One afternoon in 2014, a distressed and despondent RK Mechanical employee gave away his tools to his coworkers. Looking back, managers realized he was saying goodbye. They didn't realize it soon enough.

Later that night, the worker killed himself.

"Nobody was really prepared to notice it, acknowledge it, deal with it, or ask him what was wrong," RK Director of Marketing and Communications Heather Gallien said. "It was an instance that could've been averted had staff been better prepared."

While pockets of companies and people aiming to raise awareness of suicide issues in the construction industry have emerged, a recent Centers for Disease Control and Prevention report provided concrete data that industry experts have said is impossible to ignore. The study found that across all industries, construction has the second-highest suicide rate and highest total number of suicides.

Now that personal stories have combined with hard fact, more companies and construction groups are taking notice of a dark reality that has been under the shadow of stigma and lack of awareness. With that increased attention, a small group of industry leaders are starting to incorporate new policies, programs and training to ensure the health of their employees.

The bombshell report and its implications

The CDC report released in July was a first-of-its kind study that separated suicide rates by industry. It examined 2012 data of 12,312 suicides reported in 17 states and found that the industry with the highest rate of suicide was farming, fishing and forestry (84.5 out of 100,000 workers), followed by construction and extraction (53.3 out of 100,000 workers). Just by sheer numbers, however, construction and extraction topped the list with 1,324 suicides.

Industries similar to construction, such as installation, maintenance and repair, as well as architecture and engineering, also ranked in the top five industries with the highest suicide rates.

That 53.3 rate for construction is more than four times the overall U.S. suicide rate of 12.54 in 2012. Rising suicide rates in the population as a whole have gained national attention, as an April CDC report found that the suicide rate across all age groups in the U.S. increased by 24% between 1999 and 2014, reaching its highest level in 2014 (13 per 100,000 people) since 1986.

Cal Beyer, executive committee member of the National Action Alliance for Suicide Prevention and director of risk management for Pacific Northwest paving contractor Lakeside Industries, said that before July's report, he struggled to draw attention to the issue. "I think the lack of data kept this under a rock," he said. "What we've been able to do is move the rock and light up underneath."

Considering the significant impact of the industry-specific suicide report, some experts have expressed confusion as to why there had not been a report previously examining the data in this manner.

Sally Spencer-Thomas, CEO and co-founder of the suicide prevention-focused Carson J. Spencer Foundation, attributed the lack of previous reports to the fickle nature of federal funding. "Everybody leans to where the political will is. The funding follows where the energy is, and the researchers follow the funding," she said.

Spencer-Thomas also pointed out that so far, the majority of suicide prevention and mental health efforts has been focused on children rather than middle-aged men — despite the fact that middle-aged people account for the highest percentage of suicides and the male suicide rate is nearly four times higher than the rate for women.

"Historically, no one has really cared about men in the middle years. They're considered kind of a privileged population, and they have everything going for them," Spencer-Thomas said. She noted that although suicide prevention efforts are crucial for children, as they offer "upstream prevention," she believes researchers started to realize that there was a gap in energy and data.

Wendy LiKamWa McIntosh, one of authors of the July CDC report, said she could not comment specifically as to why this occupation-specific research has not been conducted in the past. However, she said via email, "We are currently working to address gaps in the literature to inform suicide prevention strategies. When reviewing research related to suicide, we noticed there was limited research on occupation."

Looking forward, the CDC has said that because the National Violent Death Reporting System (NVDRS) was expanded to 32 states in 2015, it plans to continue developing similar reports as more data is available.

However, Sonia Higgins, global head of social sustainability for construction and development giant Lendlease, cautioned that despite the positive effects of new data and reports, the numbers available are likely an underrepresentation of the true figures.

She said that oftentimes when suicides are reported, suicide is not listed as the primary cause of death — either because the method of death is listed, or due to the stigma surrounding suicide. "I think there's a long way to go in being open and transparent and comfortable about that," she said. "So we're still going to find issues getting that accurate information."

Factors behind the high rate of suicide in construction

Experts point to two main facets contributing to construction's disproportionately high rate of suicide: demographics and industry factors.

Demographics

With suicide rates being so high for white middle-aged men, the overlap with the construction workforce is clear, as the industry is nearly 91% male and 64% white. "If you look at that demographic, that's our labor force," said Construction Financial Management Association President and CEO Stuart Binstock.

Spencer-Thomas, who lost her 34-year-old brother Carson J. Spencer to suicide in 2004, said that through the foundation's research, she discovered the industries with the highest risk typically have:

• A male-dominated workforce
• A widespread substance abuse problem
• A shift-work system
• Access to legal means to commit suicide
• Fearlessness in a risk-taking environment

"With our law enforcement, they have easy access to weapons. Physicians have access to medicine. Construction folks have access to high places," Spencer-Thomas said. "Being in a fearless, risk-taking environment also makes people less afraid of life and death situations. When it comes to adding in a factor of having a desire for suicide, that fearlessness puts them at a higher risk because they're not afraid of their own death either.

She added that data has shown employees with only a high school-level education are at a heightened risk of suicidal tendencies, and that demographic accounts for a large percentage of construction workers. 

Industry factors

Beyer said the industry's male-dominated "tough guy" culture likely plays a role in the high rate of suicide, as employees don't feel comfortable talking to their coworkers or managers about mental health issues. He added that separation from families during seasonal work, high rates of alcohol and substance abuse, the possible lack of a steady paycheck, and a high-pressure work environment are also key factors.

A CNA report last year found that construction workers were at a higher risk of abusing prescription medication and using illegal drugs than employees of other industries. The report found that more than 15% of construction workers have used illegal drugs or abused prescription medications.

Jon Kinning, chief operating officer of Denver-based RK, said, "I think it's probably a perfect mixture of … alcoholism, drug addiction, financial issues and home issues. I think there's a lot of transient nature to construction. It's always reacclimating. It's just part of the lifestyle of construction sometimes."

"The early hours, the late nights — that separation from family is a source of loneliness and isolation," Beyer said. "And I think it's a high-pressure industry. In construction, you've got budget, schedule, bidding, quality, safety pressures. And the scorecard is pretty visible every day. You're either winning or you’re losing. If you're losing, there's a lot of that shame, rejection, frustration, anger. And you can't always expose that in the workplace."

On top of all of the industry factors, experts cite the stigma around mental health and suicide prevention as a primary reason keeping people from getting help. Herbert Nieburg, a psychologist and associate professor at Mitchell College, said that in his experience treating construction workers, he found that "people in the construction industry are not big on going to therapy and going to counseling." He added, "The bottom line is it's a very high-stress job, and stress is correlated with depression and suicide."

This story is the first of two parts. Read the second part here.