While hardhats and safety helmets protect heavy construction personnel from head injuries, they don’t shield workers from anxiety, depression, and other mental health challenges that can be just as crushing as a falling beam.
More than 5,000 American construction workers died by suicide in 2022, and according to the federal Centers for Disease Control and Prevention (CDC), the construction industry has one of the highest suicide rates compared to other industries. Men account for most of the fatalities, with the suicide rate among male construction workers being 75 percent higher than men in the general population.
If the risks of falls, electrocutions, chemical hazards, and suicides aren’t enough, the construction industry also leads all other occupations in fatal drug overdoses—largely attributable to counterfeit fentanyl, which has spurred a national crisis. The CDC logged more than 162 overdose deaths per 100,000 construction workers in 2020, the most recent year for which data is available. About 10 construction workers per 100,000 died from other causes while on the job that year, suggesting that construction personnel were roughly 16 times as likely to die of an overdose as they were from a work-related injury.
Why?
Construction work is physically demanding, and workers suffer high rates of acute and chronic pain. Workers with occupational injuries are three times more likely to be prescribed opioids than their non-injured peers. Construction workers diagnosed with chronic muscle and bone disorders—a common phenomenon—are more than four times as likely to develop an opioid use disorder (OUD) or addiction to pills compared to those who started on opioids for other diagnoses.
When prescriptions run out or the amount of opioids needed to manage pain increases, workers may scramble to buy unprescribed—and potentially tainted—pills from acquaintances, on the street, or online. These days, that’s risky business.
Opioids may treat physical pain, but they can also dull psychological distress. Other substances like cannabis, alcohol, and cocaine are also being used by workers—not just at the end of a long day, but even on job sites to get through the day.
The recent surge in construction, spurred by historic federal investments in infrastructure, clean energy, and downtown revitalization projects, has placed more strain on an already stretched workforce tasked with completing jobs on time and under budget.
High-pressure deadlines, fear of injuries, extreme weather, extended hours, and long commutes make construction jobs not only physically but mentally and psychologically taxing.
Nearly 1 in 5 construction workers report having anxiety or depression, yet the overwhelming majority—83 percent—haven’t sought professional help. Shame, stigma, and social pressures often leave male construction workers struggling silently to “suck it up.”
How do we strengthen, support, and, in some cases, save the lives of those working to rebuild our communities?
Supervisors should be trained to recognize signs of distress, such as increased tardiness and absenteeism, conflicts with co-workers, decreased productivity, or more frequent near misses, incidents, and injuries. Human Resources personnel should be skilled in effective intervention techniques to engage employees in need. A robust Employee Assistance Program (EAP) can help guide struggling workers into care. It’s critical that employee health plans include adequate mental health and addiction treatment coverage for both inpatient and outpatient care, with affordable deductibles and co-pays. More than anything, sustaining a culture of safety must include ground-up conversations and commitments—both on job sites and in executive offices—to address the invisible injuries and scars that are claiming too many lives.
Dr. Reynolds is the President/CEO of Family and Children’s Association, a 140-year-old nonprofit that operates two NYS-licensed treatment centers in Nassau County, three recovery centers, and 50 other programs that together serve 35,000 Long Islanders annually.
