Exploring Health, Safety, and Mental Health Practices in the Saudi Construction Sector—Knowledge, Awareness, and Interventions: A Semi-Structured Interview

<b>Background</b>: Mental health is increasingly recognized as an integral component of occupational health and safety, particularly in high-risk industries such as construction. However, in Saudi Arabia, limited attention has been given to understanding mental health knowledge, beliefs, and workplace support mechanisms, especially among a diverse workforce that includes both migrant and national employees. <b>Methods</b>: This qualitative study employed semi-structured interviews with 30 construction sector participants occupying a range of professional roles. Thematic analysis was conducted using NVivo 15 software, guided by the COM-B model and Health Belief Model, to explore perceptions related to mental health, safety practices, and organizational interventions. <b>Results</b>: The findings highlight significant disparities between migrant and national workers. Migrant workers reported greater challenges related to language barriers, cultural stigma, and a lack of access to culturally appropriate mental health support. National workers described slightly better access to safety and health initiatives but still reported inadequate mental health training. Key barriers across the workforce included limited leadership engagement, stigma, resource constraints, and insufficient organizational training. Existing health and safety programmes were largely focused on physical safety, with minimal incorporation of mental health concerns. <b>Conclusions</b>: The study reveals a pressing need to integrate mental health into occupational safety frameworks in the Saudi construction sector. Culturally sensitive, leadership-supported mental health initiatives are essential to addressing disparities and promoting holistic workers’ well-being across both migrant and national populations.