Construction workers are dying by suicide at an alarming rate

By Shannon Pettypiece | Originally posted on nbcnews.com

The construction industry has one of the highest suicide rates among professions, with an estimated 6,000 construction workers dying by suicide in 2022.

In a swath of Arizona desert that will soon be home to a multibillion-dollar semiconductor plant, Justin Azbill stood before thousands of construction workers and told the story of the day he almost took his life.

Pressure had been building on Azbill for months at his job as safety director for a large Boston construction firm during the height of the pandemic. Sleep-deprived and overwhelmed, Azbill said he packed a lethal means to harm himself in his lunch sack.

But as he was preparing to leave for work that morning, his daughter asked him to stay home with her that day. He did and the day provided a moment of clarity for Azbill, who then sought out help from a friend.

Azbill, who got his start in construction as an ironworker, has been traveling to construction sites across the country sharing his story as he and others in the industry race to address what they say is an epidemic of suicide among their colleagues — many of whom are under increasing strain amid a nationwide construction boom and a shortage of workers.

“In the construction industry, we’ve generationally been taught that if you talk to someone about a weakness or you’re struggling then you’re weak and you won’t get hired,” said Azbill. “One of the reasons I talk about it so freely is so people know that it’s normal and it’s OK.”

The construction industry has one of the highest suicide rates among professions — with the rate among male construction workers 75% higher than men in the general population, according to the Centers for Disease Control and Prevention. An estimated 6,000 construction workers by suicide in 2022, an increase from 2021, according to the most recent data available. That compares to around 1,000 who died from a construction work-related injury.

“When you’re more likely to be killed by your own hands than to get killed in a jobsite accident, that’s a crisis in our industry,” said Brian Turmail, vice president of public affairs and workforce for the Associated General Contractors of America. “We know pretty much what needs to happen to protect people physically. We’re figuring out how to protect people mentally.”

While construction wages are up and jobs are plentiful, those in the industry fear that the pressures on their workers’ mental health are only getting worse. A recent surge in construction projects, spurred by billions of federal dollars for infrastructure, clean energy and semiconductor projects have put increasing strain on an already stretched workforce.

As a result, workers are putting in more than 10-hour days in harsh weather conditions, facing high-pressure deadlines and having to spend months away from home living in hotels, temporary workforce housing or their vehicles. There is also the risk of workplace injuries and a higher rate of opioid misuse along with the general financial instability of hourly work.

“There’s a lot that goes into how stressful it is, not just physically, but mentally and psychologically,” said Josh Vitale, a superintendent for Hoffman Construction, the general contractor overseeing the Intel Arizona project where Azbill recently spoke. “I think progress is fantastic, but we have to realize that we are legitimately wringing the life out of people.”

One of the biggest building booms is being driven by the semiconductor industry. Companies are planning to spend $450 billion on 80 new semiconductor manufacturing projects in 25 states as part of a nationwide push led by the Biden administration to increase U.S. manufacturing of high-tech chips that go into everything from cars to military equipment, according to the Semiconductor Industry Association.

In Arizona, workers building the $20 billion Intel facility typically work two 60-hour weeks followed by a 50-hour week for months at a time in the hot Arizona weather with no paid vacation time, said Vitale. Because of a shortage of local workers, many are coming in from out of state, leaving behind friends and family and living for months or years in hotels or temporary housing.

For Azbill, a number of factors came together in a matter of months that pushed him to a place where he was close to ending his own life.

Azbill had spent decades working his way up the ranks of the construction industry, and when the pandemic hit, he was thrust into the role of Covid czar, working in an emotionally challenging and negative environment as his company tried to navigate the pandemic on its worksites, he said.

“I was working 19-hour days, and then I couldn’t sleep at night. Try that for six months and see where someone would be,” he said. “You start seeing everything negatively, there is this darkness. I was crying myself to sleep.”

At home, his relationship with his wife and daughter was fraying because for months he had barely been around, but he worried that if he cut back his hours at work he would let his family down financially, he said.

“At the time, I didn’t think that my wife or my daughter really cared for me because for six months I was angry all the time, they were cautious being around me, they didn’t want to cause more problems for me,” Azbill said.

After about six months, Azbill said he hit a breaking point. There was a Covid outbreak on a jobsite after some workers weren’t following safety protocols. The incident angered him in a way he’d never experienced. He said he blacked out and started having thoughts of suicide. He knew something was wrong so he went home to try to get some sleep.

He woke up at 2:30 a.m. the next morning and decided he was going to take his own life. He wrote three goodbye letters: one to his mother, one to his wife and one to his daughter.

“Before I left, I said, ‘Goodbye. I’m going to work, I love you guys,’” he said.

Then, his 8-year-old daughter, who was doing remote school, came running out of her room.

“She says, ‘Papa, Papa,’ and anytime she calls me Papa she steals my heart. It’s also her way of saying she loves me,” Azbill said. “I think she knew I was struggling bad, and I was her best friend. She said, ‘Papa, I love you, spend time with me, I don’t like my teacher and I don’t like school, can you spend time with me today?’ And so I did.”

Azbill stayed home from work that day and watched his daughter.

In the afternoon, he got on a weekly Zoom call with dozens of other safety professionals in the industry. Near the end of the call, one of the participants began crying, talking about losing one of his best friends to Covid and shared how he was struggling with the loss.

“I call that my clarity moment. It completely changed my mindset,” he said. “I realized I can’t do that. I’m not going to do what I was thinking.”

After the Zoom meeting, Azbill called a friend and shared that he was struggling. His friend told him how important he was to those in his life and that people are grateful for all he does. That phone call, he said, helped save his life.

At the Intel project, the site’s general contractor, Hoffman Construction, has tried to tackle the risk of suicide in a number of ways across its worksites after the company lost two of its supervisors to suicide over the past several years, said Vitale. Intel doesn’t employ any of the construction workers on the site or have direct involvement in the construction process.

The company has created community center-style spaces on its worksites where workers can have some personal space, attend a substance misuse meeting or talk with a peer who can help connect them to mental health resources. It also started including discussions about mental health in its regular staff meetings.

“It would be rare to find someone in the industry who hasn’t known a person that has taken their life within the last year or two,” said Vitale. “As an industry, we just keep putting more and more pressure on the worker to outperform what they’ve done before, and at some point it’s just untenable.”

Vitale has gotten involved in a number of efforts to reduce suicides in the industry after he struggled with his own mental health crisis after the loss of his baby, he said. Several times a week, he said, he is involved in a suicide intervention at the Arizona jobsite and has counseled dozens of colleagues thinking about hurting themselves, like a young carpenter he’s been talking to recently who is struggling with the loss of his mother and grandmother.

But even with those efforts, the worksite hasn’t been immune from loss — an employee for one of the project’s contractors recently died by suicide at home over the weekend.

Alarm bells about the high rate of suicide started going off in the construction industry in 2016 when a CDC report showed construction workers had one of the highest rates of suicide by profession, leading various industry groups to start looking for solutions. For every 100,000 male construction workers, 56 died by suicide in 2022, according to CDC data. That compared to 32 suicide deaths per 100,000 men in the general population. Males have a significantly greater rate of suicide than females.

A key focus for the industry has been trying to tackle the taboo nature of talking about mental health and seeking treatment. Industry organizations have been using everything from PSA-style videos and worksite talks to stickers, poker chips and magnets plastered around job sites informing workers of the 988 Suicide and Crisis Lifeline. Groups have also been creating resources like worksite talks and suicide prevention training courses to help guide employers in how to talk about mental health with their employees.

Construction firm Bechtel said earlier this year that it would spent $7 million toward an effort with the American Foundation for Suicide Prevention to reach 500,000 construction workers with industry-specific mental health programs.

Shannon Niles, safety director for construction firm Paric Corp., said he experienced the mental toll the job can take firsthand after witnessing a co-worker die on a jobsite when a trench collapsed on him. Niles tried to dig the man out but was unable to save him. He said he bottled up the trauma of the incident, becoming angrier and more withdrawn and drinking heavily until his family intervened and urged him to get help.

But Niles said there is an industry culture that discourages many from asking for help and a fear that showing any perceived weakness could jeopardize their job prospects.

“Construction workers think they’re so big and bad, that they don’t ever need any help. But we’ve got to realize we’re all human beings, and we all need help at some point,” Niles said.

Giving added urgency to the issue is an industrywide shortage of workers. At the start of 2024, the construction industry needed an additional 500,000 workers on top of the normal pace of hiring to meet the expected demand, according to Associated Builders and Contractors.

“You spend a couple-hundred-thousand dollars to train a superintendent for 20 years, and you’re going to throw them out the door now because they have a mental health problem or substance abuse?” said Mike Pugh, who oversees safety for DPR Construction. “They’re finding financially it’s not viable, it doesn’t pay any more to ignore and separate these issues because we don’t have anybody to replace them because there’s a worker shortage.”

It’s a stark change from when Pugh was facing his own mental health struggles more than two decades ago. Pugh said he began a downward spiral with drug and alcohol addiction following several traumatic deaths in his family. At the time, he was working in a high-level position for an HVAC company that worked on large-scale commercial construction projects.

“My bosses are watching me circle the drain and nobody’s really saying anything,” Pugh said. “As men, we’re taught to take care of your stuff, take care of your family. When you’re unable to do that you feel even more shame and guilt and it just all piles on until I just kind of snapped and couldn’t do it anymore.”

Ultimately, it was his brother who urged him to get help, and he has been in recovery for 25 years. Like Azbill, he now travels the country talking at worksites about the need for a culture change in the industry.

He thinks the message is starting to get through. Recently, he was at a jobsite in California where he had spoken about a year ago. While talking with the site’s safety manager, a laborer approached him and pulled him aside so no one would see them talking.

“He tells me, ‘Sir, after your talk last year, I went home and told my wife for the first time about my drinking, and I’ve been sober for five months,’” Pugh said. “We both started crying and hugging.”

If you or someone you know is in crisis, call 988 to reach the Suicide and Crisis Lifeline. You can also call the network, previously known as the National Suicide Prevention Lifeline, at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.