A Better Blueprint for Construction Mental Health

The construction industry has made progress in addressing suicide prevention and mental health, but challenges remain. From demanding schedules and workforce shortages to stigma around asking for help, many workers continue to face pressures that can impact their wellbeing.

As the industry comes together for Construction Suicide Prevention Week, BUILDER caught up with The Wounded Workforce founder and CEO Stephanie Lemek. She says, “The most recent CPWR data shows overdose deaths among construction workers dropped nearly 29% in a single year, with suicide deaths beginning to tick down too. Not because we made anyone tougher, but because of education, reduced stigma, putting naloxone on sites, and better support. When we change the conditions, people live.”

Encouraged by the progress, Lemek shares practical strategies for building trauma-informed workplaces, recognizing warning signs, and creating cultures where workers feel supported before a crisis occurs.

You’ve spent years helping organizations become more trauma-informed. What are some of the unique mental health challenges facing people in the trades and construction industry today?

The construction industry faces mental health challenges on several fronts. The first, and I think the most obvious, is that the conditions of the industry, long hours, physically demanding, and stressful work, can and do take a physical and mental toll. Long hours and work travel can also drive time away from family and friends, contributing to loneliness and isolation, common contributors to mental health challenges.

Something we often overlook is that the demographics of the industry are part of why we see higher rates of suicide and addiction. Construction still skews heavily male, and men die by suicide at a rate 4 times greater than women. We also have a larger veteran population in construction, and veterans statistically have higher rates of PTSD and other mental health challenges. So, the very makeup of the industry lends itself to a higher-risk population.

Lastly, the construction industry is changing fast. While I’m a big believer that change can be and often is good, it can also be very stressful and difficult to navigate. When we look at the changes in construction, technology, younger generations entering the workforce with different experiences and priorities, all on top of a skilled talent shortage, that amplifies the stress for those in the trenches, especially in the short term.

How can companies encourage workers to seek help without feeling like they’re showing ‘weakness’?

I think there is this outdated idea of strength and resilience that exists in our culture, even beyond the construction industry of the ultimate ‘tough guy’ doing it all on his own. Like you’re John Wayne, gritting your teeth and your knuckles and just making it through. But that isn’t the reality, both what we all live day to day and what the data tells us. All of us need support sometimes, whether that’s from our family and friends, from our employer, or even from a medical professional.  We often think of support in specific ways, but it shows up in more forms than we give it credit for. A hard talk with your spouse, a foreman who notices you’re off and actually asks, a therapist, a peer who’s been there. Needing support isn’t a character flaw. It’s the most human thing there is.

So how do companies encourage people to seek it without feeling weak? Stop treating it as a courage problem and start treating it as a condition problem. Leaders go first because permission travels downhill. Build support into toolbox talks and check-ins instead of burying it in a benefits portal for the person having their worst day to go dig up alone. And use the language of the trade: nobody calls fall protection weak, and asking for help is the same idea. It’s what keeps you standing.

Many leaders want to support employee wellbeing but aren’t sure where to start. What are the first practical steps a construction company can take to create a healthier workplace culture?

I’m actually a firm believer that most construction leaders and companies are better at this than they give themselves credit for. Not because they have a formal program, but because they get to know the people they work with and care about them as humans (even when they really piss each other off). So if you’re looking for where to start, start here: knowing and caring about your people is the most important step in prioritizing wellbeing, even if you haven’t formalized it. Everything else builds on that.

And here’s how you build on it. There are a lot of natural problem solvers in the field, so when they’re concerned about someone, their instinct is to ‘fix it,’ and if they don’t know how to fix it, they don’t know what else to do. So that’s where I encourage leaders to start. Give your team the tools to connect people to resources when they’re concerned. That can be as simple as knowing the two or three places you’d point someone to and having the number saved before you need it. And drive home that this isn’t weakness, offering or needing support; it’s how we take care of each other.

Then have people practice these conversations but make them real. Use the language of the field, not ‘flowery’ mental health language. Give everyone the right tools for the job.

Suicide prevention is an important conversation across the trades. What warning signs should supervisors, coworkers, and company leaders be paying closer attention to?

The single most important thing to watch for is change. You know your people. When someone who’s always steady goes quiet, or someone easygoing gets short-tempered, that shift is the signal. You don’t need to be a clinician. You need to notice when someone isn’t themselves.

Here’s what that can look like, in three buckets:

• What they say. Talking about being a burden. ‘They’d be better off without me.’ Hopelessness, feeling trapped, or that nothing’s going to get better. Even offhand jokes about not being around.
• What they do. Pulling away from the crew. Drinking or using more. Taking bigger risks on site than usual. Showing up late, missing days, or a sudden drop in work quality. Giving away tools or things that matter to them.
• How they seem. Down, on edge, or angry in a way that’s new. Exhausted or checked out. Or the one that catches people off guard: suddenly calm or relieved after a rough stretch, which can mean a decision’s been made.

One sign on its own isn’t a verdict. A few of these together, or a clear change from someone’s normal, is your cue to say something. Not to fix it. Just to ask, directly: “You haven’t seemed like yourself. Are you doing okay?” Then stay long enough to connect them to help.

Noticing is the whole job. You don’t have to have the answer. You just have to not look away.

The Wounded Workforce focuses on trauma-informed workplaces. What does a trauma-informed approach look like on a jobsite or in a construction company’s daily operations?

The term ‘trauma-informed’ can sound pretty overwhelming, but don’t worry, it’s not about asking your team about their ‘trauma’ or making you play therapist. It really just comes down to understanding that hard experiences are far more common in any workforce than we tend to realize and then using what we know to actively minimize harm. It’s about respecting everyone and making sure they have a sense of self-efficacy and support.

At The Wounded Workforce, we use the seven principles of trauma-informed workplaces to build processes and cultures that minimize harm and automatically support people. And here’s the part I love, no one has to opt in or out. We’ve built a more mentally healthy environment for everyone.

If you could leave builders, trade contractors, and construction executives with one message about protecting the mental health of their workforce, what would it be and why?

Change the conditions, not the coping. For nearly two decades, I have watched organizations respond to a struggling workforce by trying to make individuals tougher, and it does not work, because you cannot train someone to be resilient in conditions that are breaking them. Resilience is not a trait a worker either has or lacks. It is an outcome of the environment you build around them.

Leaders in construction hold enormous power here because they control the very conditions that determine whether people thrive or fall apart: the schedules, the culture, the way help is offered, the way people are treated on their worst day.

And make no mistake, this is a talent decision as much as a human one. The organizations that win the next 10 years will be the ones that keep their best people, and people stay where they are treated like they matter. The conditions you build are what your workforce will be built on.

So my message is this: stop asking your people to absorb more and start designing the conditions resilience requires. That is where the leverage is, and that is where lives are saved.

When you work with companies that have successfully improved employee wellbeing, what common practices or leadership behaviors tend to make the biggest difference?

The organizations that actually move the needle work from both ends at once and reinforce each other.

At the top, leadership doesn’t just approve a program; they change what they do. They go first. When an executive says that they’ve struggled too or protects a schedule instead of grinding people through it, that does more than any policy document. They also treat the work conditions as their job. Schedules, workload, how help is offered, and how someone is treated on their tough days. Those are leadership decisions, and when leaders own them, everything below gets easier.

In the field, the crew gets the right tools for the job. The people on site already know and care about each other, so it isn’t about manufacturing that. It’s about giving them something to do with it. How to notice when someone isn’t themselves, how to start the conversation in the language of the trade, and where to point someone when they’re concerned. Natural problem solvers want to fix it, so you give them a real move to make instead of leaving them stuck.

What makes the difference is that these two meet in the middle. Field-level care without leadership backing burns out the people doing the caring. Leadership commitment without field-level tools stays a poster on the wall. When the conditions change from the top and the crew is equipped from the bottom, you’ve built something that holds. That’s when wellbeing stops being a program and becomes part of company culture.