Weekly Topic: In depth: Rural mental health
Lauren Bernstein

Mental health services lacking for American farmers

In 2018, numerous news outlets reported on CDC’s widely cited 2016 Morbidity and Mortality Weekly Report (MMWR) that estimated the suicide rate among U.S. male agricultural workers in farming, fishing, and forestry to be five times higher than any other industry in the country. The CDC began a re-analysis of the study this summer, citing concerns over inaccuracies due to coding errors.

Regardless, the CDC confirmed that rural Americans generally experience more health disparaties than urban and suburban Americans, and that the gap in suicide rates between rural and urban Americans has widened since 1999.

These health disparities are often associated with poorly accessible or unavailable healthcare options, especially mental health services. This is particularly problematic for farmers who experience many of the rural risk factors for higher rates of suicide and mental health issues, including physically demanding jobs, social isolation, socioeconomic inequities, and higher access to firearms.

The USDA reports that farmer income has dropped 35% since 2013, leading to growing concern of a repeat of the 1980s Farm Crisis. In addition to this income trough, farmers often endure situations that are simultaneously out of their control and integral to their general productivity, such as unpredictable weather extremes that may threaten their crops, variable commodity prices that offer less than production costs, rising interest rates, debt, and tariffs.

CDC
CDC MMWR

A local perspective: rural mental health efforts in Minnesota

Minnesota farmers are no exception to the mental health disparities felt across the country. In rural parts of the state, each primary care doctor sees 2.7 times the number of patients that an urban primary care doctor sees. These limited primary care options often lack mental health services.

Another important barrier remains, however: even if these services were available, accessible, and affordable, many farmers fear how their communities will perceive them if they seek help. A large challenge with the geographic and social isolation of the job is delivering the resources and information they need to shed the stigma associated with seeking support for job-related emotional challenges.

The Minnesota Department of Agriculture’s (MDA) only rural mental health counselor, Ted Matthews, wants to reduce this stigma and provide a nonjudgmental space to simply talk about the job’s daily stressors. This state-funded service also enables farmers to learn where they can seek additional legal help, loan assistance, or business counseling.

In March, Matthews testified before the Minnesota House Agriculture Finance Committee, explaining that more access to counselors is needed. Proposed legislative changes for the state include budget increases to add a second counselor and outreach-initiatives for farmers experiencing mental health crises.

For more information about MDA’s stress and crisis resources, please visit the links provided below.

MDA Stress and Crisis Resources
NPR

Not just an animal tragedy: a look back at the UK’s 2001 Foot and Mouth Disease outbreak

Inadequate farmer and rural mental health resources are not unique to 2018, nor are they unique to this country. The job entails daily mental health and suicide risk factors. When managing these daily stressors becomes overwhelmed with an unpredictable disease outbreak that threatens livelihoods, families, and reputations, feelings of hopelessness and desperation become insurmountable.

The devastating 2001 Foot and Mouth Disease outbreak in the United Kingdom provided unfortunate insight into a conversation that is often left out of disaster planning and management: what are the short and long term psychological effects on the stakeholders in such events?

Prior to the outbreak, British farmers already struggled with decreased prices, decreased incomes, and high debt. The outbreak lasted about seven months and cost the UK’s agriculture, food, and tourism industries about $13 billion. Between 6.5 and 10 million animals were slaughtered, including healthy animals on neighboring farms. In addition to coping with these financial losses, rural workers experienced psychological trauma associated with mass animal incineration. They also experienced social isolation due to travel restrictions and tension within communities.

Several rural workers committed suicide during and after these events, and few sought social services, either because they were not available or because the workers did not recognize their reaction to the events as emotional trauma. The long term effects included a loss of confidence in governing authorities and insecurity about future employment. These events provided a serious re-evaluation of disaster management: community resources for psychological support should be available before an unpredictable, devastating event occurs.

BMJ (PDF)
Advances in Psychiatric Treatment (PDF)

Crisis resources

If you or someone you know is struggling emotionally or experiencing a mental health crisis, please contact these resources:

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Crisis Text Line: Text "CONNECT" to 741741
Farm Aid Hotline: 1-800-FARM-AID (327-6243)
Minnesota Department of Agriculture's Farm and Rural Helpline: (833) 600-2670

For additional information about national and state resources, stress management guides, and additional helplines, please visit Agrability.

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Lauren Bernstein

Lauren Bernstein

Lauren received her BS in Animal Science from the University of Tennessee. Following a Rotary International site visit to South Africa as an undergraduate student, she decided to focus her prospective veterinary career on public health, specifically on issues involving diseases at the human-animal-environment interface. She completed her veterinary education at the University College Dublin, School of Veterinary Medicine. When she's not in the office, she enjoys yoga, embracing the outdoor activities in Minneapolis, and finding excuses to talk about her rescue cat.