Prior articles in this series have explained the construction industry’s challenges with mental health, substance misuse, and suicide risk before and during the pandemic. These factors are an “invisible crisis in construction.” These issues were problematic in construction before COVID- 19 but the pandemic has worsened the mental health stress and financial pressures among workers which, in turn, has increased behavioral health risks among the workforce and their families. Similarly, behavioral health challenges pose risk to all construction stakeholders. There are some telltale warning signs, including the rising risk of near hits and/or serious injuries and fatalities (SIFs) on jobsites. According to the Bureau of Labor Statistics in 2019 the construction industry experienced 1,066 workplace fatalities, the highest number since 2007. Moreover, among all industries, unintentional overdoses due to nonmedical use of drugs or alcohol increased for the seventh consecutive year.