Key Takeaways

- In addition to the four leading causes of death in the construction industry (fall, struck-by, electrocution, and caught-in or between), suicide has recently become an increasing concern, as construction workers have the second-highest rate of suicide among all industries.

- A pilot study was conducted in the U.S. Midwest. Results indicate a gap between the degree of importance employers and workers place on mental health and suicide issues. Workers did not view mental health or suicide as an important workplace issue and indicated low comfort levels in discussing mental health or suicide with coworkers and supervisors.

- Most organizations or employers did not have suicide prevention programs, and limited resources for mental health or suicide issues were available from the organization or employer.

- The increase of suicide in the construction industry demands increased implementation of suicide prevention programs, greater awareness, and available resources relating to mental health and suicide issues. Safety professionals are well positioned to increase awareness and implement mental health and suicide prevention programs as part of their safety role.

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According to the CDC, approximately 11.4 million workers were employed in the U.S. construction industry in 2019, a 25% increase since 2011 (Peterson et al., 2020). The construction industry experiences the highest numbers of fatal work injuries among private industry sectors in the U.S. (U.S. BLS, 2022). The top four leading causes of death in construction have consistently been fall (33%), struck-by (15%), electrocution (7%), and caught-in or between (5%). However, mental health and suicide have become increasingly relevant to workplace safety and wellness. Construction workers have the second-highest suicide rate of all industries (Peterson et al., 2020). The rate of suicide in construction is 45.3 deaths per 100,000 people, which is three times the U.S. national average of 14.2. In fact, in all developed countries, blue-collar construction workers are at a higher risk of suicide among all employed men (Dong et al., 2022). In addition to the loss of life, construction- related deaths cost the U.S. nearly $5 billion in lost productivity, reduced family income, pain and suffering, and lower quality of life (CPWR, 2007; Midwest Economic Policy Institute, 2017).

Several risk factors have been identified for high rates of suicide in the construction industry. First, construction workers are more likely to be male (90.8%), a much larger proportion compared to the general U.S. workforce, and most deaths due to suicide are among males (CDC, 2024a). Other risk factors related to construction industry personnel and their work environment have been suggested, including work-related chronic pain, high rates of substance use, access to lethal means, poor working conditions, and lack of accessible mental health care (Stergiou-Kita et al., 2015). Also, research has highlighted that construction work culture values risk-taking, stoicism and self-reliance, which may interfere with help-seeking behaviors (Stergiou-Kita et al., 2015). Moreover, research has indicated that most construction workers are hesitant to discuss mental health issues with their employers and coworkers, which may further limit help-seeking (Center for Workplace Mental Health, 2021). Lastly, males have greater levels of stigma toward mental illness compared to females, and greater levels of stigma are associated with greater psychological distress and sleep difficulties (Eyllon et al., 2020).

Although safety professionals traditionally focus on occupational risks to physical health, the high rate of suicide in construction suggests an urgency for safety professionals to address mental health and suicide prevention. However, there is a lack of research examining prevention programming, and existing prevention programming has been largely ineffective (Duckworth et al., 2022). Thus, the present study sought to examine views of employers and construction workers toward mental health and suicide as a problem in the workplace, their comfort level with discussing these issues, and the frequency of mental health and suicide resources available within organizations as an initial step for developing safety professional interventions to address knowledge and attitudes in the local industry.

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