Mental health crisis in construction: PwC

Key takeaways:

Mental health is a growing business risk in construction; poor mental health impacts safety, productivity, and retention, increasing the likelihood of accidents, errors, absenteeism, and burnout.
Employee Assistance Programs alone are not enough — organizations need supportive cultures, trained managers, and accessible mental health resources.
Construction leaders should treat mental health like any other enterprise risk, embedding it into governance, workforce strategy, and jobsite operations.

The mental health crisis in construction: Risks, costs, and what leaders can do

Few industries face the combination of capital intensity and physical risk that defines engineering and construction (E&C). As those pressures mount, industry leaders are paying close attention to mental health as an issue with significant implications for safety and workforce performance.

No longer just an HR concern or a periodic awareness exercise, mental health can be both a business risk and strategic opportunity to improve retention and jobsite performance. A 2025 survey of more than 1,000 US construction workers conducted for E&C firm Clayco found that 64% reported experiencing anxiety or depression within the previous 12 months, up from 54% in 2024. The findings underscore the growing strain many workers face.

And the consequences often extend beyond employee well-being. According to a 2024 report from CPWR (The Center for Construction Research and Training), suicide rates among male construction workers are nearly twice as high as those of working men overall. Construction workers also account for approximately 17% of overdose deaths among the US working population, despite representing only about 8% of the workforce. These statistics highlight the urgency of addressing mental health challenges across the industry.

To better understand these dynamics and explore what industry leaders can do to foster healthier, more resilient workforces, PwC engineering and construction partner Mike Sobolewski spoke with Bridget K. Caletka, LPC-S, LMHC, a counselor and consultant focused on workforce mental health and resilience, and the founder of Forge My Path, a private practice offering counseling and consultation services.

Mike Sobolewski
Partner, Engineering and Construction Leader, PwC US

Bridget K. Caletka, LPC-S LMHC
Founder, Forge My Path

Understanding the business case

Mike Sobolewski: Bridget, it’s clear that many executives still view mental health as primarily a personal matter rather than a business issue. Tell us what’s changed.

Bridget Caletka: What’s changed is that in recent years compelling evidence has linked mental health directly to business-critical outcomes. This work specifically connects work-related stress, fatigue, and distraction to increased accidents and shows that stressed workers are two to three times more likely to experience safety incidents. Burnout is also driving higher error rates and attrition. Overall, the World Health Organization estimates depression and anxiety cost the global economy roughly $1 trillion annually in lost productivity, while a report by the American Psychiatric Association showed that unresolved depression accounts for a 35% reduction in productivity and contributes to an annual loss of $210.5 billion a year to the US economy. In construction, this manifests as missed days, reduced focus, and slower problem-solving—all of this when margins for error are razor thin.

In construction, this manifests as missed days, reduced focus, and slower problem-solving—all of this when margins for error are razor thin.

Sobolewski: Those dynamics clearly have a cost. Still, I imagine some executives continue to see mental health programs as “nice to haves.” Is there evidence that investing in this area actually delivers a measurable return?

Caletka: There is. A landmark WHO-led analysis found that every $1 invested in scaling up treatment for common mental disorders produced an estimated $4 return in improved health and productivity. Nearly a decade later, the economic and operational costs of untreated mental health concerns have only become more visible across industries.

Moving beyond Employee Assistance Programs

Sobolewski: When I ask leaders how they support mental health, the first answer is almost always going to be: “We have an EAP.” Why isn’t that sufficient?

Caletka: Employee Assistance Programs are valuable and can provide an important entry point to care, but they have limitations. Many employees don't fully understand the benefit, worry about confidentiality, or need more support than the limited number of sessions typically provided. Access can also be challenging when providers aren't familiar with the realities of construction work or when continuity of care becomes difficult after EAP sessions end. That's why an EAP, by itself, isn't enough. An EAP is a resource, not a culture. The organizations making the greatest impact are the ones that pair access to care with supportive leadership, mental health education, and an environment where asking for help is viewed as a strength rather than a liability.

A CMHO understands why mental health demands the same strategic attention and importance as safety, cybersecurity and sustainability.

Sobolewski: So, if we’re going to get out of this narrow, more program-centric view and start treating mental health as a system that spans culture, benefits, leadership—everything—what does that look like? What should the approach be?

Caletka: At the foundation—what every organization needs to have—are clear policies. This includes EAP access and crisis numbers posted visibly. You need behavioral health benefits. You need a defined internal point of contact for mental health crises. Next, at the comprehensive level—this is what good companies are already doing—you add manager training to recognize distress, as well as regular wellbeing check-ins, recovery-friendly policies, peer support communities and mental health apps. You also start getting collaboration with mobile crisis teams and local mental health providers at this level. Finally, world-class organizations embed the concept of good mental health into their operations. They’ve added in-house counselors to provide unlimited no-cost counseling or even created a Chief Mental Health Officer role to integrate mental health into organizational strategy and culture. That’s what you need to do to encourage openness and prevent speaking-up from being career-limiting.

The path forward

Sobolewski: You mentioned Chief Mental Health Officers. Is that realistic for E&C firms?

Caletka: It’s a bold step, but I think it’s one that reflects the severity of the challenge. A CMHO, ideally a licensed clinical professional, brings a mental health perspective to the entire business. The role integrates mental health into operational strategy, advises on benefit design, aligns efforts across HR, Safety and Operations, and develops meaningful metrics around workforce risk and wellbeing. It also provides organizations with a trusted escalation point during mental health crises or high-risk situations. HR leaders already carry enormous portfolios, making it unrealistic to expect them to also function as chief mental health strategists, particularly without clinical training. A CMHO understands why mental health demands the same strategic attention and importance as safety, cybersecurity, and sustainability.

Engineering and construction are people industries. If those people aren't healthy and supported, the industry can't thrive.

Sobolewski: What about companies that aren’t ready for that level of investment?

Caletka: Community partnerships offer tremendous value. Where I live in Texas, we have a community organization using what’s essentially a concierge model for mental health navigation. A worker calls in, tells their story to a licensed clinician, and within 48 hours they receive a list of verified resources matching their specific needs, geography, and insurance. There’s less friction this way, and you increase the likelihood of appropriate care. It also demonstrates to employees that the company invests in solutions that work in practice. The core principle is not leaving workers to navigate a complex and highly fragmented system alone, especially when they’re facing crisis.

Sobolewski: What’s your call to action for industry leaders?

Caletka: First, put mental health on the governance agenda by making it a standing topic at board meetings. Next, honestly assess your culture and programs. That means asking hard questions about whether a frontline worker can actually afford a year of therapy under your current plan. Organizations should approach mental health with the same discipline they apply to other areas of enterprise risk, using meaningful metrics to better understand workforce resilience, barriers to care, and factors that contribute to safety, retention, and productivity. You also have to invest in awareness and training; otherwise, supervisors won’t have the tools to recognize distress and direct people to help. Another important step is building community partnerships.

Sobolewski: Any final thoughts?

Caletka: Engineering and construction are people industries. If those people aren’t healthy and supported, the industry can’t thrive. The question is no longer whether mental health belongs on the business agenda. It’s how prepared we are to address it.