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"Safety starts with what's under your hard hat:" Construction worker suicide prevention week highlights the importance of mental health

by: Enjoyiana Nururdin, M.A. for 27 News

Sept. 15, 2024


There were more suicides in construction than at-work fatalities in 2022. The suicide rate in construction is nearly three times higher than all industries, according to the CDC. In 2020, 83% of construction workers reported struggling with their mental health.

MADISON, Wis. (WKOW) -- Joshua Vitale lived with suicidal ideation for most of his life until he decided to do something about it.


“From the time I was a young child up until my mid-30s I dealt with PTSD or CPTSD,” he said. “The suicidal ideation piece was something I lived with for most of my life until I was able to reach out and get the help that I needed.”


Vitale, 45, is a Superintendent with Hoffman Construction Company in Chandler, Arizona. When it comes to his mental health journey, he’s not alone. 


In 2020, 83% of construction workers reported struggling with their mental health.


Vitale briefly mentioned his grief and loss following a miscarriage he and his wife experienced just a couple of years ago on a webinar Thursday for Construction Worker Suicide Prevention Week, where he serves as the Vice Chair. He also spoke about how he and his wife were able to get help through his company’s wellness program.


“We were both really struggling, and I was able to use our mental health program, our mental wellness program, and our Employee Assistance Program (EAP) to get the help that we needed when we couldn't find anyone that would even take us,” Vitale said. “It saved our marriage and I would be remiss if I didn't say that it saved our lives.”


Vitale spoke on the webinar alongside Kara McCaffrey, Chief Wellness Officer for her family company, Houck Group, Inc., and Asma Bayanus, EHS - Operations Manager at Jordan Foster Construction.


The webinar, titled “From Awareness to Action: Workplace Mental Wellness for Contractors of Any Size,” emphasized the importance of mental health initiatives in the construction industry, and highlighted the challenges workers face and the risk factors contributing to the decline in mental health.


"The biggest thing I want to change in construction specifically is making it okay to talk about mental health. It's okay to need help." McCaffrey said. 


"It's not just people in the field, it's people in the office, as well," she added. "I lost my brother to suicide. He was in construction, he was an executive."


The suicide rate in construction is nearly three times higher than in all industries, according to the CDC. And there were more suicides in construction than at-work fatalities in 2022.


"Construction has a lot of risk factors that just make it more high risk. Because it is such a physically demanding job and a high-stress environment, you have all of that on your body," McCaffrey said. "You have to wear a hard hat, you have to wear safety glasses, you have to take care of your body,” McCaffrey added, noting that mental health should be included in that conversation.


One construction company shared on their Instagram “Safety starts with what’s under the hard hat.”


September is National Suicide Prevention Month. 


Governor Tony Evers proclaimed Sept. 8-14 Suicide Prevention Week. Sept. 9-13 also marks Construction Suicide Prevention Week, an initiative that began regionally in 2020 and has now grown to a national effort bringing awareness to the mental health of those working in construction.

Chances are, you know somebody, or know somebody who knows somebody, who works in construction. Over 7.5 million people are employed in construction in America. According to the latest U.S. Census Bureau data, in Dane County, the construction industry represented 4% of employed individuals-- which is around 15,000 people. More than triple that number, 49,000 people in America died by suicide in the U.S. in 2022. Among those deaths by suicide in Wisconsin that year, nearly 70% were men 25 years and older in rural counties.


“This is a statewide problem in our most rural areas– we are seeing White men who are feeling very disconnected from their communities,” Paula Tran, State Health Officer and Wisconsin Department of Public Health Administrator said, pointing to the fact that beyond the data, many people in the community are experiencing mental health challenges in some capacity.


“From our veterans and farmers to kids and families across our state, mental health affects everyone, and it’s no secret that Wisconsinites in every corner of the state are experiencing increased mental and behavioral health support needs. But we want to remind everyone that, in Wisconsin, no one carries their struggles alone,” Governor Tony Evers said in a press release.

The Wisconsin Department of Health Services held a virtual press conference on Wednesday, September 10, World Suicide Prevention Day, where they shared an overview of mental health across the state.


“Many of our community members, neighbors, or loved ones are experiencing challenges across the mental health spectrum,” Tran said. “This is not a problem that’s isolated in one place or one community, but the data helps us strategize around the best ways to reach folks and get the resources they need to stay well and healthy. There’s work for each of us to do in each of our communities to really think about well-being, prevention, and coordinated care and support for folks in crisis.”


Why are suicide rates for construction workers so high?


Short answer– it’s complicated.


“There are many factors contributing to suicide deaths in our state, including broad social and economic factors and challenges with personal finances, income challenges, school environments, and community environments,” Tran said.


Researchers have cited stigma around mental health, financial instability, time away from family, and working conditions as factors in construction worker's lives.  


“Construction professionals work long hours in a physically demanding and stressful profession, contributing to irregular sleep patterns and higher incidence of physical pain, including chronic pain, a risk factor for depression and/or self-medication,” JLG Industries, Inc. wrote. “In addition, construction workers often spend significant time away from family and friends and face greater than average layoff potential due to seasonal work or economic downturns.”


“Loss of connection, loss of sleep, loss (or potential loss) of income, loss of physical wellbeing … these factors may seem insurmountable, but there are ways the construction industry can mitigate their impact.”


The Covid-19 pandemic also played a significant role in the declining mental health among construction workers, or what industry officials refer to as "the silent pandemic.”


“Before the pandemic, we saw some concerning trends already among youth, among folks that were experiencing social isolation and other mental health and behavioral health challenges all across the state," Tran said. "Folks are increasingly disconnected from each other. During the pandemic, we saw much of that exacerbated."


The panelists for Construction Worker Suicide Prevention concur.


“Everyone was filled with fear,” Vitale, who was a Foreman/Superintendent at the time said. He compared the work environment to the Twilight Zone. “Are we putting our lives in danger by even being here today and supporting our families? You know, are we going to be able to work? Are they going to shut the job down?”


Prior to the pandemic, most critical trades were already experiencing industry growth while facing worker shortages, according to the National Conference of State Legislatures. The heavily male, mostly blue-collar trades together employ 45% of the workers in the frontline occupations, according to Econofact.


“We had never experienced that, and I don't think we've really even seen statistics that accurately reflect the damage that was done to people's mental well being during that time, because it was such a shift away from connectedness and to separateness,” Vitale said.


“Quite honestly, Covid did push all of this forward, but it is the fact that there is still an immense stigma around this conversation that does hold us back,” Asma Bayunus said on the webinar. “The job insecurity, the lack of conversation, I do believe, is a huge part of the reason why there is still a lot of stigma surrounding this.”


Nearly 90% of construction workers are men, which also contributes to the stigma around opening up about mental health concerns in safe spaces.


I spoke with Kara McCaffrey and Leah Ronaldo from the Suicide Prevention and Harm Reduction Coalition (SPHRC) and Safe Communities in Dane County at the start of Construction Suicide Prevention Week. 


McCaffrey now lives in Madison and works remotely for her family's construction company based in Pennsylvania. Before that, she spent over a decade working with Epic where she led the suicide prevention team, putting tools into the healthcare software system to better identify patients at risk for suicide. Through that work, she got connected to Safe Communities, which had a clinical task force that worked with local hospitals. McCaffrey began working with the Zero Suicide Collaborative where she met Leah, and the rest was history.


“It’s important to remind people that suicide is deeply personal and also impacted by a lot of social factors. It’s never just one thing,” Ronaldo said.


Some of the factors they shared that contribute to the mental health of construction workers include:

  • job instability due to weather, project management, and automation

  • physical demands

  • opioids and drug misuse

  • access to lethal weapons, including firearms (in Wisconsin, 65% of gun deaths are by firearm suicide)


"When you think about who's in construction, it's primarily men, and they are not people who always want to talk about their feelings or talk about mental health. There's this tough, macho nature in construction– suicide is kind of taboo, mental health is taboo to talk about," McCaffrey said.


But it doesn’t have to be that way.


What can be done to support construction worker's mental health?


Locally, McCaffrey is excited to begin working with companies to introduce VitalCog Training, which focuses on suicide prevention in the workplace. 


"The most important thing is when we think about it from a workplace perspective, whether it be construction or not, it's about talking about it more," McCaffrey said. "What we're trying to make it easier for construction companies in the Madison area to do is to know what resources are out there for them, that are free, for them to try to integrate mental health into traditional safety."


Hoffman Construction, where Vitale works, is a large-scale example of finding a way to introduce mental health practices into the daily operations of construction work. 


“For the last two years, we’ve been heavily involved in creating a program called Tough Enough to Talk through Hoffman which allowed us to build community centers on our job sites that focus on mental health year-round,” Vitale said. 


“We basically created a bar environment without the alcohol. We have pool tables, foosball tables, TV, video games, music, couches, a nice place to sit, and get a moment away to quiet their mind and do it in an intentional space that’s designed with mental health resources available to them.”


The “safe spaces” were plastered with mental health hotline numbers, and featured private rooms where people can close the doors, lock them, and have a private conversation. Vitale said so far, it’s changed the context around mental health on the job site, and at an inter-personal level. 


“We place the trailer on our job site right next to when everyone gets off the bus, and there's signage all over it that says, if you're stressed out, reach out,” Vitale said. “What we’ve seen in the last few years is the shift to really understanding that mental wellbeing is as an important part of physical safety as the physical safety piece. I think we’re on the leading edge of that,” Vitale said. 


“The conversation is now at the whiteboards, and at Toolbox Talks, and the foreman talking to their crews every day– they're talking about mental well-being. They're checking in with each other. I have people that come to my whiteboard and they're telling the other folks, ‘I'm not having to beat the drum anymore.’ It's become part of the culture, and that's been a shift that's been really heartwarming for me.”


Lastly, Vitale referred to the decline in mental health among construction workers as a cancer, saying that it can’t be cured through just awareness.


“When we talk about education and awareness, for me, that's great, but you know, you can't treat stage four cancer with awareness,” Vitale said. “We have to get in there and do really, really hard work and do some painful things as companies, as leaders, you know, as individuals. Like my panelists were talking about self-care, get in there and start understanding that if you want to change the bubble around you, change yourself.”


“Start a meditation practice, get into prayer, get spiritual, figure out what it is that makes you tick,” he continued. “Find a purpose in what you're doing and handle your physical well-being, and start to do that.”


Leah Ronaldo emphasized peer recovery coaches and peer support as resources for adults in construction in Dane County. 


“If somebody is in the construction industry and looking for individualized support from someone who has actually been there and kind of struggled with the same things they’ve struggled with, that’s an option for them,” Ronaldo said. “These groups are non-clinical groups for people to talk about their experiences with wanting to die or having attempted suicide, and they’re a really open space for people to talk about those without fear of involuntary intervention or counseling.”


For those seeking clinical counseling, there are Survivors of Suicide (SOS) groups run locally through Journey Mental Health.


The free National Suicide 988 Hotline is available 24/7, and staffed by trained counselors. Call 988 or click the link to visit the website. 


On Tuesday, September 17, Safe Communities is hosting "Better Together: A Recovery & Suicide Prevention Community Event” from 5 to 8 p.m. at the Goodman Community Center. There will be pizza, books for the kids, and self-care kits for the first 100 guests. The event is free and open to the public.

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