Current Research

Research Projects: CPWR and NABTU’s Research and Action Agenda Tackles Suicide and Overdose in the Construction Industry

 

Overdose and suicide rates 2-3 times than the national average emphasize why construction workers’ mental health demands urgent and broad interventions. CPWR’s Research and Action Agenda is designed to drive change and save lives by finding solutions. It focuses on three objectives:

#1 — Tackling Root Causes

It is imperative to address upstream work-related factors that contribute to mental health struggles and substance use. Employers, building trades unions, worker and employer organizations, and others can change contributing factors, such as poor jobsite safety climate, that directly and indirectly damage mental health.

#2 — Breaking Down Barriers

Workers must have access to critical treatment and recovery resources. By better understanding the dynamics of stigma within the industry and developing strategies to overcome it, people across construction can promote interventions that encourage help-seeking and connect workers with evidence-based care.

#3 — Enhancing Support Systems

Services, programs, and policies that assist workers facing mental health and substance use challenges must be more effective. These improvements include studying effective peer support programs, as well as promoting naloxone training for workers and supervisors and ensuring it is available in every first aid kit, jobsite, union facility, and worker’s pocket.

CPWR pursues these objectives by coordinating with people across industry, preventing duplication of efforts, and catalyzing initiatives that lead to effective and sustainable changes.

 

As part of this work, in 2023, CPWR invited proposals from construction professionals and researchers to tackle the issues of suicide and opioid-related deaths in the industry. Experts reviewed the nineteen proposals submitted, with those that evaluated programs and interventions for efficacy and scalability a top priority. After this rigorous selection process, five studies were funded by CPWR thanks to an unrestricted private donation. These projects, all of which have issued their final reports, are contributing to the science behind suicide and opioid overdose prevention in the construction sector.

A Case Study Examining the Development and Impact of the International Union of Elevator Constructors (IUEC) Local 1 Member Assistance Education Program (MAEP)Jonathan Rosen, MS, CIH, FAIHA; Allison Weingarten, LMSW, MDB, Inc.; Maggie Wiener, MSPH, MDB, Inc.
Consultants from MDB, Inc. and representatives of Local 1 of the International Union of Elevator Constructors worked together to gather the lessons from scaling up a union-based peer support program. Local 1’s Member Assistance Education Program is a peer-driven initiative offering support for mental health and substance use. This research found that:

  • A successful peer-driven member assistance program requires strong leadership buy-in, structured training, and peer engagement.
  • Local 1’s adaptable model can be replicated across other unions and industries.
  • A well-implemented member assistance program reduces stigma around mental health and substance use disorders.
  • Resources are needed to address leadership training and establish a family support network.
  • Program effectiveness research is required to better understand outcomes.

 

Impact of employment laws on construction worker suicide. Jonathan Davis, PhD., University of Iowa College of Public Health

This work analyzed publicly available data on state “paid-leave” policies and suicide rates to understand how employment laws and community-level factors influence suicide rates among construction workers. Dr. Davis found that:

  • Female construction workers had significantly lower suicide rates in states with family and paid leave laws, and male workers also benefited.
  • States with laws restricting opioid prescribing practices saw lower suicide rates among male construction workers.
  • Substance use was more common as a contributing factor to suicide among construction workers than in other professions.

 

Peer Support Programs to Promote Mental Health Among Construction Workers. Bradley Evanoff, MD, MPH, Washington University in St. Louis; Anna Kinghorn, MS, Washington University in St. Louis; Jacey Henrichs, PhD student, University of Iowa; Sami Tayeb, MA, Washington University in St. Louis; Diane Rohlman, PhD, University of Iowa
This study evaluated two peer support programs for construction workers in that region. One, LEAN StL, was carried out by the Greater St. Louis Area  Laborers Health and Welfare fund, modeled after a program from the Laborers fund in Massachusetts, and the other by a local firm, the Tarlton Corporation, is based on the successful MATES program in Australia. Pre- and post-measures of effectiveness were obtained to compare these two different models of peer support. The researchers found that:

  • Key stakeholders reported increased awareness of suicide and mental health in the workforce due to both the LEAN StL and Tarlton MATES program.
  • Peer support models that build upon existing relationships and experiences are effective.
  • LEAN StL and Tarlton Mates addressed stigma and promoted mental health awareness in a way that stakeholders felt was congruent with industry culture.

 

Reducing Opioid Deaths – Naloxone Training and Distribution to SMART MAP Program Participants. Chris Carlough, Aldo Zambetti, Ed Robison, Jeffrey Bradley, and Ben Court, Sheet Metal Air Rail Transportation Union, and Sheet Metal Occupational Health Institute Trust
This study piloted a naloxone training and distribution program its members of the Sheet Metal, Air, Rail, and Transportation (SMART) union. Participants across three states received hands-on training to recognize and respond to opioid overdoses. They were able to:

  • Dramatically increase preparedness: Over 80% of trainees reported they were likely to carry naloxone post-training (up from just 16% who did carry it before).
  • Instill greater confidence in responding to emergencies: After training, more than 80% felt “very confident” administering naloxone, compared to fewer than half before.
  • Catalyze immediate industry impact: Over 4,000 doses of naloxone were distributed in 2024, with even higher numbers projected for 2025.

 

Suicide Prevention Practices for Iron WorkersJohnson D. Adetooto, Maritsa Romero, MPH, Laura Schwab Reese, Ph.D., and Behzad Esmaeili, Ph.D., Purdue University
This study explored the effects of prevention practices on ironworkers in the Indianapolis area by analyzing employer-led suicide prevention practices and the effectiveness of two suicide awareness trainings created by LivingWorks, a company specializing in that work. It used three rounds of expert surveys to identify high-priority areas for improvement in employer-led interventions: integrating mental health education into safety training, conducting active follow-ups with employees at risk, and equipping workers with suicide prevention skills. The LivingWorks evaluation showed increases in suicide awareness but no “sustained changes in emotional wellbeing suggesting that a one-time training may not be sufficient.” This finding aligns with previous research, and the authors recommend long-term employer-support for mental health initiatives tailored to ironworkers’ occupational stressors, such as “structured peer programs, ongoing education, and reoccurring training.”

 

As stakeholders in the construction industry, CPWR recognizes the value of collaboration, research, training, awareness, access to services, and effective communication. We have sponsored and conducted hundreds of research studies, including those focused on preventing suicide and opioid-related deaths, and we are committed to building on our progress. With continued investment in these initiatives, we can collaborate to prevent suicide and opioid-related deaths in the construction industry.