While falls cause more worksite deaths than any other type of accident, prompting the Dept. of Labor’s Occupational Safety and Health Administration to launch a new fall prevention program, there is growing recognition that there is another invisible jobsite danger in mental health disorders.

“Devastatingly, more construction workers die annually from suicide than from every other workplace-related fatality combined, making suicide rates in construction the second highest of any U.S. industry group,” wrote John F. Fish, chairman and CEO of Boston-based Suffolk Construction in a May 2 letter to the OSHA, urging it to include suicide awareness and prevention training as a core requirement in the OSHA 10 and OSHA 30 curricula.

Fish co-signed the letter with retired Brigadier General Jack Hammond, executive director of Home Base, a private clinic in Charlestown, Mass. that provides clinical treatment, wellness and other services for veterans and first responders.

An OSHA spokesperson says the agency "recognizes that mental health stressors exist at work" and noted that OSHA is "currently exploring how we may better incorporate information to increase awareness and help employers recognize signs and symptoms of mental health concerns. Our goal is to better protect workers through education and outreach training programs."

Sobering Statistics

Suicide rates were highest among males in construction at 53.2 suicides per 100,000 workers in 2015, according to the Centers for Disease Control. 

A Construction Industry Rehabilitation Plan (CIRP) study found that 83% of construction workers have struggled with mental health issues although only a third said they would communicate this to their employers.

“Construction workers are four times more likely to commit suicide than any other occupation,” said Tim Stroud, Suffolk national chief operating officer, who recently hosted Suffolk's Mental Health Fireside Chat during Safety Week. While the industry doesn’t talk much about mental health, it is “a major issue in the industry,” he says. 

Suffolk says it hopes to lay the foundation for providing workers with practical information about mental health awareness and strategies and approaches for managing it, he says. 

Speaking during the fireside chat, Dr. Louis Chow, senior director at Home Base Training Institute and Network Development, says “one of the realities of the industry is that it is predominantly male, middle-aged and white … and easily associated with mental health outcomes including, unfortunately, completed suicides.” The focus needs to shift from remaining silent “to knowing when, where, and from whom to get help,” he says.

App-based Wellness

Firms across the country are coming up with new ways to battle the industry's mental health issues.  

For example, Counslr.com on May 12 announced a partnership with Tri-Star Construction Corp. to provide Tri-Star workers with access to its platform providing unlimited access to mental health support with licensed counselors via its mobile app. 

“When an organization partners with Counslr, their employees gain access to an unlimited number of live texting sessions with licensed counselors for one fixed price, all from within the Counslr mobile app," says Josh Liss, Counslr, CEO. “Licensed mental health professionals are on-call around the clock, so covered employees can hold a session any time or day, either on-demand or by scheduled appointment,” he says.

Douglas Dupas, vice president and director of operations at Tri-Star, says despite working in a "stressful" industry, they can better serve their clients, which include architects, subcontractors and vendors, "by having access to licensed mental health professionals." 

He says that's "key to helping us maintain our high standard of service. One of our core values is dedicated teamwork and having such a helpful resource like Counslr at our disposal helps the entire team stay on top of their game.” 

Behavioral Changes

Lyra Health, a Burlingame, Calif.-based provider of global workforce mental health benefits, provides benefit-based wellness support to Suffolk workers.

Suffolk relies on Lyra wellness webinars to help employees learn observational skills that can help prevent suicide. Employees are encouraged to look for signs of change in teammates in four broad categories. The first involves changes in mood or behavior; the second, statements about their health and wellness such as not eating or sleeping; the third, any change in cognition, such as having trouble concentrating; and the fourth, any indication they are thinking about harming themselves. 

"It is valuable for everyone to be able to notice signs of distress in coworkers," says Dr. Joe Grasso, senior director at Lyra. "The goal is not to turn everyone into therapists, but to recognize basic broad, high level signs that someone could be in a state of mental health distress, so they can check in and be referred for appropriate resources."

Employees also learn about strategies for managing daily stress. This could include having a worker notice when they get stressed by monitoring tension in their body or deciding if they want to work on their stress by asking the question: Is stress serving or blocking you? Deep breathing and body scans are other strategies Suffolk offers in its mental health toolbox.

Lyra offers a range of care options. including in-person video conferencing, text messaging through a Lyra mobile app; and 24/7 access to their in-house concierge, a Suffolk spokesperson says. Typically, "the first interaction will be with a care advocate who can transfer a member to a licensed care navigator if that member needs to speak with a licensed clinician to help with their search for care or provide in-the-moment support," he says.

Suffolk pays Lyra to have employees receive 16 free sessions per year, but the fee per session is not a fixed rate since every provider has different contracted rates based on factors such as experience, location, and specialties.