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When Buddy Osborne’s phone rings, it’s because something has gone wrong. An accident. A death. A traumatic event on a job site. This past April, it was a catastrophic collapse. A parking garage had fallen, and three construction workers were dead.

Osborne, 67, the chaplain for the Philadelphia Building and Construction Trades Council, arrived at the scene to find an ironworker being interviewed by investigators from the Occupational Safety and Health Administration. The man had witnessed the collapse. The workers who died had been part of his crew. Osborne did not know him. They had never met. But as a chaplain, Osborne was there to help the workers who witnessed the traumatic event. His job, as he put it, was to “render support to workers in distress.”

He waited until the interview ended. Then he walked over, introduced himself, and placed a hand on the worker’s shoulder. “He’s a tough guy,” Osborne said, “but he just broke down.” Osborne hugged the worker as he wept. By the time he pulled away, his shirt was wet with the man’s tears.

The ironworker Osborne comforted was part of a workforce that is deeply woven into Philadelphia’s civic identity. Roughly 121,000 people across the Philadelphia metropolitan area work in construction, following a decade of steady growth. The Philadelphia Building and Construction Trades Council alone represents more than 50 local unions. Politicians court their support. The city celebrates the buildings, roads, and public projects they construct. But behind that civic pride is a workforce in profound distress.

Construction has one of the highest suicide rates of any major industry in the country, according to the Centers for Disease Control and Prevention. More than 5,000 construction workers die by suicide each year, roughly five times the number who die from fatal worksite injuries, and male construction workers are 75% more likely to die by suicide than the general population. Construction workers also die from drug overdoses at a higher rate than workers in any other industry.

Those numbers have set off an urgent effort in Philadelphia to confront the mental health crisis roiling the construction industry. Osborne is but one small part of it. An entire alphabet of organizations, from ATAP, the Allied Trades Assistance Program, and CIASP, the Construction Industry Alliance for Suicide Prevention, to CWC, Carpenters Who Care, and MACSC, the Mid-Atlantic Construction Safety Council, now offer expanded access to mental healthcare and substance use treatment.

There are peer-support networks and suicide prevention training programs. On job sites, there are daily stand-downs and toolbox talks devoted to mental health awareness. There is a Construction Suicide Prevention Week every September, and this past May, for the first time, 50 workers gathered in the Wissahickon for the Greater Philadelphia Construction Hike for Hope, sponsored by the American Foundation for Suicide Prevention.

All of this is to say: Everybody cares. All eyes are on the issue.

As Johnathan Davis, a professor at the University of Iowa’s College of Public Health, put it: “The construction industry has had a phenomenal response to this problem, and the awareness, the destigmatization, and the support programs are important parts of that response.” Indeed, it has never been easier for a construction worker in distress to get help.

Yet the crisis of the distressed construction worker persists, in part because, according to interviews with dozens of workers, the industry itself produces the suffering. And, so far, it has done more to treat it than to prevent it. The focus now, Davis said, needs to be on “upstream solutions.” So, not only helping workers once they hit their breaking points, but also addressing the conditions that bring them there in the first place.

The same day Osborne, who lives in Kensington, was at the parking garage, Marianne Wolfe was meeting with the workers in their union halls.

Wolfe is the managed care supervisor for ATAP, an employee assistance program that provides mental health and substance use services for organized labor. After a tragedy like the parking garage collapse, part of her job is to lead workers through critical incident stress debriefing, a structured, therapist-led conversation meant to help people process the trauma they have just experienced.

In this case, that meant sitting with workers who had witnessed the collapse and were still trying to make sense of it.

“They were just trying to wrap their heads around what took place,” Wolfe said. “Survivor’s guilt. It was a ‘Why wasn’t it me?’ type of thing.”

Trauma, Wolfe said, “is a very tricky thing.” It does not always arrive when expected. It can surface weeks or years later. That is why she expected ATAP to keep receiving calls about the collapse for at least several months. If so, those calls will come into an office that is already busy.

“We’re a high-volume call center,” Wolfe said.

Workers reach out to ATAP when they need help and don’t know where to turn. They call ATAP’s 24-hour emergency hotline when they are desperate, sometimes actively suicidal, and an ATAP employee quickly connects them to the right level of support, whether that is outpatient counseling, substance use treatment, or immediate inpatient care.

For years, Wolfe said, most of the calls coming into ATAP were about substance use that was exacerbated, in part, by wear and tear from demanding physical labor.

“We were still in the opioid epidemic,” she said. “Now we are in what we’re calling a mental health epidemic.” She attributed the shift to years of education and anti-stigma work that made it easier for workers to ask for help.

Some workers call because they are anxious. Some call to discuss family or work-life balance issues. Sometimes they call because they cannot sleep. Their reasons run the gamut, but they all lead back to a simple truth: “Being a construction worker isn’t an easy job,” Wolfe said.

Layoffs and financial instability are par for the course. The hours are grueling. Some work seven days a week. There is hardly any time to see family. Left unaddressed, those pressures can pile up until a worker feels helpless, or hopeless, or, in Anthony Zecca’s case, both.

“I’ll be honest with you,” Zecca, who lives in Fairless Hills, said in April. “I didn’t want to live anymore.”

He was describing how low things had gotten the previous December. His marriage was on the brink of collapse. His father-in-law had warned him that if he couldn’t get his temper under control, he was going to lose his family. He had been having anger issues ever since he got out of prison in 2023, after serving four years for possession of a firearm. “I had a very hard time adjusting,” he said.

At Christmas, Zecca got so angry that he kicked over the tree and broke his toe. He had to get surgery and could not work for six weeks. But the real wake-up call was his daughter’s reaction that night.

“I saw how terrified she was of me, and I just broke down in tears,” he said. “I couldn’t do it anymore.”

Zecca, 41, called ATAP the next day and spoke to Wolfe. “I told her I’m having a lot of problems at home,” he recalled. “I said I’m really depressed. I’m not doing good.”

Wolfe got to work on Zecca’s behalf immediately. She got him into anger management and found him a therapist and a psychiatrist, whom he now sees every month. She helped his 8-year-old son who has autism, too, by connecting him with a behavioral psychologist. Zecca ended up calling ATAP so frequently that Wolfe gave him her personal cell phone number.

Life has been much better for Zecca ever since he reached out to ATAP. He and his wife still fight sometimes, mostly about his hours. He is away from 4 a.m. until 7 p.m. every day. But they have not had any major blowouts since Christmas. His psychiatrist put him on Wellbutrin, which Zecca says helps with both his depression and his ADHD. He uses his therapy sessions to work through the different stressors in his life.

Zecca still has many sleepless nights and considers himself an “anxiety-ridden person.” And the construction industry remains his biggest stressor. He wakes up every day worried he will be laid off and out of work for the next month. “It really wears on me,” he said.

Unable to make peace with the industry’s uncertainty, Zecca is trying to change his circumstances.

“I just want a steady job where I don’t have to worry about being laid off,” he said. He is tired of the stress on the job, the demanding timelines, and the endless hours. He is hardly alone.

John Sobetsky, 35, was among the workers who gathered in the Wissahickon for the Greater Philadelphia Construction Hike for Hope. For him, the cause is personal: Sobetsky survived a suicide attempt in high school and is now active in the industry’s mental health efforts. He also knows firsthand how the pressures of construction can overwhelm the rest of a person’s life.

The former technician and concrete mixer-turned-business development manager said his life is much more manageable ever since he traded the grind and churn of construction work for a 9-to-5.

“It’s almost night and day,” he said. “I don’t have those deadlines weighing on me. I have freedom. I have flexibility.”

Three years ago, Sobetsky, who lives in Royersford, was managing a construction project that was such a “complete cluster from beginning to end. … I wasn’t sleeping. I wasn’t eating,” Sobetsky recalled. “My anxiety was out of control.”

Eventually, it affected his ability to do his job. “I was missing wire runs,” he said. “I was spending way too much time on tasks that should have taken me half the time because I was just mentally out of it.” It got so bad that his boss asked him if he was OK. That, experts say, is often how distress shows up on the job.

“Warning signs often masquerade as performance issues,” said Sonya Bohmann, executive director of the Construction Industry Alliance for Suicide Prevention. “It’s things like not showing up for work on time anymore. It’s things like jumping to conflict when you’re usually the person who’s really the steady Eddie.”

Those sorts of behavioral changes are opportunities for bosses and supervisors to check in and point workers to available services. But, according to Bohmann, culture frequently gets in the way.

“It’s hard to say I’m going to therapy because people will look at you like you’re weak or selfish,” she said, “and you never want someone to think that you’re not fit for duty under the hard hat because then they don’t want you on their crew.”

That fear stopped Zecca from seeing the free mental health counselor at his union hall. “I didn’t want a higher-up to see me go in and out of there and think I was a head case,” he said.

According to Sobetsky, until the culture changes, even the best-intentioned services are nothing more than a “checkbox.” Because when a boss or superintendent treats leaving 45 minutes early on a Tuesday to see a therapist as a problem, the help exists only on paper. “Then you don’t really offer it,” Sobetsky said, “because I can’t use it.”

To Bohmann, that is where the work has to move next: from checking the box to creating what she calls a “culture of care,” built on the understanding that the way the industry functions actually affects workers’ mental health.

That’s not just her hunch. It is what new research from professor Davis and the Center for Construction Research and Training (known by its former acronym, CPWR) suggests. Davis conducted an unpublished study that he says shows the presence of family and paid leave policies correlated with lower rates of suicide for construction workers.

“I believe it,” Zecca said when told about the study’s findings. The implications could not be clearer.

As Davis said: “If you as an employer, you as a contractor, you as a union, are interested in lowering the rate of suicide … these are the type of benefits that you should be working into your programs.”

One upstream, preventive solution the industry so desperately needs? It already exists. It is called PTO.

Jason Scholl, the owner of LK Miller, based in Ambler, recently transitioned all of his workers from hourly to salaried wages. He gives them Friday afternoons off in the summer and generally tries to create a culture where his team feels safe. “I try to give them every tool in my toolbox to help them handle the rigors of what they’re doing on a day-to-day,” Scholl said.

There are concerned bosses, too. Ones who take decisive action, like Mary Pat Geppert, who runs Geppert Bros., the demolition contractor that cleaned up the site of the deadly January 2025 plane crash in Northeast Philadelphia. The work was horrifying, Geppert said. Debris and human remains were spread across a 12-block area. Geppert’s workers would not even bring their boots home because of what they walked through. She knew they needed help, so she brought in Buddy Osborne and gave everyone the morning off to talk about what they had seen. She bought them new boots, too. And reminded them of one of her favorite sayings: “It’s OK to not be OK.”

But it’s what Geppert does not do that she believes makes the biggest difference to her workers’ mental health. She does not lay people off. Or at least she tries very hard not to. Even when Geppert Bros. does not have a contract, she keeps her guys working in the company’s own yard. “That’s our secret sauce,” she said. “We don’t let our guys go back to the hall.”

What Geppert Bros. has figured out is what Davis hopes the industry can move toward: steadier, more long-term employment. Such big conceptual changes, like reconfiguring benefits packages and contracts to increase stability, might take more time, but Davis says the industry is well-suited to address these problems.

Zecca is not waiting for those changes to arrive. For more than a year, he has been trying to land a full-time job with Energy Transfer, an oil and gas company headquartered in Texas. The job would involve maintaining the company’s pipelines in Pennsylvania. Instead of starting over with new bosses, crews, and equipment every few months, he would work with the same team on the same project.

It is his dream job. Not because of the work itself or the money. Because it is steady. He wears the company’s navy-and-white hat every day for good luck.

“I just need something with more consistency,” he said one evening in May.

Two days later, he was laid off.