The stats on mental health in the construction industry are serious: According to the Centers for Disease Control (CDC), the construction industry has the highest rate of overdose deaths and the second highest rate of suicides compared to other industries in the U.S. We focus so much on physical safety, but what about what’s under the hard hat? What about safety on the inside?

Over the past year, we’ve been lucky enough to talk to several leaders in the construction space about safety on the inside and breaking the stigma around mental health in construction on our You Learn You Turn podcast. Because it’s Women in Construction week, we wanted to highlight some of the thoughts from women around mental health issues, stigma, and how employers can offer resources to effectively support their employees. These are just quotes from our conversations, but the full episodes are embedded below.

(Quotes below are all from the You Learn You Turn podcast and may have been edited for brevity and readability.)

Meet the Contributors

Kelly Flagg, Executive Director of Associated General Contractors (AGC) of Maine. We spoke to Kelly during a March 14, 2024 episode of You Learn You Turn.

Mandi Kime, Director of Safety, Associated General Contractors (AGC) of Washington. We spoke to Mandi during a March 7, 2024 episode of You Learn You Turn.

Heather Kurtenbach, Business Agent for Local Ironworkers Local 86 in Tukwila Washington. Heather spoke to us along with Vicki O’Leary on a March 9, 2023 episode of You Learn you Turn.

Vicki O’Leary, General Organizer for Ironworkers International. Vicky spoke to us along with Heather Kurtenbach on a March 9, 2023 episode of You Learn You Turn.

Mental Health and Substance Use in Construction

Mandi Kime

“In my state, we have had a number of on-the-job construction fatalities related to either suicide or drug overdose. So it’s happening on the job site. And you cannot tell me that when something like that happens on the job site, that it doesn’t leave an indelible mark on every other human being that was on that site that day, that has to continue showing up to work every day in a place where something so tragic took place. And unfortunately we end up with survivor guilt, we end up with all sorts of struggles that happen because we weren’t addressing this head on.”

Heather Kurtenbach

“I think it’s really the machoism of it all, having to hold in your feelings and not being able to show any kind of weakness at all when you’re on a job site because you are made fun of, or ridiculed, or thought less of. It really gets to people. And then you’ve got the opioids, having to work when you’re hurt. Or let’s face it, being an iron worker is a hard, physical trade. It’s hard. Even if you’re not hurt, your body is still going to ache and it’s going to hurt. And a lot of men and women turn to pills and alcohol at the end of the day to help their bodies feel a little bit better so they can get up the next day and get to work. There’s a lot there in that.”

Vicki O’Leary

“I believe especially in the iron workers, in the last study I saw that the iron workers in construction were number one for suicide. And I think part of that is because of the macho… we’re kind of the top dogs of the trades. And part of that is that we have to work when we’re injured and so we, many times, take opioids to get us through the day so that we can continue working because your insurance is tied to the hours that you work, your pay is tied to the hours that you work, you don’t get sick time. So that’s unfortunate that we’re working injured, first of all, and that we have to go to such extremes and that doctors are so quick to prescribe opioids, which is another issue.”

The Impact of Stigma

Kelly Flagg

“One of the things when I think about construction, I think there are some challenges when it comes to mental health that are very, very real. And we have to be willing to acknowledge them. I think a lot of times, we want to pretend they don’t exist.”

Mandi Kime

“Society has told us for a long time that if you’re one of those people that has one of these struggles, that it’s somehow a failure of your constitution or your fortitude or your intelligence that you found yourself in this scenario instead of saying, “Wow, man that really stinks for that individual, and I know of some resources that could help, and I could be a lifeline to that person.”  I think also some of the stigma challenge that we have is that these conversations are uncomfortable. You know, you don’t want to appear as though you are judging a person for what their struggles are.”

How Employers Can Help

Kelly Flagg

“I see companies really taking a step forward to help support their employees in a way that is different. I think a few years ago mental health and substance use challenges happened, and we knew they happened, but I think nobody really knew what to do or how to handle it. And I think that’s still a reality, I think we still have a lot of growing room. But I think it’s more common for us to talk about it now. Instead of “how do we drug test everybody to keep drugs off a drug site,” now we’re talking about “how do we get to know our people and support them before they’re in a place of crisis?” And so I think that conversations have shifted. And I think that’s a really, really positive thing.”

Mandi Kime

“Things that I have seen be very impactful as far as workers in the construction industry getting help, one of them is taking mental health assessments. And the reason why that is so helpful as a tool is because we don’t often know that we’re struggling. Or we don’t cognitively realize that that is a sign that we’re struggling. It may be something that we’ve dealt with our whole entire lives. Sometimes that knowledge makes you feel so much more empowered in the journey for yourself. So I think that that is critical. There’s lots of free tools to do that as well. And there’s ones that are kind of a little bit more light hearted and a little tongue-in-cheek like So if someone is resistant to that messaging, that’s a real easy, low-stress entry point.”

Heather Kurtenbach

“I would like to see some sort of resource list for covered providers. Like “Here we have these covered providers in our network who do mental health counseling, these treatment centers over here. Here’s the Employee Assistance Program,” but when you call the Employee Assistance Program, have it be more like a friendly space than a business transaction. And the anonymity of it as well. Some people aren’t as comfortable sharing their identities for fear of retaliation or whatever the case may be. So having it be some sort anonymous so they can call these people and be like, “Hey this is what’s going on with me.” And then have the person on the other side of the line genuinely offer some help, like “Here, I have this place. Where do you live again? Oh this place is close to you.” That kind of thing I think would be extremely beneficial.”

Vicky O’Leary

“I also think, and Heather’s Local is one of them, but you have many Locals across the country that are having AA meetings or 12-step meetings in their local unions. And I think that that is so incredibly responsible for them to do. And I also have seen at Impact and at our convention at our Tradeswomen Build Nations conference having these 12-step meetings because everything is centered around alcohol. So having a place for them to go to be with likeminded people that have issues is so, so important. And I’m so proud that the iron workers have stepped up and followed suit with doing this. I think it’s great and I hope to see more local unions opening their doors for these types of meetings. I think it’s really important for them as brothers and sisters of the same group being able to come together and finding out who else needs that support because then they’ve got each other to lean on. Also they have sober gangs where they put all the people that are struggling with alcohol that are in a 12-step program. They’re working together in a group on a job. So they’ve got each other’s backs when they’re on the job.”

Full Podcast Episodes

For more on substance misuse or suicide prevention, please visit our resource pages. For more on how Youturn Health can help the construction industry, check out Employee Wellbeing in the Construction Industry.