available to them and feel comfortable coming forward. This past May, the company hosted its first mental-health-focused speaker during Construction Safety Week, which typically is dedicated to all things physical safety. “We didn’t know how it was going to go over, but it turned out to have a huge impact,” Alter says. “After that meeting, five different employees came forward and shared some pretty serious things they were dealing with. I think talking about this issue in a group setting, where you’re not singling anybody out, to stop and let people know that someone is there for them—that’s huge.”

For those employees who aren’t quite ready to talk, publicizing other resources is critical. “When we started talking about this at the company level, we knew that posting the crisis hotline number and other information on where to seek assistance was going to be key, because not everybody was going to speak up,” Alter says. “We have had to make sure those resources are widely available, so that the people who need help but aren’t necessarily ready to come forward at work can take advantage of services from the comfort of their own homes.”

Taking a STAND

Like any serious problem, suicide in the construction industry isn’t going to go away by being ignored—and the industry is taking steps to make sure that it’s not. When the CDC released data about the alarming suicide rate among construction workers, alarm bells rang. The Construction Financial Management Association convened a summit of key industry stakeholders—including contractors, insurance professionals, association professionals, educators and subject-matter experts in suicide—to start talking about what could be done to fight this five-alarm fire.

“This was really an ‘aha’ moment to have this data point that said what a huge problem suicide had become in our industry,” Sizemore says. Recognizing the need for organization, a group from the summit formed the Construction Industry Alliance for Suicide Prevention (CIASP), an independent 501(c)(3) dedicated to raising awareness about suicide prevention and providing resources and tools to create a zero-suicide industry by uniting and supporting the construction community. Says the organization’s website: “CIASP is dedicated to changing the statistics by educating and equipping organizations, industry service providers and construction professionals to STAND Up for suicide prevention and address it as a health and safety priority.” CIASP encourages companies to take the steps outlined in its pledge to:

• create safe cultures;
• provide training to identify and help those at risk;
• raise awareness about the suicide crisis in construction;
• normalize conversations around suicide and mental health; and
• ultimately decrease the risks associated with suicide in construction.

“When I sat down with our CEO, George Pontikes, and said that I wanted the company to take this pledge, it was a zero-hesitation ‘let’s do this,’” Smith says. Since then, Satterfield & Pontikes has devoted time and resources to incorporating mental health into toolbox safety talks, providing trainings on suicide prevention and even investing in an app, free of charge to employees, that sends daily push notifications to encourage them to check in on their mental health. “We’ve taken the pledge really seriously,” Smith says, “and it’s made a real impact on our team’s ability to cope with some of the challenges we’ve faced in the past couple of years.”

This isn’t easy—but not much about construction is. When it comes to growing suicide awareness and prevention, that can be an advantage. “At our core in the construction industry, the millions of men and women that make up our workforce are problem solvers,” says Sizemore, who serves as chair of the CIASP Board of Trustees. “Every day we deal with a variety of challenges; we do that on projects large and small across America and around the world. If we approach suicide in construction as problem solvers, as challenge overcomers, if we do the work, if we put in the time, if we roll up our sleeves and are willing to sometimes get dirty doing it, we will make a difference and we will create a zero-suicide construction industry.

“This is one of those moments in life that we need to take a pause and say, ‘You know what? It’s time for the construction-owner community to become servants of the industry,’” Sizemore continues. “We need to protect the current and the next generation of craft workers, because we are the caretakers. This isn’t about what the industry can do for you; it’s about what you can do for your industry. When we become servants of our industry as opposed to just owners of our companies, then things will change for us.”