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November 07, 2022 Mental Health & Wellness

Deconstructing Stigma: What Attorneys Can Learn from the Prevalence of Mental Health and Substance Abuse Issues in the Construction Industry

The construction industry has some of the highest rates of suicide and substance abuse in the United States.

By Thomas Morales
We face many of the same substance abuse and mental health risks as our construction industry clients.

We face many of the same substance abuse and mental health risks as our construction industry clients.

Pexels | Mikael Blomkvist

As legal counselors and advisors, we are asked to identify risks for our clients. We’re used to spotting the usual issues—the legal, business, and financial risks. But what about mental health risks? What if our clients’ industry is at a higher risk for employee depression, suicide, and substance abuse disorders? What can we do about these issues?

Identifying these risks is particularly relevant for attorneys advising construction industry clients. But all attorneys—regardless of practice area—are humans first and should understand the mental health risks their clients face and become comfortable initiating discussions about those issues and risks for the benefit of our clients.

There Is Something Unique about the Construction Industry

The construction industry has some of the highest rates of suicide and substance abuse in the United States. Citing data from the Centers for Disease Control and Prevention, the Associated General Contractors of America (AGC) reports that the construction industry has the highest rate of suicide in the U.S., at 53.2 per 100,000 workers. See Associated General Contractors of America, Mental Health & Suicide Prevention. For reference, that is four times the national average.

The National Survey on Drug Use and Health (NSDUH) reports that the highest rates of heavy alcohol use are found in the mining (17.5%) and construction (16.5%) industries. See Donna M. Bush & Rachel N. Lipari, Substance Use and Substance Use Disorder by Industry, National Library of Medicine (2015). Similarly, the National Safety Council (NSC), in collaboration with the University of Chicago, reports that the construction industry has the highest rates of substance abuse disorder among all occupations, at 19.0%. See NORC at the University of Chicago & National Safety Council, Substance Use Disorders by Occupation. Notably, when controlling for gender and age difference across industries, the NSDUH study found “there is something unique about . . . the construction industry that would remain even if the construction industry had the same gender and age distribution of any other industry.”

As these numbers suggest, there indeed may be something unique about the construction industry. The AGC offers some possible explanations: (i) a male dominated industry which historically does not encourage seeking assistance; (ii) high job stress with demanding schedules, seasonal work, layoffs, and frequent travel; and (iii) high rates of injury and chronic pain (sometimes being treated with opioids). These factors lead to higher rates of substance abuse which, in turn, contributes to higher rates of anxiety, depression, and suicide.

Human and Financial Costs to Mental Health and Substance Abuse Issues

The human costs of substance abuse and suicide cannot be overstated. Tragically, families lose loved ones every day and struggle alongside their parents, children, siblings, and friends who struggle with substance use and mental health disorders.

But the financial costs are also remarkable. The NSC concludes that construction workers with untreated substance use disorders cost their employers $8,591 per worker per year. These figures include the costs of turnover, absenteeism, and health care. Untreated substance use disorders undoubtedly present financial and legal risks for all our clients, regardless of industry.

Experience in the Legal Industry Gives a Unique Perspective, and We Must Leverage that Perspective

When it comes to substance abuse and mental health disorders, the legal industry is not unlike the construction industry. Much has been written about the high rates of substance use and mental health disorders among law students and lawyers. See American Bar Association, New Study on Lawyer Well-Being Reveals Serious Concerns for Legal Profession (2017). Like construction professionals, we also face high job stress, long hours, and demanding schedules. We should use this shared experience to better understand the risks, pressures, and vulnerabilities our construction clients face.

I understand these similarities well. I am a relatively new attorney beginning my fourth year of practice. Before my legal career, I was a construction worker for over a decade. I am also an addict and alcoholic in recovery.

My substance abuse began long before I worked in construction. It developed early in my life. But my substance abuse only worsened when I worked in construction. Working in construction allowed me to hide my disorder in plain sight: everyone (I thought) drank and used like me. And the frequent isolation of the work allowed me to suffer in relative peace. I could smell like alcohol, be hungover the entire day, or work on absolutely no sleep, as long as I showed up to work each day. And why wouldn’t I? My paycheck supported my habit. But my career also made my habit worse. That continued for years until I hit bottom.

Through the support of family and—in particular—a twelve-step program, I did get sober and have been for fifteen years. In sobriety, I became a much better construction worker. I also became a better partner, son, brother, and friend to my loved ones. Eventually, I went back to college, then law school, and became a construction attorney.

When I began my career as an attorney, I was surprised by how similar the two industries were as they relate to substance use, stress, and anxiety. There are still long hours working in relative isolation (especially during the pandemic). There are still stressful situations that encourage taking the edge off with a drink or a drug. And, especially in the legal profession, alcohol is often at the center of social gatherings. Fortunately, the tools I gained in recovery allow me to cope with those stressors without using.

We Can Advise Our Clients and Colleagues on These Issues

We face many of the same substance abuse and mental health risks as our construction industry clients. By better understanding these risks and the available resources, we can offer a unique perspective that may help a client (or even a colleague) who needs assistance. We should become more comfortable discussing substance abuse and mental health issues. We should continue to destigmatize and break down the barriers that prevent our clients, colleagues, friends, and family from seeking help.

For our construction clients specifically, the Construction Financial Management Association offers ten action steps companies can take to save lives, including building a caring culture in the workplace, screening for mental health and substance abuse, and training supervisors to identify and discuss these issues. Sally Spencer-Thomas, Construction + Suicide Prevention: 10 Action Steps Companies Can Take to Save Lives, Construction Financial Management Association (2016). Employers in all industries should also consider efforts to create recovery friendly workplaces, which are equipped with “the knowledge and tools they need to better understand substance use disorder (SUD) and support employees who have been impacted.” See Samantha Lewandowski, Recovery Friendly Workplaces, Journey Magazine; The Recovery Friendly Workplace Initiative, Recovery Friendly Workplace New Hampshire.  We should direct our clients to these resources and understand how to utilize these tools.

As attorneys, we consider ourselves natural problem solvers. We expect that we can find a solution on our own. But in my experience, I couldn’t fix my substance abuse and mental health disorders on my own. Our clients can't solve these substance abuse and mental health disorders alone either. Working together in a community and knowing how and when to utilize available recovery resources is the only way to make a lasting change.

We’ve built our practices on our ability to have difficult conversations with our clients. By familiarizing ourselves with these issues and using these tools, we too can become more comfortable initiating conversations about substance abuse and mental health disorders.

If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the 988 Suicide & Crisis Lifeline is available 24/7 across the United States. Simply dial 988.

Thomas Morales is an associate in the construction projects and litigation practice group at Holland & Hart, LLP in Denver, Colorado.

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