A tour of the Tonnelle Ave. construction site for the Gateway Tunnel
A tour of the Tonnelle Ave. construction site for the Gateway Tunnel
A century ago, it was common to expect one worker fatality for every million dollars spent on a construction project. Thanks to industry-wide safety reforms, occupational fatalities are now 90% lower than in the 1940s. These improvements didn’t happen by chance. They are the result of decades of collaboration among all stakeholders to prioritize worker well-being and establish effective jobsite safety protocols that protect workers, limit injuries, and save lives on jobsites.
Yet despite this progress, the construction industry now faces a different kind of challenge; a deepening mental health crisis where stigma and fear often keep workers suffering in silence rather than seeking support. Addressing this issue will require buy-in from the entire construction industry to achieve a cultural shift where psychological safety is prioritized as much as physical safety and where workers feel valued and supported enough to realize that seeking help for mental health issues is as an act of strength, not weakness.
The unfortunate reality is that construction workers experience a higher prevalence of anxiety, depression, substance misuse and suicide than almost any other profession. The combination of long hours, tight deadlines and physically demanding work combined with a culture that values toughness and discourages vulnerability creates an environment where workers often feel ashamed or afraid to seek help.
Mental Health concerns are on the rise in the construction industry
Unfortunately, new data shows that the problem is growing. A national survey of 2,000 construction workers and executives commissioned by design-build firm Clayco found that 64% of U.S. construction workers reported experiencing anxiety or depression in the past year, up from 54% in 2024 and nearly three times the rate in the general population.
Equally troubling are workers’ perceptions of mental health in the workplace. Nearly half (45%) said they would feel ashamed to discuss mental health issues on the job, and 37% reported experiencing discrimination after doing so. While the construction industry has made strides in expanding access to counseling and resources, stigma and discrimination clearly persist. One in five construction executives surveyed admitted they would be less likely to assign important tasks to a worker who sought mental health support, and 30% said those workers would be more closely monitored on the job.
The consequences are wide-ranging. More than a third of construction workers say they’ve missed work due to mental health concerns in the last year, demonstrating the direct impact on productivity and project schedules. It’s also difficult to quantify how anxiety or depression can impair focus and safety on a jobsite, where a single moment of distraction can have devastating physical consequences.
Many workers also turn to unhealthy coping mechanisms. More than a quarter report misusing substances to manage mental health struggles, and over one-third of executives say they’ve faced substance misuse or addiction challenges themselves in the past year. Particularly troubling is that male construction workers are 75% more likely to die by suicide than the general population, and the industry has the highest rate of drug overdose deaths of any profession.
To reverse these trends, the construction industry must adopt universal best practices that prioritize psychological safety alongside physical safety that also fosters a culture of openness and trust.
Just as every construction firm employs safety managers, companies should designate dedicated mental health and psychological safety advocates responsible for the well-being of all employees and subcontractors. Additionally, mental health resources and protocols should be incorporated into new-hire orientations and jobsite safety materials, and firms should create wellness zones as safe spaces where workers can decompress or seek help.
Construction firms must ensure psychological safety
To encourage honest dialogue about mental health and substance use, construction firms should ensure all employees attend at least one annual group psychological safety session led by a certified mental health professional. For those who prefer anonymity, companies should offer a confidential, 24/7 consultation hotline.
Employers must also confront fear and retaliation head-on. Every worker should be encouraged to sign a Good Samaritan, Anti-Retaliation Psychological Safety Commitmen and companies should implement recovery-friendly workplace initiatives so employees struggling with addiction can seek help without fear of losing their job.
Breaking the stigma around mental health in construction won’t happen overnight, but the industry is ready to confront it. That’s why industry leaders are partnering with expert organizations like the National Alliance on Mental Illness, or NAMI, to accelerate progress. These collaborations bring evidence-based strategies and credibility that will help construction firms move from good intentions to measurable impact. Partnering with groups like NAMI ensures psychological safety isn’t just a buzzword but a core aspect of every company’s culture, backed by trained professionals and real-world support systems.
For anyone in construction, worker safety is the industry’s top priority. But now it’s time to ensure psychological safety and mental well-being are valued just as highly as physical safety, on the jobsite and in the office, so every worker feels supported, respected, and able to thrive.
Dan Lester is the vice president of field culture and inclusion at leading design-build construction firm Clayco, where he is certified as both a coach in the 4-stages of psychological safety and a construction suicide prevention trainer. Darcy Gruttadaro is the chief innovation officer for the National Alliance on Mental Illness, where she leads NAMI’s workplace mental health StigmaFree initiative. Clayco has partnered with NAMI to increase education, awareness and support for mental health and psychological safety across the construction industry.
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