The construction industry is built on the strength of materials, structures, teams and individuals. Yet even the most resilient workforces are vulnerable to the challenges of today’s world. In recent years, the rise of drug overdose deaths across the United States has reached crisis levels, with Bexar County, Texas, home to San Antonio, seeing some of its highest numbers in history. While often viewed through a public health lens, this epidemic deeply affects industries like construction, where the physical demands of the job can intersect with mental health and substance use challenges.
Construction workers perform physically demanding labor, often under high-pressure conditions. Long hours, physical strain and the risk of injury can lead to chronic pain, which are frequently treated with prescription opioids. What begins as legitimate pain management can quickly evolve into dependency, especially without the right support structures in place. Nationally, construction workers are estimated to be seven times more likely to die from an opioid overdose than the average worker, underscoring the need for industry-specific solutions.
Under Skanska’s Care for Life framework, safety includes both physical and psychological well-being. In response to the growing threat of opioid misuse, Skanska has taken proactive steps to ensure its teams are prepared, informed and supported in the face of this challenge.
Narcan Training: A Critical Safety Tool
To address the growing need for overdose prevention and response training, Skanska has partnered with Be Well, Texas, a program committed to increasing access to substance use education, prevention, and treatment. The Texas Health and Human Services Commission supports this program through federal funding from the Substance Abuse and Mental Health Services Administration, as well as other state and federal funds. The collaboration led to on-site Narcan training sessions for workers, focusing on how to recognize signs of an opioid overdose and how to administer Naloxone (Narcan), a life-saving medication that can reverse opioid effects in minutes.
Each participant in the training received a Narcan kit to carry with them. While substance use is not tolerated on jobsites, the reality is that workers may encounter drug-related emergencies near or around project locations. Equipping them with the knowledge and tools to respond appropriately.
Addressing Mental Health on the Jobsite
Just as overdose response training equips teams to act in emergencies, addressing mental health may help to proactively prevent crises before they occur.
The opioid crisis cannot be separated from the broader context of mental health in construction. The industry has long faced cultural and structural challenges related to mental well-being. The “tough-it-out” mindset, combined with job-related stress, long hours and sometimes unpredictable income, creates an environment where mental health struggles often go unrecognized and unaddressed.
Skanska has taken steps to break down these barriers through the Green Sticker Program, which trains and certifies employees as “Mental Health First Aiders”. These individuals are equipped to identify early signs of mental health issues or emotional distress and to connect their peers with appropriate resources. The program is integrated into the overall safety approach and reinforces the message that mental health is just as important as physical safety on the jobsite.
With suicide rates in construction among the highest of any industry, this level of intervention is essential. September, which marks Suicide Prevention Awareness Month, is a particularly relevant time to spotlight these efforts. But awareness and action cannot be limited to one month a year. For initiatives like these to be effective, they must be sustained and supported year-round.
This means embedding mental health support into daily operations, not just as a safety protocol. It requires leaders at every level to support open dialogue, reduce stigma, and ensure that resources are accessible and visible. When mental health becomes part of everyday conversation, a culture is created where seeking help is seen as a strength, not a weakness.
A Holistic Approach to Safety
Traditional safety programs in construction have mainly focused on hazard avoidance, fall prevention and equipment protocols. While those remain critical, today’s environment calls for a more holistic approach that incorporates mental health literacy, overdose prevention, emotional resilience and physical health.
Incorporating elements such as toolbox talks, safety briefings and daily jobsite meetings now integrate themes that go beyond physical hazards. Topics include stress management, substance misuse awareness, crisis response planning, and access to confidential counseling and recovery support services.
In addition to internal programs, partnerships with external experts like Be Well, Texas, and even the American Heart Association, which has programs for walking and blood pressure challenges, can be vital for any group. These organizations bring clinical knowledge and a non-judgmental perspective that helps normalize conversations around substance use and mental and physical health. Their involvement ensures initiatives are rooted in best practices and community-specific expertise.
Empowering the Workforce
The goal is not to turn every construction worker into a mental health expert or emergency responder. Instead, the goal is to empower the workforce with the awareness, tools and confidence to act should a difficult situation arise. This can mean administering Narcan, encouraging a peer to seek help or simply knowing when and how to escalate a concern.
Workers who feel supported are more likely to seek help and engage in safer behaviors on and off the jobsite. Working toward a cultural shift in construction that is more open is one of the most powerful safety tools a company can deploy. It also contributes to overall teamwork.
Looking Ahead
The challenges facing the construction industry today are complex. Addressing them requires leadership willing to challenge outdated norms and confront these issues head-on. By investing in education, strategic partnerships and a culture of care, we’re not just protecting our workforce; we’re redefining what safety means in our industry.
Committing to the long-term health and well-being of every team member isn’t just good for productivity, it’s the right thing to do. Training, wellness services and mental health support are essential components of a modern safety strategy. When we prioritize the whole person, we build stronger teams, safer jobsites and a more resilient future for construction.
