BIRMINGHAM, Ala. — Frank Wampol, vice president of safety and health at BL Harbert International, was struck by a disturbing realization: Over 5,000 male construction workers die by suicide every year, a number five times higher than those who die from work-related injuries. This alarming statistic underscores what Wampol calls a crisis in the construction industry.

“To say this is a crisis would be an understatement,” Wampol remarked, pointing out that construction workers face mental health challenges at a staggering rate.

In response, BL Harbert has implemented mental health first-aid training for supervisors and distributed suicide prevention resources to workers. This is part of a broader initiative to address mental health concerns within the industry, which also involves unions, research institutions, and federal agencies.

But implementing mental health initiatives has proven more difficult than simply providing physical safety equipment like hard hats and safety vests. One of the challenges has been addressing the industry's resistance to additional costs, such as paid sick leave.

While construction work has long been associated with physical dangers, the mental health hazards have only recently garnered attention. According to Douglas Trout, an occupational medicine physician at the National Institute for Occupational Safety and Health, construction ranks the highest for suicide rates and overdose deaths due to substance use, with opioids like heroin and fentanyl being particularly widespread.

“Rates of suicides and overdose deaths are some of the worst outcomes related to mental health conditions,” Trout said. “And unfortunately, these are the more measurable ones.”

Anxiety and depression are also prevalent but harder to quantify, with nearly half of construction workers reporting symptoms of both. However, fewer than 5% seek help, compared to 22% of the general U.S. adult population.

The demanding nature of construction work — long hours, separation from family, and job insecurity — combined with minimal support systems, creates a perfect storm for mental health issues. Despite health insurance and workers’ compensation, paid sick leave is not common for many workers, and industry advocates argue that such mandates don't fit the transient nature of the industry.

“When workers get injured, they try to tough it out and get back to the job as quickly as possible,” said Nazia Shah of the Associated General Contractors of America.

Workers’ struggles are compounded by self-medication through prescription opioids, creating a vicious cycle of dependency that can lead to severe outcomes, including fatal accidents on-site.

The biggest challenge remains breaking the stigma surrounding mental health in this male-dominated field, where discussing emotional struggles is often seen as a weakness. According to Shah, the key is “normalizing conversations around mental health.”

Various initiatives, including “toolbox talks” on mental health and hard hat stickers symbolizing support, have begun to make headway. Programs such as the “Mates” program, which originated in Australia, aim to train on-site workers to support colleagues in crisis.

Stanley Wheat, a safety manager at BL Harbert, stresses the importance of connecting with workers on a personal level. “A PowerPoint presentation alone won’t cut it. You’ve got to know your people, and you’ve got to engage them,” Wheat said.

Peer-to-peer support and the integration of wellness coordinators and mental health professionals into the workplace are also showing promise. Some contractors have even installed dedicated quiet rooms on job sites to give workers a chance to decompress.

As the industry faces ongoing challenges, including potential policy shifts under President-elect Trump, Wampol believes the construction sector must invest in mental wellness programs to build a more productive, healthier workforce.

“Investing in mental wellness and suicide prevention programs creates a healthier, more productive workforce,” Wampol stated, “and ultimately, a better bottom line.”