One of your workers shows up on the jobsite one day and asks his buddy if he wants his boots. He gives his tool belt to another coworker. Two days later, his family calls to say your worker took his life and ask if there had been any warning signs of suicide.
Giving away possessions is just one of the warning signs that a person is seriously contemplating suicide, according to Dr. Sally Spencer-Thomas, a clinical psychologist and speaker on suicide prevention. Extreme mood swings, increased use of drugs or alcohol and talking about wanting to die or acquiring the means to do so are also signs that someone is struggling.
Suicide is not just a problem for the construction industry. It’s the leading cause of death in the United States, and suicide rates have increased in almost every state, according to the Centers for Disease Control and Prevention. Colorado is among the states with the biggest increase in suicide rates. Between 1996 and 2016, the suicide rate in our state increased over 34%, compared to the national average of 25.4%.
Although suicide rates are increasing everywhere, looking at the data, it’s clear that the construction industry bears the greater share of the burden. Between 2004 and 2014, the most recent data available from the Colorado Department of Public Health, construction was the most common occupation of people who took their lives. That’s a period that covers the housing crash, but consider this: over that 10-year period, the number of suicides was higher among construction workers than it was for unemployed people, even in 2006 when housing prices peaked.
Part of the reason suicide is so common in the construction industry is demographic. The workforce is predominantly people who are already at high risk of taking their lives: white, middle-aged men.
Men are nearly four times as likely as women to take their lives, according to the National Institute of Mental Health. Suicide rates are highest among American Indian and Alaskan Native men, but white men are right behind them.
Suicide is a continuum, Spencer-Thomas said, from thoughts and feelings to attempts to lethal outcomes. People across all demographics think about suicide and may even make an attempt, but the ones who are most likely to die by their own hand are men.
“We have some research that shows that the more self-reliant you are, the more at risk for suicide you are,” she said. “We respect that type of person in our culture so much, but when you get to the stage of white-knuckling it through difficult life experiences and not reaching out to your support [network], that’s where the despair and the isolation gets compounded.”
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She continued, “We know it’s not the industry’s fault; it’s who shows up to this industry. That said, the work itself has components to it that increase risk.”
The transitory nature of construction jobs creates a sense of instability and makes it harder for individuals to develop a network of people to turn to when they’re in trouble, Spencer-Thomas said. Workers are also less likely to have health benefits. Over 15% of people employed in the construction industry are uninsured, according to the Census Bureau’s American Community Survey.
The work itself can lead to injuries that may result in prescriptions for powerful pain medications that create a whole new set of problems. “For many, getting that first legitimate prescription for pain medication for acute injury turns into a dependence on opioids that decreases quality of life significantly,” Spencer-Thomas said.
In fact, she believes the opioid crisis and the high rate of suicide in construction are directly related. “I think the numbers that we’re seeing [regarding opioid deaths] are a gross underestimate as to what’s actually happening. I think a lot of the overdose deaths are in fact suicides, but people aren’t investigating them as such,” she said.
But she suspects there’s a more profound reason construction workers are at higher risk than those in other industries.
“In order for people to step over our self-preservation instinct, you have to have a certain sense of fearlessness of life and death,” she said. “A lot of work in construction is stuff that most people would find pretty intimidating: being up in high places, working heavy machinery. There’s a sense of courage that it takes to do that work.”
Spencer-Thomas believes the inherent fearlessness among people in this industry makes them less afraid of self-harm or death. “When it comes to that, they are more likely to choose more lethal means and to make sure that they die.”
The pressure to perform can also push people in this industry past their limit, especially those at management levels.
“Everything is driven by the bottom line so there’s always this pressure to do more under budget and within a time frame. There’s no room for error or for failure,” Spencer-Thomas said. “There’s constant, never-ending pressure, and the intense competition that exists in this space is a reality that, especially those at the business-decision making level, have to face all the time.”
For trades workers who love what they do every day, getting promoted into a management position may actually take them away from what they love to do, Spencer-Thomas said. “Maybe they have a real skill, talent and passion at being a carpenter or a plumber, and they’re really good at that and they love it—and as a reward they get promoted into positions of management, and maybe that’s not where they’re skills and passions lie.”
She calls this a “golden handcuffs” situation, where someone has “locked themselves into a certain lifestyle. Maybe they have this vision now where their kids are going to go to college and they’re going to have the white picket fence … but they’re miserable because they’re not doing the thing that brought them joy.”
What builders can do to prevent suicide
Spencer-Thomas is confident that while suicide prevention is complicated and daunting, “there’s also a ton that we can do to make a difference.”
Having a leader willing to address the issue is critical, Spencer-Thomas said: “someone with a mindset about this being a safety and a health priority.”
That kind of straightforward leadership reduces the stigma that prevents people from seeking help, and builds momentum toward real change, she said.
Specific training to educate workers about the risk factors and warning signs is another important way to get resources to people who need them.
Gatekeeper training helps builders identify signs of suicidal distress, open a conversation with people who might be struggling and help connect them with resources that can get them through their distress.
The QPR (Question, Persuade, Refer) Institute and LivingWorks’ safeTALK are two such training programs. Spencer-Thomas has developed a two-hour training course called Working Minds that specifically targets suicide prevention in the workplace.
Unfortunately, a suicide death is usually when people start thinking about prevention, Spencer-Thomas said.
“Nobody thinks it’s ever going to happen to them until it happens to them, and then they’re reeling. ‘What did we miss? What could we have done?’ There’s a very specific set of things to do in what we call the ‘post-vention’ state; the weeks and months following a suicide death are really critical to help alleviate the grief and trauma that the workers are dealing with.”
People who aren’t equipped to address a suicide among their ranks will usually avoid addressing it altogether, Spencer-Thomas said. This demographic is more inclined to internalize emotional responses anyway, so business leaders need to be deliberate in helping their workers cope with the loss of a colleague.
“If we don’t process it properly and give people the tools to cope, it increases the risk of future suicide,” she said.
One of the most effective ways to address suicide and suicide prevention is peer support, according to Spencer-Thomas. Programs that identify and train people who are highly trusted by their peers, who have a natural ability to listen, who may have experienced something like addiction or depression and can bring that lived experience to their interactions can bring help within reach of someone who is struggling.
Those types of peers are “sometimes overlooked in other types of leadership roles,” Spencer-Thomas said, “but those are the folks that can make a world of difference here.” They act as a bridge between a struggling worker and mental health professionals, who may seem out of reach for someone in despair.
“I’ve seen this work magic, especially in male-dominated industries where there’s a huge intimidation factor of reaching out for help, especially professional help,” Spencer-Thomas said. “For most companies, safety is the top priority, and safety only works if the workers have got each other’s back.”