For decades, thousands of construction workers have battled mental health issues silently and alone in a “tough guy” culture and high-pressure situations, leading to stress, burnout and self-harming behaviors such as alcohol/substance disorder and suicide.

According to the Associated General Contractors of America, the construction industry has one of the highest rates of suicide at 53.3 per 100,000 U.S. workers. This is four times higher than the national average, and five times greater than all other types of construction fatalities combined. Of the millions of men and women currently working in construction, 83 percent have experienced some form of moderate to severe mental health issue.

With these statistics looming, companies and organizations are uniting in their efforts to ensure that people are no longer left to feel alone in dealing with their issues and that help and hope are available.

For the last 22 years, Project Superintendent Greg Nanney has understood the importance of mental health but has not always felt the industry provided the environment for open discussion.

“The older generation didn’t talk about their issues and their problems, which was something that was passed down from generation to generation. This younger generation is more open to their feelings and open to talking about real things happening in their lives,” Nanney said. “This openness is continuing to reach the next generations and helping them want to be more even open about mental health, which still needs to be instilled even more on the job site.”

What Changes Are Being Made

Construction safety is much more than ladder safety and being prepared during severe weather. It is also about taking care of one’s mental health. Talking about mental health should be as common when discussing safety as talking about safety glasses or slips, trips, and falls.

The Associated General Contractors of America, Missouri Chapter (AGCMO) offers workers and employers resources websites, along with a variety of materials including a Pledge of Hope to help raise awareness for suicide and mental health in construction, job-site posters, hardhat stickers, videos related to mental health, and link to Suicide Prevention Awareness for Construction podcast. Also, anyone can dial 988 to reach a crisis counselor 24/7 on the Suicide & Crisis Lifeline. Check out the available resources here on the AGCMO website.

“A career in construction can often be demanding, working 70-80 hours a week, seven days a week. Traveling employees may also sacrifice so much, spending so much time away from their families, friends and support systems for weeks at a time. Despite all of this, construction has been an industry dominated for years with the mentality that the job must go on and there is no time for stress, depression or anxiety,” – Brandon Anderson, VP of Safety, AGCMO 

“Mental health is different for everyone. No two people will have the same experience. While every employee is allowed to have an off day, there are familiar signs that there may be a deeper problem. Building a trauma-informed workplace can be key to understanding changes like these. Through mental health first aid training, this allows staff to know when to step in. 

AGCMO was recently awarded the 2024 CWM Summit Mental Health Visionaries Award in the Regional/Chapter Organization Category for executing a comprehensive 12-month plan and evolving it into a resilient system fostering mental health support locally in the construction industry. The chapter has been influential in making advances in mental health awareness, prevention and providing assistance. 

Where to Start

During National Mental Health Month in May, people are celebrating and recognizing the opportunity to continue spreading the message that no one is alone. This year’s theme is “Where to Start” when it comes to taking care of one’s own well-being and mental health. 

In construction, common stressors include tight deadlines, budget restrictions, the physical demands of the job and the work conditions, layoffs, and the off-season. Given the fast-paced nature of the industry, stress is just one more challenging part of one’s day. 

Increased emphasis on standing together, recognizing the importance of mental health, and taking care of one another is a recurring message now, especially from companies like S. M. Wilson & Co.

Like many companies, S. M. Wilson offers its employees an employee assistance program (EAP) to seek confidential help. The EAP through S. M. Wilson, mental health services available with the company’s insurance, and the Carpenter’s Union Wellness Center are additional resources accessible to employees. 

Normalizing discussions around mental health and mental illness helps decrease the stigma related to seeking help when needed. We encourage team members to support and encourage one another as well as access resources available through Member Assistance/Employee Assistance Programs,” said Tom Burns, director of safety at S. M. Wilson & Co. 

Throughout May and other times in the year, S. M. Wilson will host toolbox talk conversations in an effort to mitigate the stigma around mental health. The company also hosts Suicide Prevention Stand-Downs at job sites to help team members understand the warning signs of mental health struggles not only in themselves but also in their coworkers, friends, and family members. Anderson often attends the stand-downs to talk about the warning signs and how to help one another. 

“The Culture of CARE program is an important part of the safety conversation. Through toolbox talks and other resources, we’re sharing information with our team and trade partners, encouraging conversation and relationship building and highlighting the interconnectedness of diversity, equity, inclusion and mental health,” said Maggie Farrell, diversity and human resources manager at S. M. Wilson.

Since coming to S. M. Wilson two years ago, Nanney said that it has been undeniable that this company does get it right when it comes to hiring caring people and treating people with respect. 

“The creation of the Culture of CARE has opened a platform for mental health to become a discussed topic. Honestly, I never heard mental health mentioned much on a job until the Culture of CARE was established,” Nanney said. “S. M. Wilson has been one of the best places I’ve worked when it comes to caring about and instilling mental health.”

Later this month, the Construction Forum and Missouri Works Initiative is offering the first in a free three-part series to assist in navigating a better path for mental health culture in construction. 

The first part of the series is “Mental Health in Construction: From Awareness to Action” on May 15 from 7:30 to 9:00 AM at the LiUNA Event Center in St. Louis. Speakers — John Gaal, Ed.D., Director, MO Works Initiative, Christine Patterson, PhD., Executive Director, NAMI, James Pursell, LEAN-STL – will discuss how the epidemic of mental wellness issues in this industry can be translated from awareness and concern into action within your organization. Click here to register. 

This program is the first part of a three-part series. Suicide prevention will be addressed on July 31 and Substance Use Disorder will be covered on September 17. Details for these events will be released at a later date.

“Mental health needs to be addressed on a regular basis internally. It can be a 10-minute weekly reminder to help your employees know their mental health needs are important,” said Dr. John Gaal, who was instrumental in bringing mental health to the forefront in 2016 when the opioid epidemic could no longer be ignored in the construction industry. 

“The change must start at the beginning.” 

Dr. Gaal continued that if the implementation of no less than a 1-hour formal training program addressing the mental aspect of safety within all of our trades’ Registered Apprenticeship Programs (RAPs), then there is a good chance that within five years we will start to see positive benefits of mental health training in our industry, similar to the OSHA-10 training decades ago. 

“Also, let’s not forget, that by the time, many of these apprentices from today will ascend into supervisory roles years from now. In essence, their generation will have ‘broken the silence’ and ‘stopped the stigma’ of mental health in the construction industry and society,” Dr. Gaal said. 

Also, check out Lean STL program. Established as a Laborers’ Peer Support Network, it offers help and hope with resources for mental health/addiction. Available 24/7 and 100% confidential.   

For more information on what resources are available, how to get help or even how to get involved, start with Maggie Farrell, diversity & human resources manager at

If you are in crisis, feeling overwhelmed, or not sure where to turn you are not alone, call or text the Suicide & Crisis Hotline at 988

As a trusted partner, the company has built its reputation for over 100+ years as a design/build, construction management and general contracting firm. Always putting people first, our company is committed to adding significant value and building client partnerships. S. M. Wilson enriches lives by building spaces to live, work, heal, learn and play. Our expertise is in many specialty markets, primarily education, commercial, municipal, healthcare, industrial and retail. S. M. Wilson continues transforming landscapes and communities throughout the country, especially in the Midwest.

To learn more about S. M. Wilson, go to