Beyond hard hats: Mental struggles become the deadliest construction industry danger
By Katja Ridderbusch / KFF Health News | Originally posted on popsci.com
If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.”
BIRMINGHAM, Ala. — Frank Wampol had a dark realization when he came across some alarming data a few years ago: Over 5,000 male construction workers die from suicide annually — five times the number who die from work-related injuries, according to several studies. That’s considerably more than the suicide rate for men in the general population.
“To say this is a crisis would be an understatement,” said Wampol, vice president of safety and health at BL Harbert International, a construction company based in Birmingham with over 10,000 employees.
Since then, the company has added mental health first-aid training for on-site supervisors and distributed information about suicide prevention to laborers in the field. The efforts are part of a larger push led by the industry and supported by unions, research institutions, and federal agencies to address construction workers’ mental health.
But initiatives to combat this mental health crisis are tougher to implement than protocols for hard hats, safety vests, and protective goggles. And some of the potential solutions, such as paid sick leave, have drawn pushback from the industry as it eyes costs.
Safety experts have long been concerned about the physical hazards of construction work. The “Fatal Four” hazards are falls, electrocutions, being struck by an object like a brick or a crane boom, and getting caught between two objects, according to the Occupational Safety and Health Administration.
Only in recent years have the psychosocial hazards of construction work moved onto the public radar. Studies paint a grim picture, said Douglas Trout, an occupational medicine physician and deputy director of the Office of Construction Safety and Health at the National Institute for Occupational Safety and Health.
In addition to high suicide rates, drug use is rampant, especially opioids such as heroin and fentanyl. A recent study from the Centers for Disease Control and Prevention found that construction ranks highest in overdose deaths by occupation.
“Rates of suicides and overdose deaths are some of the worst outcomes related to mental health conditions,” Trout said. “And unfortunately, these are the more measurable ones.”
Less measurable but also prevalent among construction workers are anxiety and depression, which often remain undiagnosed. Almost half of construction workers have experienced symptoms of both, a rate higher than that of the general U.S. population, according to a preliminary 2024 study by the Center for Construction Research and Training, an arm of North America’s Building Trades Unions. But fewer than 5% of construction workers reported seeing a mental health professional, compared with 22% of all U.S. adults, according federal statistics.
The combination of high-hazard environments and organizational factors puts construction workers at particular risk for mental health issues, Trout said. Construction is a high-stress occupation involving long hours, extended separation from family and friends, and low job security due to the industry’s cyclical nature.
Even though health insurance and workers’ compensation are offered by some contractors, paid sick leave for laborers, craft workers, and mechanics is not standard. While 18 states and Washington, D.C., have approved laws requiring paid sick leave and federal contractors have to offer it, the mandates don’t apply to many construction workers. And industry advocates are pushing back against such legal requirements, claiming they don’t fit the transient and seasonal nature of construction work.
If workers get injured, they often “try to tough it out and get back to the job as quickly as possible,” said Nazia Shah, director of safety and health services at the Associated General Contractors of America, the country’s largest construction trade association.
To manage pain from injuries, workers often resort to prescription opioids. Some then develop a dependency and turn to street drugs. “It’s a vicious cycle,” Shah said.
