As a specialist in diversity, equity, and inclusion, Sofia Khaira has dedicated her career to reshaping corporate cultures from the inside out. Her work as an HR expert focuses on the critical intersection of labor practices and employee well-being, particularly in industries facing acute mental health crises. In our conversation, we explore the deeply rooted cultural and economic factors contributing to the staggering suicide rate in the construction trades. We’ll delve into how the industry’s demographic makeup creates a perfect storm of risk, the dangerous pipeline from on-the-job injury to addiction, and the profound disconnect between the mental health resources companies offer and the brutal realities of the job site. Khaira offers a powerful critique of the “hustle hard” mentality and outlines what a truly compassionate and effective corporate response to tragedy should look like.
In construction, deaths from suicide tragically outnumber job-site accident fatalities five to one. What specific cultural and economic pressures unique to the trades create this disparity, and what are the most immediate, practical steps a company can take to start changing this reality?
The disparity is staggering, isn’t it? We’re talking about roughly 1,000 deaths from work-related injuries, a number that is already far too high, but it’s dwarfed by the 5,100 workers who died by suicide in 2023. This isn’t an accident; it’s the result of a culture built on a foundation of immense pressure. Imagine walking onto a job site where, from day one, you’re “already in the red,” as one worker put it. The expectation is to go 100 miles an hour, constantly. This “hustle hard” ethos is generational, a blue-collar badge of honor. But it comes at a cost. Add to that the economic instability. These are often cyclical jobs. One week you might be working overtime, the next you’re laid off, with no guarantee of a 40-hour week. That constant uncertainty gnaws at you. The most immediate step a company can take is to change the conversation on the ground. It has to start with foremen and supervisors. They need to be trained to lead with empathy, to create an environment where a worker can say, “I’m not okay today,” without fearing for their job. It’s about building psychological safety right alongside physical safety.
The industry often attracts veterans and men without college degrees, groups that can face unique stressors. How do these demographic factors intersect with the job’s physical demands and cyclical instability to heighten risk? Please share specific examples of support that effectively target these workers.
It’s a collision of risk factors. You have a workforce dominated by two groups—veterans and men without a college degree—that already face higher suicide rates. These are often men who have been conditioned to be tough, to solve problems with their hands, and to not show emotional vulnerability. Then you place them in a physically punishing job, often far from home, where their bodies are their primary tool. An injury isn’t just painful; it’s a direct threat to their livelihood. This is what happened to Shawn Nehiley, the union leader. An injury led to an opioid prescription, which triggered a relapse. This pathway is tragically common. You add the job’s instability, and you create a pressure cooker. Effective support has to be targeted and accessible. It can’t be a generic 1-800 number. It means peer-support programs, connecting veterans with other veterans in the trades who understand that specific transition. It means bringing counselors to the job site, because these workers are not going to take a day off to go to an office. It’s also about financial wellness programs. Helping workers manage the feast-or-famine cycle of contract work can alleviate a massive source of stress.
On-the-job injuries can lead to opioid prescriptions, which sometimes spiral into addiction and increase suicide risk. How prevalent is this pathway today, and what specific protocols should companies implement to manage workers’ pain and support their recovery without over-relying on painkillers?
This pathway is terrifyingly prevalent. Construction has the highest rate of substance abuse of any occupation. The story of TJ Kimball, who battled a Percocet addiction that started with a football injury in high school, is a case in point. For so many, an injury on the job becomes the first step into a long-term battle. Think about it: a doctor prescribes opioids for legitimate, severe pain, and for someone already in a high-stress environment, it can quickly spiral. Even for those in recovery, like Shawn Nehiley, a new injury can lead to a relapse. His nightly prayers became pleas to not wake up in the morning; that’s the depth of the despair we’re talking about. Companies need to shift from a reactive to a proactive model. This means robust partnerships with physical therapists and pain management specialists who offer alternatives to opioids. It means ensuring that any worker on light duty after an injury has a clear, supportive return-to-work plan. And frankly, it means destigmatizing addiction. Stocking Narcan in first aid kits is a good step, but it’s the last line of defense. The protocol should start with prevention, early intervention, and non-judgmental support for treatment, making it clear that seeking help for addiction is a sign of strength, not a fireable offense.
A high-pressure, “hustle hard” culture can discourage workers from showing vulnerability or seeking help. How does this mentality directly contribute to the mental health crisis? Please describe a compassionate, step-by-step response a company should enact in the 24 hours following a worker’s suicide.
The “hustle hard” mentality is the very air these workers breathe. It’s a culture where toughness is currency. Showing emotional pain or admitting you’re struggling is seen as a weakness, a liability. This directly fuels the crisis because it forces people to suffer in silence. They feel isolated even when they’re surrounded by a crew. TJ Kimball’s story is a tragic example; he was a good foreman, a perfectionist, but he was dealing with delirious exhaustion and immense personal stress, and that pressure had nowhere to go. Now, contrast that culture with what a compassionate response to a tragedy should look like. When TJ’s co-workers found out he died, it was through a cryptic Facebook post. There was no official announcement from the company or the union. They were confused, uneasy, and then they just… went back to work. Because it’s a “cutthroat business.” A compassionate response is the complete opposite. Within the first 24 hours, leadership must be on-site. Work stops. A representative from the company and the union should gather the crew, deliver the news directly and with compassion, and make it clear that their well-being is the only priority. Grief counselors should be immediately available on-site, not just a number to call. The message must be unequivocal: “We are stopping. Your pain matters more than this deadline.”
Warning signs can be subtle; a worker might just seem stressed, withdrawn, or “off.” What are the most overlooked behavioral changes specific to the construction environment, and how can co-workers be trained to intervene appropriately without overstepping professional boundaries?
This is one of the biggest challenges because in construction, being “stressed” or “exhausted” is the baseline. It’s a physically and mentally demanding job. That’s what makes spotting the real warning signs so difficult. In TJ Kimball’s final weeks, his co-workers noticed he was “really off” and uncharacteristically withdrawn. He was a guy known for motivating his crew, but he became distant. That kind of change in social behavior is a huge red flag. Another overlooked sign is a change in work quality, especially for a perfectionist like him. Maybe someone who was always meticulous starts making mistakes, or someone who was always on time starts showing up late. It’s not about being lazy; it’s often a sign of deep distress. Training co-workers is about moving from “minding your own business” to “minding your own.” It’s teaching them to trust their gut. Intervention doesn’t have to be a dramatic confrontation. It can be as simple as, “Hey, you seem a little off today. Everything okay?” or “I’m grabbing a coffee, want to take a break with me?” The goal is to open a door, to let the person know someone sees them and cares, without forcing them to talk. It’s about creating a culture where that small act of checking in is normal and expected.
Many companies now offer mental health programs and stock Narcan on job sites, yet the crisis persists. Where are the biggest gaps between the support being offered and what workers actually need? Please provide an anecdote or metric that illustrates this disconnect.
The gap is a chasm between policy and culture. A company can have the best Employee Assistance Program in the world, but if a worker feels they’ll be seen as weak or risk their job by using it, that program is useless. The most searing anecdote that illustrates this is what happened on the job site the Monday after TJ Kimball died. His crew learned their foreman had taken his own life by scrolling through Facebook on their coffee break. The mood collapsed. And what did they do? They went back to taping drywall. As one worker said, “Jesus no, you had to stay, it’s a cutthroat business.” That right there is the disconnect. The company offers support, the union offers support, but the on-the-ground culture of deadlines and pressure was so powerful that it overrode their human need to grieve, to process, to even stop for a moment. The metric that confirms this is the number of suicides itself. In 2023, it was 5,100, a figure that remained “virtually unchanged” from the year before, even as more of these programs were rolled out. This tells us we are applying bandages when the industry needs major surgery on its core culture.
What is your forecast for the mental health crisis in the construction industry over the next five to ten years?
My forecast is one of cautious, hard-won progress. The crisis is no longer a secret. We have articles, nonprofits, and unions all sounding the alarm, which is a monumental first step. Awareness is growing, and more companies are implementing programs that, on paper, are the right thing to do. However, the numbers will not dramatically improve in the next five years. They will remain stubbornly high because the real work is so much deeper than adding a new benefit. We are talking about dismantling a multi-generational culture of stoicism and self-reliance, a culture where physical toughness is inextricably linked to a worker’s identity and value. Changing that is slow, painstaking work that has to happen foreman by foreman, job site by job site. I believe we will see a gradual reduction in suicide rates over the next decade, but only if the industry commits to the long, difficult process of making psychological safety as fundamental and non-negotiable as wearing a hard hat. If we only focus on posters and programs without changing the daily pressures and expectations, we will be having this same tragic conversation ten years from now.
