In July, the Centers for Disease Control and Prevention (CDC) released a report that set off alarm bells in the architecture, engineering, and construction (AEC) industry. In the report, the CDC concluded that, among all occupational groups in the U.S., the construction and extraction industry had the second-highest rate of suicide, and architecture and engineering the fifth-highest. (The farming, fishing, and forestry occupational group topped the list.) The report, which compiled data from 17 U.S. states in 2012, tells a story that many in AEC know too well: The industry’s high-stakes, competitive nature can put undue pressure on the mental health of everyone involved, from students to practitioners.

The CDC estimates that, in the U.S., suicide costs the public and employers more than $44.6 billion annually in combined medical and work-loss expenses. But the issue extends well beyond suicide. Depression and anxiety, and even the symptoms of adult ADHD, can threaten productivity in the workplace and classroom and, most importantly, the well-being of students and employees. According to recent research from the Harvard University Medical School, nearly two in 10 Americans between the ages of 15 and 54 said they experienced symptoms of a mental health issue in the prior month. Other research has linked traits like perfectionism, prevalent among individuals in detail-oriented fields like architecture and medicine, to self-harming behaviors. And a study conducted last year by the Substance Abuse and Mental Health Services Administration found that among all occupations surveyed, workers in the construction industry exhibited the second-highest rate of heavy alcohol use (mining was first)—another factor that experts say can negatively affect mental health.

“We first attack the argument that ‘[suicide has] never happened here,’ ” says Sally Spencer-Thomas, a clinical psychologist and CEO of the Denver-based Carson J. Spencer Foundation, which works with companies in high-performing field to implement suicide-prevention strategies. "A suicide at work is a very rare thing, but that’s how [many of our clients] were thinking about this issue.” The first thing she addresses with workplaces that don’t think they have a problem with their approach to mental health? Their definition of it.

While many employers and institutions have broadened their view of what mental health encompasses—spurred in part by the Millennial generation, which continues to push for a better work-life balance—there's still work to be done.

The Problem of Studio
In architecture, the issue can be traced all the way back to the classroom—specifically, studio. In December 2013, the Graduate Architecture, Landscape, and Design Student Union (GALDSU) at the University of Toronto partnered with the institution’s psychology department to conduct a survey of the university’s graduate architecture students. The goal was to identify ways to improve mental health, considering what the survey's authors called the program’s “unique academic environment.” Those privy to the pressures and rituals of architectural education know what they meant by “unique”—long hours in studio and frequent all-nighters coupled with anxiety and stress from rigorous reviews, and exacerbated by the poor eating and exercise habits prevalent across college campuses.

The majority of students surveyed said that the faculty were not sufficiently responding to concerns they had raised about their mental health, and that the students themselves weren't using on-campus mental health resources (including counseling and psychological services) often because they weren’t aware of their existence. Students surveyed described the environment during the final two weeks of studio—time spent feverishly finishing and presenting semester-long projects—as “incredibly toxic.” As the researchers explained in their subsequent report: “Anxious, nervous, frightened, worried, grouchy, irritable, angry, depressed, down, hopeless, distant. This is what most students admit to feeling more than half of the days during the last two weeks of studio.”

Thomas Fisher, Assoc. AIA—today a professor in the School of Architecture at the University of Minnesota and an ARCHITECT contributor—acknowledged this phenomenon in his 1991 editorial for Progressive Architecture, titled “Patterns of Exploitation.” He wrote it shortly after an architecture student, exhausted by his academic workload, attempted to drive home to change clothes before presenting his studio project, lost control of the car, and was killed in the ensuing accident. Fisher called out the architectural profession for perpetuating the “fraternity aspect of architecture,” in which students and even interns at architectural firms are deemed “in need of toughening up" in order to succeed in the field. He asked: “When do we cross the fine line between hard work and exploitation?”

The American Institute of Architecture Students (AIAS) sought to answer that question in December 2000, following dishearteningly similar circumstances. Another architecture student had been killed in an automobile accident after he attempted to drive home following two consecutive sleepless nights spent working on a final project. In response, the AIAS formed the Studio Culture Task Force to offer, what it called, "a critique on the current practices in design studio education.”

The task force’s 2002 report, “The Redesign of Studio Culture,” echoes the sentiments outlined by Fisher and identified by the Toronto architecture students—chiefly, that studio culture is pervaded by “myths” about what the experience is meant to entail (an all-consuming workload, winner-take-all mentality, and sleepless nights) and thus encourages an environment that, through isolation from the rest of the campus community and schedules and pressures that encourage poor self-care, can strain mental health. The report recommends ways to make studio more interdisciplinary and group-oriented, reducing the singular pressure placed on individuals and emphasizing a culture of “optimism, respect, sharing, engagement, and innovation.” It was followed by a multi-school summit on the topic in 2004.

That same year, the National Architectural Accrediting Board (NAAB) added comments on “studio culture” to its Conditions for Accreditation, formalizing the AIAS report’s calls for “optimism, respect, sharing, engagement, and innovation” among faculty, students, and staff in studio, and directing schools to “encourage students and faculty to appreciate these values as guiding principles of professional conduct throughout their careers.”

“Anxious, nervous, frightened, worried, grouchy, irritable, angry, depressed, down, hopeless, distant. This is what most students admit to feeling more than half of the days during the last two weeks of studio.”

Today, many students remain conflicted about the extent to which studio culture needs to change. “Studio Culture: Stories and Interviews,” a recent survey conducted by the 2015–2016 AIAS National Advocacy Task Force, shows varying opinions over stressful academic environments. “Architecture is an intense profession,” one student responded. “I feel like it would be doing the world a disservice by making architecture school less intense.”

The desire for such rigor is part of the problem. “The architectural discipline has traditionally defined rigor in terms of our product—buildings—and paid fair too little attention to the rigor of our process,” Fisher told ARCHITECT. “As a result, we have undervalued our thinking and our time, leading to everything from poor compensation for the hours we put into our work to poor time management habits that start in school. The mental health of our students and our profession will greatly improve when we properly value our time, our thinking, and the process by which we work.”

AIAS representatives say that balanced lifestyles and workplaces foster mental health, rather than detract from it, and are paramount to the organization. "Our Advocacy Task Force is charged with advancing the progression of a healthy studio culture within schools of architecture,” AIAS national president Sarah Wahlgren told ARCHITECT. “Habits started during studio often carry into someone’s career.” She encourages students to engage with AIAS chapters to promote “healthy self-awareness,” she says, and “to get out of studio and interact with others in positive ways."

In the fall of 2007, a second AIAS Task Force on Studio Culture was formed to see what progress had been made. It found that the architectural community was more willing to openly discuss issues related to mental health, and could benefit from bringing the conversation out of the classroom and into the workplace.

That's beginning to happen. “The AIA has been investigating the attributes of a truly successful architect firm culture,” John Schneidawind, the AIA’s director of public affairs and media relations, wrote in an email. “They include a focus on workplace culture, including firms that have employment policies supporting professional development and work-life balance. This focus on firm culture also includes transparency between firm/project leadership and staff, diversity and inclusion, and a conspicuous application of a collaborative studio environment.”

A Bigger Picture
Spencer-Thomas says workplaces have come a long way in their approach to employee mental health over the past two decades. She started the Carson J. Spencer Foundation in 2005, after losing her brother to suicide. Seeing a specific need for action in the construction industry, her organization created Construction Working Minds, an offshoot of its workplace-focused Working Minds Program, which provides “blueprints” for effective prevention strategies and “toolbox talks” that give managers guidelines for discussing the issue with employees. The Construction Working Minds program points at the factors in the field that can affect employees' mental health: a culture that thrives on fearlessness, jobs that may involve physical strain, and the often-cyclical nature of work. “It’s a ‘tough guy’ culture,” Spencer-Thomas says. “It’s where the toughest company wins the bids. It’s the culture where you don’t show your weakness. You get the job done before the deadlines.”

Even further, the male-dominated AEC field is inherently at risk because, according to CDC data from 2011 and 2013, men are four times as likely as women to take their own lives. (Statistics for suicides by women working in AEC were too low to draw reliable conclusions, though the CDC reports that women are more likely than men to have suicidal thoughts.) For that reason, the Carson J. Spencer Foundation and other agencies developed Man Therapy, a resource that takes a faux-macho approach to sharing information about the topic of mental health and suicide among men who, experts say, tend to avoid asking for help when it comes to their own emotional well-being.

“It’s a 'tough guy' culture. It's where the toughest company wins the bids. It's the culture where you don’t show your weakness. You get the job done before the deadlines.”

Like Spencer-Thomas, clinical psychologist Paul Quinnett sought to develop a more proactive approach to mental health in the workplace, with a focus on suicide prevention. In 1999, he founded the QPR Institute (short for Question, Persuade, Refer). The agency trains individuals around the world to become “gatekeepers” able to recognize signs of suicidal behavior among coworkers, friends, family, neighbors, and others, and intervene. The agency likens what it does to training individuals to conduct CPR, a helpful analogy in understanding the potential impact of QPR’s grassroots-style work.

Quinnett says that one of the biggest assets in responding to individual's mental health concerns is creating awareness in people’s close communities, which includes the workplace. Still, employers are often reluctant to admit that their culture may be damaging to their employees’ mental health. “There's still a lot of stigma around the issue of mental illness,” he says. "Suicide is part of mental illness and therefore it’s kind of doubly stigmatized.”

A resilience-focused company culture can sometimes be what hurts employees the most. “It makes people afraid to show or disclose any vulnerability,” Spencer-Thomas says. And in the economic troughs or recovery periods of a cyclical industry like AEC—when the volume of work is low, resources limited, and the rewards few and far between—the culture she describes as “keep your head down, do the job well, get the reward for it,” can further raise the stakes.

Rethinking Resources
Patricia Kagerer, a risk-management executive at American Contractors Insurance Group, in Richardson, Texas, says that the CDC numbers should push AEC companies to do more. “Companies often think that implementing an EAP [Employee Assistance Program] is enough.” EAP programs are an added benefit that typically include short-term counseling for a variety of work and personal issues. “Unfortunately, many companies implement the EAP and it goes unused for years. No one seeks the resources that are a phone call away,” she says.

The idea that employees' mental health should be valued as much as their physical health is beginning to take hold. As the AIA’s Schneidawind notes, “all of the [Affordable Care Act]-compliant plans offered through [the Institute’s] health insurance exchange contain mental health coverage as part of the required Essential Health Benefits. When an AIA member uses the AIA Trust Health Trust Insurance Exchange, the health plan should contain mental health coverage benefits.”

An analysis of research by Harvard University Medical School on mental health in the workplace, published in 2010, found that the impact—on employees personally, and their employers financially—would be considerably less if the workers who needed treatment were able to get it. “The authors of such studies advise employees and employers to think of mental health care as an investment—one that's worth the up-front time and cost,” according to the analysis, which notes that most of the research focused on workers with depression.

Changing the Culture
The mental health experts interviewed for this article say that stories—of loss, of survival, of recovery, of moving forward—are central to breaking the silence and changing toxic school and workplace cultures. In 2015, Quinnett partnered with the American Association of Suicidology, in Washington, D.C., to present the “Lived Experience Writing Contest” for individuals to share their stories of resilience and recovery related to suicide. Spencer-Thomas points to the recovery testimonial videos on the Man Therapy website, and to the videos discussing the prevention efforts of police and fire departments at their own workplaces hosted on her foundation's YouTube page.

Despite increasing public awareness, change can be slow. The University of Toronto's GALDSU program repeated its mental health survey for the 2014–2015 and 2015–2016 academic years. The authors wrote in the introduction to their latest report that the surveys, "considered across multiple years, will provide us with an important tool by which we can measure the effects of changes made by GALDSU and faculty on the student experience." They note that, so far, the school has responded to survey responses and additional feedback by creating more spaces for students to "eat, relax, study, and rest," and that it also helped the Canadian Architecture Students Association conduct its own well-being survey of architecture schools in Canada.

Still, for the 2015–2016 academic year, a majority of students in the GALDSU survey again reported that during the final weeks of studio they felt "anxious, nervous, worried or on edge," as well as enduring "pressure from many sides: from their fellow students, critics, studio instructors, the discipline as a whole and from themselves." And, again, many said they were "grouchy, irritable, angry, depressed, down or hopeless." Students continued to report low use and limited awareness of mental health services available to them on campus.

Nevertheless, says the University of Minnesota's Fisher, portable and cloud-based design technology and a more diverse student population are driving positive changes in studio culture. “Today’s students seem more interested in work-life balance and less willing to pull all-nighters,” he says. “The digital nature of studio, too, has changed things. Students can now work almost anywhere and are much less willing to live in their studios. This is a positive and healthy change from the past.”

In his Progressive Architecture editorial, Fisher argued that the status quo at architecture school shouldn’t be accepted just because it’s always been that way. Resolving the problem, he wrote, "will demand that students and recent graduates simply not take it anymore.”

Millennials, Fisher says, were the ones to heed his call. That generation tends to value work-life balance over career advancement, a preference that some employers have viewed as a lack of commitment—spurring the cycle of mental health abuses. “Millennials have not accepted what some view as a toxic professional culture, evident in the number of graduates, and especially the number of women, who are pursuing alternative career paths that allow for a more reasonable work life,” he says. “This generation is voting with its feet, and firms need to adapt or they will find themselves unable to attract or keep staff.”

Additional Resources
National Suicide Prevention Lifeline
1-800-273-TALK (8255)

Construction Working Mindshttp://www.constructionworkingminds.org/

Man Therapyhttp://mantherapy.org/

Cal Beyer, director of risk management at asphalt paving company Lakeside Industries, in Issaquah, Wash., and an execute committee member for the National Action Alliance for Suicide Prevention, in Washington, D.C., offers strategies for the AEC community to address the mental health of employees:

  • Identify at-risk individuals
  • Create a dialogue around mental health and suicide prevention
  • Integrate mental-health awareness with safety, health, and wellness programs
  • Provide resources to employees, such as posters and links to relevant websites
  • Build peer support networks
  • Train managers and supervisors to address at-risk individuals with behavioral interventions
  • Evaluate EAPs and other crisis-management services
  • Create a call to action for leaders to address the issue in their companies
  • Generate media attention to create broader awareness to expand or elevate the conversation

To contact the editor on this story, email Hallie Busta at [email protected].