Suicide in the Construction Industry

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By Travelers
6 minutes

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% 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 disorder5, such as depression, anxiety, substance use disorder, posttraumatic stress disorder, bipolar disorder, personality disorder or schizophrenia. Males are almost four times more likely to die by suicide than females6, and those over the age of 74 or between the ages of 44 and 65 are at highest risk.7
 
Other demographic, biological, psychological and social risk factors include:8

  • Rural residence
  • Military veteran status
  • Non-married status
  • White, American Indian or Alaska Native
  • Medical conditions including chronic pain, cancer, chronic lung disease, heart disease, spine disorders and stroke
  • Family history of suicide
  • A previous suicide attempt
  • Hopelessness
  • Adverse childhood experiences
  • Social isolation
  • Poor social support

COVID-19

Although it is too early to know if suicide rates have increased during this past year of COVID-19 and the 2020 economic downturn, suicide rates historically have spiked during times of economic contraction9 and being unemployed is associated with a two- to three-fold increase in the relative risk of dying by suicide.10 According to data published by the CDC during the earlier stages of the pandemic (late June 2020), 11% of U.S. adults reported seriously considering suicide in the 30 days preceding the survey.11 By contrast, in 2019, 4.8% of adults in the U.S. had serious thoughts about suicide.12

Suicide in Construction Workers

In 2020, the CDC reported that the construction industry had one of the highest rates of suicide among their workers, along with mining, quarrying, and oil and gas extraction workers.13 This is seen not only in the United States, but in other countries as well14 and may be explained by a higher prevalence of certain risk factors in individuals working in the industry. 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.15
 
Demographics. Ninety percent of the U.S. construction workforce are male and 38% are between the ages of 35 and 64, a demographic with a high risk of suicide in the general population.16 Additionally, over 15 percent of veterans—who have a 50% higher rate of suicide17—enter the construction industry and make up a large percentage of that workforce.18
 
Cultural. The stoic and self-reliant characteristics of individuals who work in the construction industry may increase suicide risk, according to psychologist Sally Spencer-Thomas, by reducing the likelihood that individuals seek help when needed.19 This reluctance to seek help is associated with psychological distress.20
 
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 seasonality.21
  • Low job control and a fragmented community as a result of frequent changes in coworkers and tasks as jobs change.22
  • Emotional exhaustion stemming from irregular and long work hours.23
  • Work-family conflict that may manifest itself as strained relationships, marital breakdown and difficulty maintaining relationships with children.24
  • Inefficient sleep patterns, including sleep deprivation, that may increase the risk of mental health problems.25
  • High psychological demands producing strain.26
  • Mental distress and mental disorders are common in construction workers. Furthermore, untreated psychiatric conditions are more common in this group of workers than others.27

Physical. Physically demanding construction work28 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 opioids29, as well as the higher opioid overdose rate seen in these workers.30

Drug related. Use of non-prescription opioids, binge drinking, heavy alcohol use and other drugs is more common in construction workers than in other industries.31

Suicide Prevention

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 the construction industry can be recognized, and treatment for underlying mental health conditions may help prevent suicide.32
 
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.33
 
For the construction industry, 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.
 
And 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 National Action Alliance.

Resources

 

Sources

1 Press Release: CDC study finds suicide rates rise and fall with economy. https://webappa.cdc.gov/sasweb/ncipc/leadcause.html

2,6 https://www.nimh.nih.gov/health/statistics/suicide.shtml

3 Self-injury Is the Eighth Leading Cause of Death in the United States. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2436271

4 Estimating the rates of deaths by suicide among adults who attempt suicide in the United States. https://pubmed.ncbi.nlm.nih.gov/27032110/

5 Assessment and Treatment of Suicidal Patients. https://pubmed.ncbi.nlm.nih.gov/9302306/

7 https://www.cdc.gov/nchs/data/databriefs/db241.pdf

8 http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.468.8177&rep=rep1&type=pdf

8,32 https://www.uptodate.com/contents/suicidal-ideation-and-behavior-in-adults

9 http://www.cdc.gov/media/releases/2011/p0414_suiciderates.html

10 https://jech.bmj.com/content/jech/57/8/594.full.pdf

11 https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6932a1-H.pdf

12https://www.samhsa.gov/data/sites/default/files/reports/rpt29392/Assistant-Secretary-nsduh2019_presentation/Assistant-Secretary-nsduh2019_presentation.pdf

13 https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6903a1-H.pdf

14,26 https://www.researchgate.net/publication/333091919_A_blended_face-to-face_and_smartphone_intervention_for_suicide_prevention_in_the_construction_industry_Protocol_for_a_randomized_contr olled_trial_with_MATES_in_Construction

14,20,25 Mental Health Stigma and Wellbeing Among Commercial Construction Workers: A Mixed Methods Study. https://pubmed.ncbi.nlm.nih.gov/32541624/

15 https://www.assp.org/news-and-articles/2019/03/11/suicide-in-the-construction-industry-breaking-the-stigma-and-silence

16,28 https://www.bls.gov/iif/oshwc/case/msds-chart2-data.htm

17 https://www.mentalhealth.va.gov/docs/data-sheets/OMHSP_National_Suicide_Data_Report_2005-2016_508.pdf

18 https://blog.plangrid.com/2018/11/veterans-in-construction-supporting-our-heroes-in-hardhats-infographic/?doing_wp_cron=1628865881.2633080482482910156250

19,22 https://www.nahb.org/-/media/NAHB/advocacy/docs/legal-issues/construction-liability/trending-now/10-action-steps-suicide-prevention.pdf

21,22,26 Suicide by occupation: Systematic review and meta-analysis.
https://www.researchgate.net/publication/259114970_Suicide_by_occupation_Systematic_review_and_meta-analysis

22 Modelling relationships between job stressors and injury and near-miss outcomes for construction labourers.
https://psycnet.apa.org/record/2004-10112-002

23,24 Does work–family conflict mediate the relationship between job schedule demands and burnout in male construction professionals and managers? https://www.tandfonline.com/doi/abs/10.1080/01446190500040836

24 Correlates of suicide in building industry workers. https://pubmed.ncbi.nlm.nih.gov/17178646/

24,27 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228565/pdf/ijerph-08-04180.pdf

27 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3795897/pdf/nihms495761.pdf

29 Prescription opioid use and associated factors among US construction workers. https://pubmed.ncbi.nlm.nih.gov/32677121/

29 Musculoskeletal Disorders and Prescription Opioid Use Among U.S. Construction Workers. https://pubmed.ncbi.nlm.nih.gov/32925525/

30 https://midwestepi.files.wordpress.com/2018/02/opioids-and-construction-final2.pdf

31 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5507064/pdf/nihms867531.pdf

31 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910220/pdf/nihms-1542116.pdf

33 https://www.cdc.gov/violenceprevention/pdf/suicidetechnicalpackage.pdf

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