While by now I have worked on these monthly articles for some 14 years, I am not a safety expert, former OSHA employee, or industrial hygienist. As a construction lawyer, most of my work has always involved what are essentially commercial disputes, with only a modest part of it being safety issues or OSHA compliance. I’ve long known, as all of my readers certainly know, that while construction work can be psychologically as well as financially rewarding, it’s a tough, competitive, and dangerous field.
What I was startled to learn only very recently, however, is that construction workers (who are coupled in the statistical studies with miners and other “extraction” workers) are the second highest job classification for the risk of suicide. Construction workers take their own lives at a rate roughly four times the overall U.S. average.
In recent years, compounding the risk factors for suicide, the opioid epidemic has struck construction workers harder than the general population. In addition to other stressors, many who work in construction suffer injuries which — even if not career-threatening — are likely to result in prescriptions for pain medications, that can often lead to addiction.
Opioid abuse is associated with a 75% increased likelihood of a suicide attempt.
Yet another exacerbating factor is that military veterans, with their mission-oriented way of looking at life, often “enlist” in construction work after leaving the service. Vets, many of whom have experienced physical and emotional trauma, are a demographic that, overall, has a suicide risk approximately 50% higher than those never in the military.
There are multiple additional factors that contribute to the elevated risk of suicide among construction workers. Such factors include heavy workloads, tough, physical work and wear on the body, time and other performance pressures, travel and family separation, issues with drugs, alcohol, and gambling, sleep issues due to shift work, few lasting workplace connections due to limited project duration and a largely-transient workforce, job insecurity and the fear of redundancy, seasonal unemployment and end-of-project furloughs (and associated financial issues) and a culture that includes stoicism, risk-taking, “old school” toughness, and bullying.
There are no OSHA standards requiring risk recognition training, mental health screening, crisis intervention, the provision of employee assistance programs, or other measures aimed at preventing suicide.
It’s an excellent idea, nonetheless, to include mental health issues and suicide prevention in your safety program. Supervisory and non-supervisory employees should be trained to recognize warning signs. Among the more obvious signs are talking about wanting to die, or feelings of being trapped, or hopeless, or a burden to others, or indications that one is getting his (or, rarely, her) affairs in order. Other, less dramatic signs include increased tardiness and absenteeism, an increase in drug or alcohol use, decreased productivity and self-confidence, isolation from (or conflict with) co-workers, extreme mood swings, and reckless, impulsive, or agitated behavior.
Risk factors for suicide also include divorce or other relationship losses, a history of trauma, major illnesses, prior suicide attempts, suicides among family members or close friends, financial stresses, access to guns, a lack of a personal or professional support network, and a cultural background that stresses manliness and self-sufficiency, and disdains seeking help for mental health issues.
Here are some key insights that I came across in my reading for this article.
First, suicide, and thinking about suicide, are not behaviors of the weak. Having such thoughts does not make you an unworthy person. Even if you have never in your life thought about suicide, chances are that one or more of your close friends and family members have done so (although they might never have shared those thoughts with you). Most people overcome suicidal ideation, and many transform their lives, and become much happier and fulfilled people.
Second, showing support, even in small ways, for people who are struggling, and to whom thoughts of suicide have occurred, will often make a huge difference. Being shown some compassion and support can have a major effect on a troubled individual’s mood and sense of connection.
The most at-risk demographic for suicide is white males between ages 45 and 54. Even outside that group, most people who die of suicide are of working age, and most people spend more time, by far, in the workplace than they spend at home with their families.
Management, human resources, and safety personnel in your company should all be trained concerning risk factors and warning signs that employees might be pondering suicide. There exist abundant mental health and crisis resources that can provide support, information, and training. You need to seek them out, as a matter of humanitarian concern for employees who might be thinking of suicide, but also as a matter of jobsite safety. Workers on the verge of desperate acts pose a danger to others, as well as to themselves, and suicide impacts operations, as well as the individuals closest to the person who was lost.
Until recently, relatively few construction employers have acted aggressively to address suicide risks among their employees, or to support people in grief from suicide losses.
While the trend is in the direction of action to prevent suicide, there remain substantial taboos about talking openly about it. One article I read mentioned an effort, that unfortunately found no support, to make suicide prevention a subject for discussion during “safety week” programs. It’s a disturbing subject, but one that needs to be confronted, and made a safety priority, in the construction industry. Training, participation in health and suicide prevention screening events, measures to address the opioid crisis, and supporting local crisis centers are just a few measures you should consider taking to that end.
Additional measures you might consider include providing access to employee assistance programs (these are sometimes provided by labor organizations, through healthcare companies), generous leave policies, and training for human resources and safety personnel, as well as field supervisors, in risk factors and warning signs.
The first step, however, is to talk with your employees (not just once, but regularly) about suicide prevention in particular, and mental health problems, such as depression and substance abuse, generally. Everyone needs to know that he or she is seen as a human being with their own issues and difficulties, and that their job will help to connect them, in time of crisis, with the concern and the resources that they need. You should know (and workers who are suffering from major depression and/or at heightened risk of self-harm should be told) that therapy, sometimes coupled with medication, has a success rate of roughly 80-90% among those who receive it.
As always with regard to safety matters, top management needs to make clear that suicide prevention is a health and safety priority. One resource I suggest you look into is the Construction Industry Alliance for Suicide Prevention (www.preventconstructionsuicide.com), founded in 2016 as a task force of the Construction Financial Management Association.
One article I reviewed had a photo of a hard hat, with a sticker provided by the employer — a small touch, but a fine idea — displaying the 24-hour phone number of the National Suicide Prevention Lifeline, which is 1-880-273-TALK.