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Frank Wampol, vice president of safety and health at BL Harbert International, had a chilling realization a few years ago: More than 5,000 male construction workers die from suicide every year—five times the number of those who perish from work-related injuries. This stark statistic is especially troubling considering it is significantly higher than the suicide rate for men in the general population.
“To say this is a crisis would be an understatement,” Wampol said, as he grappled with the grim findings.
BL Harbert International, a Birmingham-based construction company with over 10,000 employees, quickly responded. They incorporated mental health first-aid training for on-site supervisors and began distributing suicide prevention information to their laborers. These efforts are part of a broader push to address the mental health crisis in the construction industry, a crisis that is gaining the attention of unions, research institutions, and federal agencies.
However, while safety measures such as hard hats, safety vests, and protective goggles are standard across the industry, implementing mental health protocols remains far more difficult. Initiatives like paid sick leave have faced resistance from the industry due to cost concerns.
Traditionally, the focus has been on the physical dangers of construction work. The “Fatal Four” hazards—falls, electrocutions, being struck by objects, and getting caught between two objects—are widely acknowledged as the leading causes of death on construction sites, according to the Occupational Safety and Health Administration (OSHA).
But recent studies are shining a light on a new, silent danger: the psychosocial risks. According to Dr. Douglas Trout, an occupational medicine physician with the National Institute for Occupational Safety and Health (NIOSH), suicide rates among construction workers are alarmingly high, and drug abuse, particularly opioids, is rampant. A study by the Centers for Disease Control and Prevention (CDC) revealed that construction workers lead the nation in overdose deaths, surpassing all other professions.
“Rates of suicides and overdose deaths are some of the worst outcomes related to mental health conditions,” Trout said, emphasizing that these are the most measurable consequences. However, less visible mental health challenges such as anxiety and depression are also prevalent. According to a preliminary 2024 study by the Center for Construction Research and Training, nearly half of construction workers experience symptoms of anxiety and depression—rates that are higher than those found in the general U.S. population. Yet fewer than 5% of these workers seek professional mental health support, a stark contrast to 22% of all U.S. adults.
The high-risk environment, coupled with long hours, job insecurity, and extended time away from family, places additional strain on construction workers’ mental well-being. While some contractors offer health insurance and workers’ compensation, paid sick leave for laborers, craft workers, and mechanics remains rare in the industry. Despite the 18 states and Washington, D.C., that have passed laws requiring paid sick leave, many workers remain excluded, leaving them to “tough it out” after injury, often self-medicating with prescription opioids that can quickly escalate to street drugs.
As Wampol points out, fatigue, pain, and personal struggles can combine to produce catastrophic consequences on a job site. “When workers are impaired—by substances or mental strain—the results can be deadly,” he said.
Breaking the stigma surrounding mental health is seen as the first crucial step in tackling this crisis. In the male-dominated construction industry, where emotional struggles are often dismissed as weakness, this task is particularly difficult.
To combat this, organizations such as the Associated Builders and Contractors and the Associated General Contractors of America (AGC) are leading the charge with initiatives like “toolbox talks” that teach workers how to spot the signs of mental distress and understand the risks of self-medication. Some companies are distributing “hope coins” and hard-hat stickers to encourage conversations about mental health, while others hold stand-downs, pausing work to provide on-site training.
Stanley Wheat, an on-site safety manager at BL Harbert, emphasizes the importance of building rapport with workers. A veteran of both construction and the military, Wheat advocates for regular check-ins with employees, particularly those showing signs of distress. “You’ve got to know your people, and you’ve got to engage them,” he said.
Peer-to-peer support has shown promise in addressing the mental health needs of construction workers. One model being considered in the U.S. is the Mates program, which began in Australia in 2008. The program trains workers to identify colleagues who may be in crisis, provide confidential support, and guide them to professional help.
Smaller, local initiatives are also making a difference. Some contractors have hired wellness coordinators, established quiet rooms on-site, or introduced naloxone (Narcan) kits to address opioid overdoses.
Despite these efforts, many in the industry remain hesitant to embrace change due to potential costs. As the industry faces economic uncertainty with the incoming administration, Wampol stresses that investment in mental health services will not only save lives but also result in a healthier, more productive workforce—ultimately benefiting the bottom line.
In the end, Wampol and others argue, the construction industry’s future depends not just on physical safety, but on fostering a culture of mental well-being. After all, the true measure of safety extends far beyond hard hats and safety goggles—it must also include care for the minds of those who build our world.
