![[ Visit Client Website ]](images/banner.gif)
Background and Purpose:
U.S. construction workers face disproportionately high suicide risk, shaped by demanding job conditions, transient work arrangements, stigma, and occupational norms emphasizing toughness and self-reliance. Although workplace mental health supports such as Employee Assistance Programs are widely available, utilization remains low, suggesting a need for workplace interventions that better fit construction contexts. The Australian MATES in Construction is the most established multi-level workplace suicide prevention program developed specifically for construction, but direct transfer to the U.S. is unlikely to be effective without systematic adaptation to local implementation conditions. This study aimed to adapt MATES in Construction for the U.S. construction industry and pilot test the adapted program, with particular attention to implementation outcomes relevant to occupational practice, worker wellbeing, and workplace intervention research.
Methods:
This study used a two-phase qualitative implementation design. In Phase 1, an adapted intervention protocol was developed through quarterly consultation with a Research Advisory Committee (n=14) and semi-structured interviews with eight construction stakeholders representing six organizations. Rapid qualitative analysis was guided by a core functions and forms approach and the FRAME model to identify context-responsive modifications while preserving intervention purpose. In Phase 2, the adapted program was pilot tested at two regional construction companies varying in workforce structure and union representation. The intervention included General Awareness Training, Peer Connector training, and Applied Suicide Intervention Skills Training. A total of 337 workers participated across both sites. Post-implementation semi-structured interviews with workers who completed advanced training levels (n=14) were coded deductively using Proctor’s implementation outcomes taxonomy.
Results:
Findings suggest the adapted program worked best as a peer-centered, highly visible, and organizationally embedded workplace intervention rather than a stand-alone referral model. Acceptability was reflected in increased confidence to speak directly with coworkers about suicide, the usefulness of roleplays and scenario-based learning, and the importance of selecting trusted, nonjudgmental workers for connector roles. Adoption was supported by leadership buy-in, internal champions, and personal commitment to suicide prevention. Appropriateness was closely tied to occupational culture; participants emphasized that workers were more likely to disclose distress to trusted peers than to formal providers and that the program fit best when adapted to construction communication styles and worksite relationships. Feasibility was strengthened by concrete tools and pathways, including resource cards, 988, EAP linkages, and strategically placed trained workers. Penetration was supported through routine workplace safety communication systems such as toolbox talks, hardhat stickers, and repeated worksite messaging. Sustainability themes emphasized the need for refresher training, continued visibility, and ongoing efforts to reduce stigma and normalize help-seeking.
Conclusions and Implications:
Workplace suicide prevention programs for high-risk labor sectors may be more successful when adapted to occupational culture, embedded in existing workplace routines, and structured around peer support alongside formal services. These findings highlight the relevance of occupational social work to worker wellbeing and suggest that workplace intervention research should attend not only to intervention content, but also to the organizational and cultural conditions that shape implementation, reach, and sustainability in everyday work environments.