Suicide and the Construction Worker (USA and Canada)
RISK CONTROL eGuide
Suicide: A Serious Problem
According to the CDC, in 2019, more than 47,000 individuals died by suicide, making it the tenth-leading cause of death in the United States.1 And suicide rates increased by 35 percent between 1999 and 2018.2 However, many medical professionals believe deaths by suicide may be underreported, with some classified as accidents or unintentional deaths.3 In addition, there are an estimated 30 attempts for each suicide death.4
Historically, over 90 percent of individuals attempting suicide had a psychiatric disorder,5 such as depression, anxiety, substance use disorder, posttraumatic stress, or schizophrenia. Males are almost four times more likely to die by suicide than females,6 and those between the ages of 44 and 65 are at higher risk.7 There are many other risk factors for suicide,8 including:
- Military veteran status
- Family history of suicide
- Social isolation
Suicide and Construction Workers
In 2020, the CDC reported that one of the highest rates of suicide are among construction workers, along with mining, quarrying, and oil and gas extraction workers.9
This is seen not only in the United States, but in other countries as well10 and may be explained by a higher prevalence of certain risk factors in individuals working in construction. In fact, as stated in an article published by the American Society of Safety Professionals, some have noted that construction workers potentially have a perfect storm of suicide risk factors, including:11
Demographics. Ninety percent of the U.S. construction workforce is male and 38 percent are between the ages of 35 and 64.12 Additionally, over 15 percent of veterans enter the construction industry and make up a large percentage of that workforce.13 In 2016, the veteran suicide rate was 1.5 times greater than for non-veterans.14
Cultural. The stoic and self-reliant characteristics of individuals who work in construction may increase suicide risk, according to psychologist Sally Spencer-Thomas, by reducing the likelihood that individuals seek help when needed.15 This reluctance to seek help is associated with psychological distress.16
Psychosocial. Seasonality and fluctuations in an individual’s work may affect an individual’s mental health through the impact of:
- Economic insecurity as a result of job seasonality17
- Low job control and a fragmented community as a result of frequent changes in coworkers and tasks as jobs change18
- Emotional exhaustion stemming from irregular and long work hours19
- Work-family conflict that may manifest itself as strained relationships, marital breakdown and difficulty maintaining relationships with children20
- Untreated psychiatric conditions are more common in this group of workers than others21
Physical and drug related. Physically demanding construction work22 not only increases the risk of musculoskeletal disorders—with higher rates than in other industries—but may lead to chronic pain and higher utilization of opioids (including non-prescription)23 as well as the higher opioid overdose rate seen in these workers.
Mental health and suicide traditionally have been taboo subjects in society. And yet, the human impact of suicide is extensive and enduring, adversely affecting individuals, families, communities and workplaces. The cooperation of multiple sectors of society—government, healthcare, social, educational, community and business groups— is critical in the fight against it.
According to the American Society of Safety Professionals, the construction industry faces a challenge with this issue. However, we know that many of the risk factors of the individuals working in construction can be recognized, and treatment for underlying mental health conditions may help prevent suicide.24
Consider the CDC’s national comprehensive approach to prevent suicide, which is built around several strategies: strengthening economic supports, improving access and delivery of suicide care, creating protective environments, promoting connectedness, teaching coping and problem-solving skills, identifying and supporting people at risk, and lessening harms and preventing future risk.25
For construction workers and their supervisors, this could include having open, frank conversations, which can destigmatize mental health conditions and create a supportive environment in which workers feel free to seek and give help.
Training supervisors and other workers on the subject and how to recognize the risk factors can help create a supportive environment and make it more likely that an individual can get the help they need. A simple “Are you okay?” may open the door to better communication.
Having appropriate resources available as part of the path to better mental health and the prevention of suicide is paramount. The Construction Industry Alliance for Suicide Prevention (CIASP) provides useful resources for companies to help evaluate their mental health and suicide prevention preparedness. Other resources can be found at Workplace Suicide Prevention and the National Action Alliance.
Crisis Text Line—Text HELLO to 751741
Travelers is a proud supporter of the Construction Industry Alliance for Suicide Prevention (CIASP), which offers the following resources to help construction companies evaluate their mental health and suicide prevention preparedness:
Webinar: Mental Health on the Job Site
Living Works offering 60-90-minute online suicide prevention training.
1 Centers for Disease Control and Prevention (CDC). National Center for Injury Prevention and Control. 10 leading causes of death, United States, 2019, all races, both sexes. https://webappa.cdc.gov/sasweb/ncipc/leadcause.html. Accessed Jun 17, 2021.
2 National Institute of Mental Health (NIMH). Suicide. https://www.nimh.nih.gov/health/statistics/suicide.shtml. Accessed Jan 7, 2021.
3 Rockett IRH, Caine ED. Self-injury is the eighth leading cause of death in the United States: It is time to pay attention. JAMA Psychiatry. 2015;72(11):1069-1070.
4 Han B, Kott PS, Hughes A, McKeon R, Blanco C, Compton WM. Estimating the rates of deaths by suicide among adults who attempt suicide in the United States. J Psychiatr Res. 2016;77:125.
5 Hirschfeld RM, Russell JM. Assessment and treatment of suicidal patients. N Engl J Med. 1997;337(13):910.
6 NIMH, 2021.
7 Curtin SC, Warner M, Hedegaard H. Increase in suicide in the United States, 1999-2014. NHCS Data Brief. 2016 Apr;(241):1-8.
8 Schreiber J, Culpepper L. Suicidal ideation and behavior in adults. Post TW. Ed. UpToDate. Waltham, MA: UpToDate, Inc. Accessed Apr 20, 2021.
9 Peterson C, Sussell A, Li J, Schumacher PK, Yeoman K, Stone DM. Suicide rates by industry and occupation - National Violent Death Reporting System, 32 States, 2016. MMWR Morb Mortal Wkly Rep. 2020 Jan 24;69(3):57-62.
10 Milner A, King TL, Scovelle AJ, et al. A blended face-to-face and smartphone intervention for suicide prevention in the construction industry: Protocol for a randomized controlled trial with MATES in construction. BMC Psychiatry. 2019;19(1):146. Eyllon M, Vallas SP, Dennerlein JT, et al. Mental health stigma and wellbeing among commercial construction workers: A mixed methods study. J Occ Env Med. 2020;62(8): e423-e430.
11 American Society of Safety Professionals (ASSP). Suicide in the construction industry: Breaking the stigma and silence. Mar 11, 2019.
12 U.S. Bureau of Labor Statistics. Injuries, illnesses, and fatalities, 2018. Last modified May 1, 2020. Accessed Jan 7, 2021.
13 Ellis, G. Veterans in Construction: Supporting Our Heroes in Hard Hats. Construction Productivity Blog, November 16, 2018. Accessed Apr 16, 2021.
14 Department of Veterans Affairs, Veterans Health Administration, Office of Mental Health and Suicide Prevention. Veteran suicide data report, 2005–2016. Sep 2018.
15 Spencer-Thomas in ASSP, 2019.
16 Eyllon, 2020.
17 Milner A, Spittal MJ, Pirkis J, LaMontagne AD. Suicide by occupation: Systematic review and meta-analysis. Br J Psychiatry. 2013;203(6):409–416.
18 Goldenhar LM, Williams LJ, Swanson NG. Modelling relationships between job stressors and injury and near-miss outcomes for construction labourers. Work Stress. 2003;17(3):218–240. Milner, 2013. Spencer-Thomas S. Construction and suicide prevention: 10 action steps companies can take to save lives. Construction Financial Management Association, 2016.
19 Lingard H, Francis V. Does work-family conflict mediate the relationship between job schedule demands and burnout in male construction professionals and managers? Constr Manag Econ. 2005;23(7):733–745.
20 Lingard, 2005. Heller TS, Hawgood JL, Leo DD. Correlates of suicide in building industry workers. Arch Suicide Res. 2007;11(1):105–117. Gullestrup J, Lequertier B, Martin G. MATES in construction: Impact of a multimodal, community-based program for suicide prevention in the construction industry. Int J Environ Res Public Health. 2011;8(11):4180–4196.
21 Gullestrup, 2011. Jacobsen HB, Caban-Martinez A, Onyebeke L, et al. Construction workers struggle with a high prevalence of mental distress, and this is associated with their pain and injuries. J Occ Env Med. 2013;55(10):1197-1204. Errata in 2014; 56(9): e80-e81.
22 U.S. Bureau of Labor Statistics, 2020.
23 Dong XS, Brooks RD, Cain CT. Prescription opioid use and associated factors among US construction workers. Am J Ind Med. 2020;63(10):868-877. Dong XS, Brooks RD, Brown S. Musculoskeletal disorders and prescription opioid use among U.S. construction workers. J Occ Env Med. 2020;62(11):973-979.
24 Schreiber, 2021.
25 Stone DM, Holland KM, Bartholow B, Crosby AE, Davis S, Wilkins N. Preventing suicide: A technical package of policies, programs, and practices. Atlanta: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 2017.
The information provided in this document is intended for use as a guideline and is not intended as, nor does it constitute, legal or professional advice. Travelers does not warrant that adherence to, or compliance with, any recommendations, best practices, checklists, or guidelines will result in a particular outcome. In no event will Travelers, or any of its subsidiaries or affiliates, be liable in tort or in contract to anyone who has access to or uses this information for any purpose. Travelers does not warrant that the information in this document constitutes a complete and finite list of each and every item or procedure related to the topics or issues referenced herein. Furthermore, federal, state, provincial, municipal or local laws, regulations, standards or codes, as is applicable, may change from time to time and the user should always refer to the most current requirements. This material does not amend, or otherwise affect, the provisions or coverages of any insurance policy or bond issued by Travelers, nor is it a representation that coverage does or does not exist for any particular claim or loss under any such policy or bond. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy or bond provisions, and any applicable law.
The information provided in this document is intended for use as a guideline and is not intended as, nor does it constitute, legal or professional advice. Travelers does not warrant that adherence to, or compliance with, any recommendations, best practices, checklists, or guidelines will result in a particular outcome. In no event will Travelers, or any of its subsidiaries or affiliates, be liable in tort or in contract to anyone who has access to or uses this information for any purpose. Travelers does not warrant that the information in this document constitutes a complete and finite list of each and every item or procedure related to the topics or issues referenced herein. Furthermore, federal, state, provincial, municipal or local laws, regulations, standards or codes, as is applicable, may change from time to time and the user should always refer to the most current requirements. This material does not amend, or otherwise affect, the provisions or coverages of any insurance policy or bond issued by Travelers, nor is it a representation that coverage does or does not exist for any particular claim or loss under any such policy or bond. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy or bond provisions, and any applicable law. (A0876)