Purpose Construction work's client-driven, project-based nature creates psychological challenges for professionals. This study aims to investigate mental health stressors, outcomes and coping strategies among Thai construction professionals, focusing on differences across key stakeholder roles. Design/methodology/approach A quantitative survey of 291 Thai construction professionals was conducted. Descriptive statistics and non-parametric tests (Mann-Whitney U and Kruskal-Wallis H) were used to compare stressors, mental health risks and coping strategies across roles. Findings Approximately one-third of respondents were at risk of mental health problems. Common stressors such as workload and conflict appeared across all roles. Unique challenges in Thailand include staff shortages due to a limited pool of experienced technical professionals and contractors, along with inadequate planning and frequent task deviations causing project delays. Self-control emerged as a distinct coping strategy. Research limitations/implications This study is limited by its cross-sectional design, small client sample and reliance on self-reported data. Cultural specificity and lack of qualitative insights also constrain generalizability. Future research should adopt longitudinal and mixed-methods approaches and evaluate interventions to enhance coping and mental well-being. Practical implications About one-third of Thai construction professionals face mental health challenges from stressors like workload, conflict, and financial strain. Beyond individual coping, systemic interventions – such as workload management, financial support, team-building, fair reward systems and mental health standards – are essential. Shifting to best-value procurement may also reduce project pressure and improve well-being. Originality/value This study explores mental health challenges in Thailand's construction industry, offering insights into workforce resilience, stakeholder-specific stressors and coping strategies in an aging, technology-driven economy.