National Suicide Prevention awareness month

Why Do Construction Workers Have Higher Suicide Rates?

The construction industry knows it has a problem. Working in the building and construction trades has become the US’s deadliest occupation. But it isn’t cranes or ladders nor bad backs or broken bones that get construction workers to sign off. They are more likely to die by their own hands rather than be killed in an on-the-job accident. With 53.2 suicides per 100 thousand workers, construction has among the greatest suicide rate of any industry, according to Centers for Disease Control. This suicide rate is over four times higher than the national suicide average and five times higher than all construction deaths combined.

The construction industry as a whole needs to improve mental health awareness and assistance, but this can only be done on one jobsite at a time. September is the National Suicide Prevention Awareness Month- a time to exchange information and resources and reach out to those affected by suicide.

Workwear Guru joins the call to raise awareness and spread hope to prevent suicides. We did this by interviewing several mental health experts, statisticians and health & safety professionals who deem suicide prevention a sine qua non in the employee health and wellness efforts. The aim of our study is to educate and encourage all stakeholders to use all the resources available, familiarize themselves with the problem and better implement suicide prevention strategies

Major Industries With the Highest Suicide Rates

Suicide rates vary by industry and occupation, with certain groups within these categories suffering greater rates than the overall population.

The Centers for Disease Control and Prevention (CDC) conducted a report on suicide deaths based on industry and occupation. The results found that Mining, Quarrying, Oil and Gas Extraction industry had the highest rate of suicide with 54 suicide deaths per 100,000 population. The rate is twice as high as the national average, which stands for 27 deaths per 100,000 population. The Construction industry follows them with 45 suicides per 100,000 people. 

The following is a list of occupations thought to have the highest suicide rates. Much of this material is based on information given by the Centers for Disease Control and Prevention (CDC):

 

At the same time, CDC calculated the suicide rates for six major occupational groups, placing Construction and Extraction occupations at the top:

Work Risks that Lead to Higher Suicide Rates

Working in the building and construction industry is a demanding profession. There are tremendous production expectations on the workers in order to fulfill deadlines, as well as working circumstances that may frequently be hazardous if rigorous safety rules are not followed. The Centers for Disease Control and Prevention (CDC) reports that male workers that work in construction have a 65% higher rate than all U.S male workers. According to the same report, there are various work-related risk factors that are taking their toll on the construction workers in the worst way imaginable.

While further study is required to understand these work-related factors, CDC indicates that suicide risk is related with the following:

  • low skilled labor
  • lower education
  • relative low
  • socioeconomic status
  • access to lethal means
  • job stress
  • poor supervision and colleague support
  • low job control
  • job insecurity
 
The report indicates those working in the physical position in construction are at higher risk for suicide. Research studies as well as experts working with mental health in construction industries show that these factors are the main cause of mental health problems that lead to suicide for construction workers.
 
While the death by suicide puts an emotional toll in the families of the affected, it has a substantial effect in the economy, affecting the government, employers and the decease’s family. 
 
In this article, you will find research data and notes by experts telling why the suicide rates are high among construction workers and what construction companies can do to  tamper the suicide among their employees. 
 

Factors that Lead to Higher Risks for Suicide

Construction is one of the industries with the highest work-related fatalities due to safety risks in the workplace. However, suicide (and mental health problems) comes after that, affecting thousands of construction workers every year.

According to Kirk Bol, a vital statistician at Colorado Center for Health and Environmental Data, male suicide decedents within the industry were less likely to be diagnosed and treated for mental health problems. The lack of treatment for mental health issues minimizes the chance to prevent suicide among the workers.

According to experts, a high work-pressure environment, work at remote locations, tough guy mentality, and opioids dependency are the main factors putting construction workers at risk for suicide.

A high work-pressure environment

Mental health issues arise as the construction industry operates on strict deadlines. Such a schedule can put pressure on the workers. When workers don’t meet the deadline, they can be subject to fines. 

Besides, construction is a high-stress environment with complications of different nature happening every day. When you add together the pressure from the management and the workplace complications, you find construction workers jeopardizing their health and working longer hours to conform to deadlines, budget, and quality expectations.

Work-related stress is not an isolated event. Instead, it built over time, placing the construction workers at risk of mental health problems that lead to suicide.

All these factors can build up contributing to mental health problems. If they are left undiagnosed, it increases their chances of suicide.

Work at remote locations

Construction often requires work in remote locations. The transfer to distant locations means living in hotels, which can be a lonely experience.

This means, atop a high-pressure environment where they work, workers spend the rest of the days away from family and friends, distancing them from their main support system. The separation from the family creates the space for the family to move without you, leading to marriage and parenting problems, said Spencer-Thomas.

“Mental health or substance abuse challenges may be more likely to go unnoticed or unaddressed in situations like this,” added McGough Ph.D., Licensed Psychologist at BASE Cognitive Behavioral.

The “tough-guy” mentality

As construction is a male-dominated industry with workers mainly from low educational backgrounds, masculinity prevents them from acknowledging their mental health problems. As the “tough guy” taboo prevails in their work environment, openness is not appreciated, and “many in the field may be afraid of appearing ‘weak’ if they acknowledge a struggle,” says McGough.

Moreover, the stoicism and fearlessness they show can lead to impulsive risk-taking and destructive behaviors, says Spencer-Thomas.

Opioids dependency increases the suicide risks of construction workers

Construction is one of the industries with the highest occupational hazards happening every year. The injury rate for construction workers is 77 times higher compared to the national level. Due to high work injuries, construction is the industry with the highest use of prescribed opioids, says Spencer-Thomas.

Besides, years of hard physical labor manifests with chronic pain. As a result, a large number of construction workers take opiates as painkillers for their work-related injuries. A study from Midwest Economic Policy Institute found that a high injury rate places them at risk of forming opioid dependency, quickly leading to an overdose. The same research found that 15% of construction workers battle opioid abuse.

Opioid abuse escalates quickly, leading to overdose deaths. The Massachusetts Department of Public Health report showed that 26 percent of opioid-related overdose deaths came from construction and extraction. It translates to about 106 deaths per 100,000 workers which is six times higher than the average rate of Massachusetts populations. 

The Economic Burden of Suicide in Construction Industry

Apart from the moral, emotional, and psychological burden suicides leave to family members and friends, it also takes a significant toll on the economy. 

On the economic aspect, suicide adds to a high cost charged at employers, governments, and workers themselves. The employers with a worker that dies by suicide bear a financial debt, covering production disturbance costs, human capital costs, medical costs, administrative costs, and other costs.

The Centre for Mental Health states we lose 91 million days each year to mental health issues. The burden of the costs goes mainly to the employer. While mental health problems are a burden for the economy, suicide puts the problem to another level. 

World Health Organization shows the severity of the problem, adding that for every team member dying from suicide, 10-20 others are attempting. For employers, it means they have to pay for the recovery costs of employees that attempt suicide.

At the state level, the costs can reach high levels. In 2001 in Ireland, the cost of suicide came close to 1 billion US dollars. The same study showed that in 2012, the suicides in the South Australian Construction Industry were valued at $57.34 million, with over 98% covered by the government.

Moreover, opioid abuse amongst construction workers creates a financial burden for employers. Researchers found out that healthcare expenses, absenteeism, and turnover costs about $6,800 per year. In contrast, a recovered construction worker saves his company close to $2,400 in a year. The cost reduction comes mainly from lower medical expenses and fewer missed working days. 

What Can Employers Do to Prevent Suicides Among Construction Workers

As construction is a male-dominated industry, the expression of depression and suicidal thoughts continues to be a taboo subject. Breaking the taboo is the most effective way to deal with mental health issues in the workplace.

Greg Sizemore, Vice President of health, safety, environment, and workforce development at Associated Builders and Contractors, said every organization needs to build a culture of openness in dealing with mental health, suicide, and addiction. “The culture must create the conditions that foster openness to speak out and up and must equip and empower all employees with the personal skills they need to feel comfortable speaking up or seeking assistance,” added Sizemore. 

Along with culture, construction companies need to include strategic integration, sustained investment, harm reduction, and policy and training implementation to create a 360o approach to help workers total health, adds Dr. Spencer-Thomas.

Dr. Spencer-Thomas emphasizes the importance of construction companies taking an upstream, midstream, and downstream approach to tackling mental health and suicide prevention.

New approaches for construction companies to address emotional wellness at work

An innovator in social change, Dr. Spencer-Thomas proposes integrated approaches to tackle mental health issues and suicide prevention.

“The goal of any workplace suicide prevention program should be to increase mental wellness and resiliency and reduce toxic job strain and under-addressed mental health concerns through a focus on upstream, midstream, and downstream approach,” notes Dr. Spencer-Thomas.

Upstream Approach

Upstream strategies build protective factors that prevent problems from happening in the workplace, said Dr. Spencer Thomas.

The protective factors could be creating a culture of caring and belonging, fostering genuine community support.

It also includes the reduction of toxic work contributors such as job strain, stress, and trauma.

Midstream Approach

While a midstream approach means early and effective interventions that can help detect problems early in the stage. Dr. Spencer-Thomas tells us that for a company, a midstream strategy means implementing:

-Self-care orientation
-Training
-Peer support and well-being ambassadors

Downstream Approach

A downstream approach includes the company’s steps in the aftermath of the mental health and suicide crisis.

It includes delivering professional mental health services and resources easily accessed by the employees.

It also means minimizing access to lethal means, such as guns, pills, and other fatal methods, adds Dr. Spencer-Thomas.

Other Prevention Strategies

Besides upstream, midstream and downstream approach, there are other targeted prevention strategies:

Companies need to provide resources to their employees

The best advice you can give to a person with suicidal thoughts is to direct them to certified professionals and resources. For employers, one way to do this is to add prevention resources such as National Suicide Prevention LifelineConstruction Working Minds, or suicide prevention resources at The Center for Construction Research and Training in common where employees can see them.

Through these resources, they could get professional help to get out of their dark state of mind.

It would be ideal if construction companies train their managers and employees in spotting potential signs of suicide risk in one another, says McGough. “You look out for each other’s physical safety as well as that of yourself each day.  Noticing when a co-worker seems to be struggling, down, irritable, or not themselves is another way of looking out for each other,” she added on the importance of noticing the warning signs. 

Organizations need to create a culture of support for mental health issues

Construction companies understand the value of discussing workplace physical safety. Employees go over training and various resources before they start working on site. Companies should follow the same tenacious attitude in addressing mental health, says Sizemore.

The starting point starts with leaders setting a clear tone that it is okay to have and talk about mental health issues, says McGough. 

“This healthy attitude towards mental wellness sets an example for others and can create a positive trickle-down effect by which it becomes easier for others to acknowledge mental health and seek support when needed,” added McGough.

To do so, construction companies need to embed openness in their culture, empowering the employees to feel comfortable seeking help, noted Sizemore. Such an attitude in the workplace challenges the taboo of the “tough guy,” opening the way for employees to express their feelings freely. 

Another approach is to soften the mental health language as men with a “tough-guy” mentality with a mental health crisis may feel reluctant to respond to “if you are depressed, seek help,” adds Dr. Spencer-Thomas.

Construction companies need to provide Employee Assistance Programs

A crucial factor in alleviating suicide and mental health issues is creating Employee Assistance Programs (EAP). These programs will help “employees to connect with mental health and substance abuse services,” said McGough during the interview.

These programs can help eliminate “the negative stereotypes associated with mental health problems,” added Sizemore on the issue.

McGough tells an effective way for companies to implement EAPs is by carrying out peer-to-peer programs such as QPR (Question, Persuade, Refer) or The American Foundation for Suicide Prevention’s Talk Saves Lives or Livingworks’ safeTALK. These programs could raise the employees’ awareness of mental health and equip them in spotting warning signs in themselves, their colleagues, or their loved ones. At the same time, the programs can create easy access for them to connect with professional care. 

How to Prevent Suicide

Helping a person struggling with mental health is not always easy. If you notice any suicide warnings signs in someone, it is vital to take the next step and help them get out of their state. They are reluctant to open up and express their true feelings.

1. Recognize the warning signs

Knowing the warning signs, family members, friends, and colleagues can help those struggling with suicidal thoughts. 

Some of the most common signs include:

  • An increase of lateness and absenteeism at work 
  • Lower productivity
  • Lower self-confidence
  • Decreased communication with co-workers 
  • Shows signs of substance abuse 
  • Shows frequent signs of agitation
  • Lack of protection in the workplace
  • Segregation from the group (i.e., eating lunch alone)

2. Start a conversation

One of the best things you could do to a colleague struggling with suicidal thoughts is contact and open a conversation. You need to approach the discussion with deep empathy for your co-worker, even if you can’t understand their feelings. Being an ear to listen to their problems and emotions is a starting point.

It is crucial not to question their thoughts and feelings rather than accept them. At no point should you demeanor or say “this is just a phase” to them. That could pose a significant threat to them, as they would feel alienated. Be there for them and help them “find ways to feel that life is worth living,” says McGough.

3. Ask honest questions

Another way to help is by asking honest questions. Though this is easier said than done, asking direct questions can help you identify if the person is suicidal. Ask them direct questions on how they are feeling and if they are thinking about suicide. It is essential to communicate with compassion and openness to believe you are a person they can lean on during this difficult time.

Make sure they understand it is not weak to say they are not okay and you are happy to support them, added McGough on tips for construction workers struggling with suicidal thoughts.

4. Direct them to professional care

Once you are sure your co-worker or friend is struggling with suicidal thoughts, your next step should be to lead them to get professional care. Suppose the person is reluctant to reach out for professional help. In that case, you can help them by locating treatment facilities, setting an appointment for them, or accompany them to the doctor’s visit. 

If you are unsure of how you can help them, you can call the National Suicide Prevention Lifeline (800-273-8255) or Crisis Text Line (TALK to 741-741) to get professional advice on the next steps. 

About this research

The Centers for Disease Control and Prevention conducted their report on suicide rates for industry and occupations using the 2016 National Violent Death Reporting system data. This study report provided us with the underlying data that shows the problem of suicide.

To find more on the problem of suicide in the construction industry and what companies and employees can do to prevent it, we research experts with in-hand experience in mental health problems for construction workers.

To explain the underlying problems in the construction industry, we used other studies from public and private institutions, such as the Midwest Economic Policy Institute and the Massachusetts Department of Public Health. At the same time, we used the findings from the research paper ‘An Analysis of Suicides in the Construction Industry within the U.S.’ published in the Psychology and Behavioral Science International Journal. Please find below the complete list of our sources.

Sources

A Special Thanks to Our Interviewee

Sally Spencer-Thomas
Clinical Psychologist, Impact Entrepreneur, Professional Speaker & Podcaster

Dr. Sally Spencer-Thomas is a clinical psychologist, an inspirational international speaker, an impact entrepreneur, and a well-being writer for IRMI.com. She is known nationally and internationally as an innovator in social change. Dr. Spencer-Thomas helped start up multiple large-scale, gap-filling efforts in mental health, including the award-winning campaign Man Therapy and the nation’s first initiative for suicide prevention in the construction industry, Construction Working Minds. In 2016, she spoke on men’s mental health issues at the White House. In her recent TEDx Talk, she shares her goals in making mental health and suicide prevention a safety priority in schools. workplaces, and communities.

Connect via Twitter l Website

Amanda McGough, Ph.D.
Suicide Prevention Advocate, Licensed Psychologist & AFSP NC Board President

Base – Cognitive Behavioral Therapy & Consultation

Dr. Amanda McGough is a clinical psychologist, avid volunteer, and suicide prevention/ postvention specialist in Charlotte, North Carolina (NC). She serves as the President of the Board of Directors for the American Foundation for Suicide Prevention’s NC Chapter and is a member of the American Association of Suicidology. She speaks at the local, state, and national levels on suicide prevention and suicide loss. Her work is renowned by numerous print and television media as well as books. In her private practice, Amanda works with those struggling with suicide as well as with their families.

Connect via Twitter 

Greg Sizemore
Vice President, Health Safety and Environment, Workforce Development 

Associated Builders Contractors

Greg Sizemore is the vice president of health, safety, environment and workforce development at Associated Builders and Contractors. For decades, Sizemore has been active as a volunteer leader in the safety and workforce development space. He is a past chair of the ABC National Craft Championship Committee and NCCER Workforce Development Committee, and he served on the Occupational Health and Safety Administration’s Advisory Committee on Construction Safety and Health. He currently serves on the board of directors of NCCER and chairs the Construction Industry Alliance for Suicide Prevention. 

Connect via LinkedIn

Kirk Bol
Manager, Vital Statistics Program 

Colorado Center for Health & Environmental Data – Department of Public Health & Environment 

Kirk is a committed, knowledgeable and capable public health professional. He has an extended experience as a statistician with demonstrated success working in public health surveillance and research. Kirk has demonstrated skills in epidemiology, data collection, analysis, and complex data management.

Connect via LinkedIn

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