Building Awareness Of Mental Health In Construction Is Critical To Industry's Survival

The stress of deadlines, fear over the temporal nature of construction work and chronic pain from injuries are just a few of the stressors that plague men and women working in the U.S. construction industry.

The suicide rate among construction workers is higher than average, and the stigma around mental health and treatment continues to keep people in the industry from speaking out and asking for help. 

"I think the big issue is there is a sense of pride in the construction worker, and they do not want to show any type of weakness, whether it's physically or mentally," Skanska Environmental Health and Safety Director for Texas Carlos Alvarez said. "So I think it is important to address mental health awareness in the construction industry."

The suicide rate for men in construction and extraction services in 2016, the most recent data, was 49.4 out of 100,000, which is twice the suicide rate for the total civilian population of working men in the 32 U.S. states studied, according to the Centers for Disease Control and Prevention data.

The male construction and extraction services suicide rate in 2012 and 2015, respectively, came in at 43.6 and 53.2 people per 100,000 civilian non-institutionalized workers, according to the CDC. 

Preliminary data from 2020 shows U.S. deaths from suicide declined by 5.6%, according to the CDC. But the number of deaths from unintentional injury grew 11.1% last year, which includes opioid overdoses, a problem also plaguing the construction industry more than in other sectors and which also can relate to mental health. 

The construction industry has long been known as one where injured workers dealing with chronic pain and emotional stress have a higher likelihood of turning to opioids for relief. 

"The industry has always been a very high-stress occupation if you will. It is a situation where there is a lot of stakeholders that you are dealing with to get the job done," McCarthy Building Cos. Southern Region president Joe Jouvenal said. "There are a lot of different individuals and personalities; and at the end of the day, it is a performance-based industry."

In Massachusetts, 25% of all workers who died of opioid-related deaths from 2011 to 2015 were in the construction field, Bisnow reported last year. 

The injury rate for construction workers is 77% higher than the national average for other professions, according to the Midwest Economic Policy Institute. Painful injuries can affect mental health and often lead to addiction to opioids used for the treatment of chronic pain. About 15% of construction employees have a substance abuse problem of some sort, compared to the national average of 8.5%, the MEP said.

The problems facing construction workers are not as simple as they look on the outside, Alvarez said.

"It's not just going out and swinging a hammer and placing concrete. There's something else that goes with construction other than just the physical aspect of being safe," Alvarez said. 

The pandemic has added further stressors and intensified concerns about suicide.

Construction workers were one of the first industries in many states to return to work in 2020, and they faced major stressors from fear of exposure to the coronavirus to millions of job losses in the beginning of the pandemic.

All of this has taken its toll on their health.

"We have seen across the board mental health challenges worsen," crisis counselor Charly Jaffe said of the pandemic's impact on all U.S. workers.

CDC data released in August in the midst of the pandemic found that 40% of Americans are struggling with some type of mental health issue or substance abuse, and more than 1 in 10 American adults have seriously contemplated suicide.

"We're talking depression, anxiety, PTSD, not that all of it is necessarily diagnosed. We've been experiencing collective trauma to differing degrees," Jaffe said. 

Construction is one of the hardest-hit industries when it comes to mental health, Jaffe said. The nature of the industry fuels worker insecurity since the work is seasonal in nature, and there is a trend of sleep disruption, chronic pain and even travel that may isolate workers from family and friends, Jaffe added. 

"It's not that it didn't exist before, it intensified," Jaffe said of mental health issues amid the pandemic. "The conversation is now out in the open."

May is mental health awareness month, and construction companies around the U.S. are taking the opportunity to shine a spotlight on mental health issues in their industry and try to erase the stigma about them.

Alvarez said he recently read a few articles discussing what he considers Skanska's philosophy on mental health: "It's OK not to be OK." 

Alvarez said Skanska is dedicated to making sure employees at all levels know the signs of anxiety and depression and have information on how to seek help whether through the company's employee assistance program or through other appropriate mental health channels. 

At each meeting, the firm has a "values moment" where team members can discuss topics such as the impact of work on their mental and physical health, according to Alvarez. 

"For example, just last week our general manager spoke about ‘telepressure,’ the pressure we feel to constantly be checking and responding to messages at all hours of the day," he said. "These conversations help to open up team discussions related to mental health, allowing us to have honest and vulnerable conversations on a regular basis."

This year, the firm also hosted a talk about the warning signs of suicide and depression at all job sites. 

The construction giant also is using its Care for Life initiative to create more awareness around mental health and highlight resources available to workers, Alvarez said.

McCarthy is highlighting its Build for Life health and wellness program in May. The internal initiative aims to raise awareness around mental health and bring more strategies into focus for treatment and support for those who are struggling.

The firm offers employees talks on mental health and offers them a toolbox with materials on suicide prevention and supporting literature to educate staff members at all levels. It also has signage posted to raise awareness and keeps promoting the issue on its intranet site. McCarthy also encourages use of the employee assistance program and supports employees using paid time off to deal with mental health issues. 

The pandemic has made the initiative more important than ever, Jouvenal said.

"It shined a light on how much more important it is now that we not just address [mental health] as part of [the overall wellness] strategy, but make it a part of the conversation because there is a stigma many times that surrounds mental illness," Jouvenal said.

"Our job is to be a loud voice in the industry to draw that out and have the conversation to make sure that people know it's OK."