Top 10 Things That Actually Help: Suicide Prevention in Construction

The list, with where to start on each

Centers for Disease Control and Prevention (CDC) and CPWR – The Center for Construction Research and Training figures come from different data and methods (CDC: 2021 deaths by occupation group; CPWR: 2024 deaths by industry), so they are shown separately and not compared. Sources: CDC Morbidity and Mortality Weekly Report (MMWR) 72(50), Dec. 15, 2023; CPWR/North America's Building Trades Unions (NABTU) REASON, Issue 7, February 2026; National Institute of Mental Health (NIMH) Suicide Statistics (CDC Web-based Injury Statistics Query and Reporting System (WISQARS) data, 2023); Dong et al., PMC8842216.

1. Run it like a safety program

   • 10 steps in CPWR's guide to implementing COMPASS (Construction Organizations Mobilizing for Peer Support & Suicide Safety)
   • 1 named owner, the first thing to fix
   • Annual review built into the guide

   Tomorrow, the supervisor: Put mental health on the next safety meeting agenda and say out loud that asking for help is safety.

   Tomorrow, the company: Name one program owner and open CPWR's COMPASS ten-step guide.

   Rules and guidance: CPWR COMPASS ten-step guide [GUIDANCE]

2. Give everyone the basics

   • 1 hour general awareness training for all workers
   • 5 short toolbox talks as an alternative
   • Annual refresh recommended by CPWR

   Tomorrow, the supervisor: Give one five-minute toolbox talk on warning signs and 988.

   Tomorrow, the company: Book a one-hour awareness session for every worker, on the clock.

   Rules and guidance: COMPASS Level 1: General Awareness Training [GUIDANCE]

3. Build peer connectors

   • ~5% of the workforce trained as peer connectors (CPWR)
   • 4 hours safeTALK training
   • Volunteers CPWR says peers should volunteer

   Tomorrow, the supervisor: Ask your crew who would volunteer to be a peer connector.

   Tomorrow, the company: Book safeTALK (or a similar course) for volunteers, about 5% of the workforce.

   Rules and guidance: COMPASS Level 2: safeTALK Peer Connectors [GUIDANCE]

4. Name navigators

   • 2 days ASIST (Applied Suicide Intervention Skills Training) training
   • A few navigators: safety, human resources (HR), foremen, project managers
   • Warm handoff the goal of the referral

   Tomorrow, the supervisor: Find out who your navigator is and save the number.

   Tomorrow, the company: Name one navigator and one backup and book ASIST.

   Rules and guidance: COMPASS Level 3: ASIST Navigators [GUIDANCE]

5. Teach a supervisor check-in

   • 5 steps every supervisor can learn
   • Ask directly asking does not plant the idea
   • Next day the follow-up most plans skip

   Tomorrow, the supervisor: Check in with one person using notice, ask, listen, connect, follow up.

   Tomorrow, the company: Print the five steps on a card for every supervisor.

   Rules and guidance: Notice · Ask · Listen · Connect · Follow up [GUIDANCE]

6. Lethal means safety

   • 60.7% of male suicides in the U.S. in 2023 involved a firearm (NIMH, CDC data)
   • 88% of adult men who died by firearm suicide used their own gun (National Violent Death Reporting System, NVDRS; 5 states, 2015–2017)
   • Temporary storage during a hard stretch, offered by a peer or family member

   Tomorrow, the supervisor: Learn the words: “Would you let your brother hold onto your guns for a while, just until things settle?”

   Tomorrow, the company: Add a lethal means safety toolbox talk and order free cable locks or lock boxes.

   Rules and guidance: Temporary secure storage of guns and pills [GUIDANCE]

7. Treat pain and opioids as risk

   • 3.82× higher odds of prescription opioid use after a work injury (Medical Expenditure Panel Survey, or MEPS, study)
   • 2.31× higher odds with a musculoskeletal disorder
   • 11.3K construction overdose deaths, ages 16–64, 2024 (CPWR)

   Tomorrow, the supervisor: Call every injured worker on your crew who is off work.

   Tomorrow, the company: Stock naloxone in every first-aid kit and train people to use it.

   Rules and guidance: Injury, pain, and opioids [GUIDANCE]

8. Fix the job strain you control

   • Bullying named as a risk factor by National Institute for Occupational Safety and Health (NIOSH)
   • Long hours and shift work also named
   • Job insecurity a risk in project-based work

   Tomorrow, the supervisor: Stop any bullying or hazing you see, on the spot.

   Tomorrow, the company: Pull hours records and cap the longest overtime streaks.

   Rules and guidance: Organizational risk factors [GUIDANCE]

9. Make help easy and private

   • 988 call, text, or chat, 24/7
   • employee assistance program (EAP) test it by calling
   • Private use never reported to supervisors

   Tomorrow, the supervisor: Call the EAP number yourself to see who answers.

   Tomorrow, the company: Fix any dead number and post 988 and the EAP in every trailer.

   Rules and guidance: Access to care [GUIDANCE]

10. Plan postvention now

    • Before write the plan before you need it
    • Crew support for the people closest to the loss
    • Safe messaging how leaders talk about it matters

    Tomorrow, the supervisor: Learn who leads if the crew loses someone.

    Tomorrow, the company: Write a one-page postvention plan using Construction Industry Alliance for Suicide Prevention (CIASP) resources.

    Rules and guidance: After a suicide [GUIDANCE]

The full PDF adds, for each item, why it really happens, the rules or guidance in plain words, controls in order, a 30-minute self-audit, who owns it and a toolbox talk starter.

Download the free PDF (55-page PDF)

Practice scenarios: can your supervisors actually do it?

A sign-in sheet proves someone sat in a room. It doesn't prove they can have the talk. Run these with two people and an observer, 10 minutes each, at a toolbox talk or foreman meeting. Use the five steps from item 5: Notice · Ask · Listen · Connect · Follow up.

How to score: the observer marks each check Yes or No. All Yes = Pass. Any No = Needs practice: run it again next week. This is about skill, not grading people.

1. The quiet one

   The situation: Marcus, a framer who's always cracking jokes, has gone quiet for two weeks. He eats lunch alone in his truck and snapped at an apprentice this morning.

   Good response: Pull him aside privately, away from the crew. "Hey, you've been quieter than usual lately, and that's not like you. How are you really doing?" Then let him talk.

   Avoid: Calling it out in front of the crew. "Man up." Making it about his attitude or the apprentice.

   Observer check (all yes = Pass, any no = Needs practice):

   • Picked a private moment
   • Named what they noticed, not a judgment
   • Asked an open question and waited for the answer

2. "Sometimes I wonder what the point is"

   The situation: Driving to a job, a laborer says, "Sometimes I wonder what the point of any of this is."

   Good response: Ask directly and calmly: "When you say that, are you thinking about suicide?" Asking directly does not put the idea in someone's head. If yes, stay with him, stay calm, and connect him to 988 right then (call or text together).

   Avoid: Changing the subject. Laughing it off. Asking it the leading way: "You're not thinking of doing anything stupid, are you?"

   Observer check (all yes = Pass, any no = Needs practice):

   • Used the word "suicide" plainly
   • Stayed calm and didn't argue or lecture
   • Offered to call or text 988 together

3. Back to work hurting

   The situation: An operator came back from a back injury. He's in pain, worried about money, and mentions he's "taking whatever gets me through the day."

   Good response: Listen first. "That sounds rough. Pain and money stress together is a lot." Then connect: EAP, his doctor, and modified duty if you have it. Follow up later in the week.

   Avoid: Asking for medical details. Giving advice about his medications. Threatening his job on the spot. (Fitness-for-duty concerns go through your normal company process, separately.)

   Observer check (all yes = Pass, any no = Needs practice):

   • Listened before offering anything
   • Named at least one real resource (EAP, doctor, 988)
   • Set a follow-up time

4. "Keep this between us"

   The situation: A carpenter tells you he's been thinking about ending his life, then says, "Don't tell anybody. Promise me."

   Good response: "I care about you too much to keep that promise. I'm not going to spread it around the jobsite, but I am going to get you help, and I'll stay with you while we do." Connect to 988 now. If he has a plan or means at hand, or you think he's in immediate danger, call 911 and don't leave him alone.

   Avoid: Promising secrecy. Telling the crew. Leaving him alone to "think it over."

   Observer check (all yes = Pass, any no = Needs practice):

   • Did not promise to keep a risk secret
   • Explained privacy (not a crew story) vs. safety (getting help)
   • Stayed with the person and connected to 988 or 911

5. Worried about a coworker

   The situation: An apprentice comes to you: "I'm worried about Dave. He's been giving away his tools and saying goodbye-type stuff."

   Good response: Thank the apprentice for speaking up. Check in with Dave privately and ask directly. If you can't reach Dave and you think he's in danger, call 911. Follow up with the apprentice too. That's heavy to carry.

   Avoid: Brushing it off. Waiting until Monday. Making the apprentice handle it.

   Observer check (all yes = Pass, any no = Needs practice):

   • Thanked the person who spoke up
   • Acted the same day
   • Checked back with the apprentice

6. The next-day follow-up

   The situation: Yesterday you connected a crew member to the EAP. Today he's back at work like nothing happened.

   Good response: A quiet, short check-in: "Glad you're here. How'd it go? I'm still here if you need anything." Respect it if he doesn't want to talk details.

   Avoid: Skipping it because it feels awkward. Asking what he said to the counselor. Treating him differently in front of the crew.

   Observer check (all yes = Pass, any no = Needs practice):

   • Followed up within a day
   • Kept it private and short
   • Didn't dig for details

Listening skills, and where your role stops

30/60/90-day rollout for a small company (under about 50 workers)

Low cost. One owner. Built on the free tools already in this guide (CPWR COMPASS, CIASP resources, 988 materials).

Days 1–30: Set it up

• Name one owner (owner, superintendent or safety lead).
• Get your EAP number (or confirm you don't have one) and put 988 and the EAP on every jobsite board, hard hat sticker and the back of badges.
• Print the five-step card (Notice · Ask · Listen · Connect · Follow up) for every supervisor.
• Run one toolbox talk on mental health. Say out loud: asking for help is safety.
• Run the 3-question crew survey (below) to get your starting point.
• Have a counselor or the EAP review your plan and the words you'll use.

Days 31–60: Build the skill

• Every supervisor and foreman runs the six practice scenarios. Record Pass / Needs practice.
• Re-run anyone who needs practice within two weeks.
• Ask for one or two peer volunteers on each crew who people already go to. Point them to free materials from CPWR COMPASS and CIASP.
• Supervisors start logging check-ins (count only: date and "check-in done," no names, no details).
• Write a one-page postvention plan (what you'll do after a suicide or overdose on your team), using CIASP resources.

Days 61–90: Check and adjust

• Re-run the crew survey and compare to day 30.
• Look at the measures below with your supervisors. What's working, what isn't?
• Add a lethal means safety toolbox talk (item 6).
• Set the next year: scenarios twice a year, survey every 6 months, review at your annual safety review.

What to measure (things a small company can actually collect)

Measure	How to collect	Goal
Scenario pass rate	Observer checklist: supervisors passing all six ÷ supervisors who ran them	Every supervisor passes all six
Check-ins	Supervisor tally per month (count only, no names)	Going up, not zero
988 / EAP awareness	Crew survey Q1 and Q2: % who answer correctly	Higher at day 90 than day 30
Know where help is	Crew survey Q3: % who can point to it	Higher at day 90 than day 30
Follow-ups done	Supervisor tally: next-day follow-ups after a connect	Every connect gets one

3-question crew survey (anonymous, paper or phone, 2 minutes):

1. If you or a coworker were in crisis, what number could you call or text? (Correct: 988)

2. Do we have an EAP, and do you know how to reach it? (Yes / No / Not sure)

3. Where on this jobsite is help info posted? (Can point to it / Not sure)

Keep surveys anonymous and check-in tallies free of names. The goal is to see whether people know where help is, not to track anyone.

Sources already in this guide: 988 Suicide & Crisis Lifeline; CPWR COMPASS and Ten-Step Guide; CIASP Resources; NIOSH, Preventing Workplace Suicide (2023). Mentoring, not counseling.

Sources, as cited in the guide

1. 988 Suicide & Crisis Lifeline. https://988lifeline.org
2. CDC, MMWR 72(50): Suicide Rates by Industry and Occupation, National Vital Statistics System, United States, 2021 (Dec. 15, 2023). https://www.cdc.gov/mmwr/volumes/72/wr/mm7250a2.htm
3. CPWR/NABTU, REASON, Issue 7 (February 2026). https://www.cpwr.com/wp-content/uploads/NABTU-CPWR-REASON_February_2026.pdf
4. NIMH, Suicide statistics (CDC WISQARS data, 2023). https://www.nimh.nih.gov/health/statistics/suicide
5. Occupational Safety and Health Administration (OSHA), Preventing Suicides in Construction. https://www.osha.gov/preventingsuicides
6. CPWR, COMPASS: Construction Organizations Mobilizing for Peer Support & Suicide Safety. https://www.cpwr.com/research/research-to-practice-r2p/r2p-library/other-resources-for-stakeholders/mental-health-addiction/construction-organizations-mobilizing-for-peer-support-suicide-safety/
7. CPWR, Ten-Step Guide to Implementing COMPASS. https://www.cpwr.com/research/research-to-practice-r2p/r2p-library/other-resources-for-stakeholders/mental-health-addiction/construction-organizations-mobilizing-for-peer-support-suicide-safety/guide-to-implementing-compass/
8. CPWR, COMPASS program materials (PDF). https://www.cpwr.com/wp-content/uploads/COMPASS_Program_Materials.pdf
9. NIOSH Science Blog, Preventing Workplace Suicide (2023). https://www.cdc.gov/niosh/bulletin/2023/preventing-workplace-suicide.html
10. NIOSH, Mental Health and Work (2024). https://www.cdc.gov/niosh/bulletin/2024/mental-health-work.html
11. Dong X.S. et al., Prescription opioid use and injuries among construction workers, MEPS 2011–2018 (PMC8842216). https://pmc.ncbi.nlm.nih.gov/articles/PMC8842216/
12. Liu et al., BMC Public Health (2025) 25:1206, gatekeeper suicide prevention training meta-analysis. https://pubmed.ncbi.nlm.nih.gov/40165179/
13. American Journal of Industrial Medicine (2025), MATES in Manufacturing cluster randomized trial. https://onlinelibrary.wiley.com/doi/full/10.1002/ajim.23698
14. Construction Industry Alliance for Suicide Prevention (CIASP), Resources. https://www.preventconstructionsuicide.com/resources
15. Barber C. et al., Who owned the gun in firearm suicides of men, women, and youth in five US states? Preventive Medicine (2022). https://pubmed.ncbi.nlm.nih.gov/35461957/
16. LivingWorks (safeTALK and ASIST training). https://livingworks.net