Farmers should care for mental health

by Deborah Jeanne Sergeant

Many farmers and ranchers are so busy trying to get their operations producing and profitable that they give little thought to physical health; however, mental health also deserves attention. Michigan State University recently offered a webinar on the topic, presented by Andrea Bjornestad, assistant professor in the Department of Counseling and Human Development at South Dakota State University and Courtney Cuthbertson, community behavioral health specialist at Michigan State University Extension.

Bjornestad said recent depression rates in agricultural workers have ranged from 7.4 percent to 24 percent.

“Suicide in agricultural workers is a global concern as farming is an occupation with a higher suicide rate than the general population,” she said. “Gender differences exist, as rural males maintain higher suicide rates than rural females in most countries. Farmers may have a tendency to ignore both physical and mental health symptoms unless their work productivity is reduced.”

Ignoring depression symptoms contributes to suicide, as stressors can make individuals feel hopeless, as if they have no way out. Farmers face many different occupational stressors. As a result, the U.S. faces what Bjornestad calls a “suicide crisis in farmers.”

This reflects a global crisis. Bjornestad said in Australia, a farmer dies by suicide every four days. In the UK, that’s one weekly and in France, every two days.

So why is the suicide rate so high among farmers? Bjornestad suggested a few possibilities, including social isolation, potential for financial losses, barriers to and unwillingness to seek mental health services, and access to lethal means. With many commodity prices below the cost of production, it’s easy to see how farmers feel stressed.

“A negative stigma exists regarding mental health issues and to protect their family reputation, farming families tend to view psychiatric treatment as least desirable,” Bjornestad said. “Farmers tend to disclose to family members or friends rather than seeking professional help.”

While it may come from a desire to avoid “airing the dirty laundry,” keeping such matters private and avoiding professional help when needed can have disastrous results.

Obtaining help can also be difficult for busy and isolated farmers.

“In past research, pesticide use has been related to depression,” Bjornestad added as another possible factor.

Farmers also work long hours and under difficult circumstances. The former likely represents just one factor that keeps them from seeking counseling.

“It is difficult to get farmers and ranchers to come in just for health check-ups and it may also be related to stigma related to mental health,” Cuthbertson said.

In a survey Bjornestad conducted, farmers and ranchers ranked the stressors in their lives on a scale from 1 as not stressful to 4 as very stressful. Government/external stressors had a mean rating of 2.49; work was 2.02; finances was 2.15; operation was 2.10 and isolation was 1.39.

“The factor that’s most stressful is government and external stress,” Cuthbertson said.

Among those, market prices for crops and livestock were ranked as most stressful, followed by weather, healthcare costs, taxes, government export policy, future of the operation, season variations in workload, problems with machinery, outsiders not understanding and high debt load.

“As one has more years in farming, the likelihood of that risk for suicide goes down,” Cuthbertson said. “There’s no significant difference with gender or serving in the military.”

She added that 15 percent of adults at some point will experience depression in their lifetime. In the survey, 21 percent of respondents had both anxiety and depression, indicating co-morbidity.

“There is significant association between depression and anxiety symptom experiences,” Cuthbertson said.

She added that 20.7 percent of the sample experienced symptoms of both. Among those with anxiety, 16.9 percent are at significant risk for suicide, compared with 4.5 percent without anxiety symptoms. More than 20 percent of those who are depressed are at significant risk for suicide, compared with 2.8 percent without depression symptoms.

“There’s a significant relationship between having a diagnosis of depression or anxiety with current symptoms experiences of depression, anxiety and suicide risk,” Cuthbertson said.

What’s also concerning is that 26.5 percent of people with depressive symptoms and 23.5 percent of people with anxiety symptoms aren’t diagnosed.

Depression and anxiety do not seem to have a significant relationship with many physical health issues such as heart attack, stroke, skin cancer, other cancer, kidney disease, diabetes or high cholesterol, a finding that surprised researchers.

Cuthbertson said lack of support tends to result in negative mental health outcomes, compared with those who have strong support from friends and family, who experience lower risk of depression and lower suicide risk.

“The more social support perceived, the less risk,” Cuthbertson said. “Friendship can be protective here.”

Bjornestad said some people assume that if they farm with their family that can be sufficient to prevent isolation.

“What we’re finding is those who have higher depression have higher levels of anxiety,” Bjornestad said. “Do they have friends outside their family farm? Many report that their closest friendships are those with whom they work on the farm. For a lot of it is them, allowing time to develop friendship to share their stressors and what’s going on is difficult.”

National resources include:

National Suicide Prevention Lifeline, 800.273.TALK (8255)

National Suicide Prevention Lifeline Crisis Chat, www.suicidepreventionlifeline.org/gethelp/lifelinechat.aspx

Crisis Text Line: Text “GO” to 741741

Veterans Crisis Line: 800.273.8255

“Operators will talk with anyone with a mental health issue, not just someone contemplating suicide,” Cuthbertson said.

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