Finances, markets, weather, pests and diseases – farmers worry about all this and more. For some people, these stressors contribute to their risk of death by suicide. To discuss how farmers can better understand how to help others and themselves, Jennifer Schwytzer, personal consultant for New York FarmNet, recently presented “Talk Saves Lives” at the NOFA-NY Winter Conference.

Schwytzer wants more people to talk about mental health and suicide, including farmers and ag professionals, because of the unique challenges associated with the industry. In addition to a hefty number of stressors, many farmers work in isolating circumstances with few opportunities to commiserate with colleagues or even workers on their own farms.

“Just like when there are warning signs for physical health issues, there are also warning signs for emotional or mental health issues, along with suicide,” Schwytzer said.

In the U.S., suicide is the 12th leading cause of death. In 2020, 45,979 people died by suicide. For each suicide that occurs, 25 others attempt suicide. That accounts for one million Americans who survive a suicide attempt.

“These are some pretty significant numbers,” Schwytzer said. “It is such a significant health concern within our communities and within our world … and those high numbers are really the reason that programs such as Talk Saves Lives are brought about, so that we can spread awareness on what a significant issue this is and what we can do.”

Not only does suicide impact the person, but it also impacts their families, Schwytzer said. The majority of Americans will experience a suicide loss over the course of their lifetimes.

The big question is why some people take their own lives. There is no one cause, but research has identified several intersecting factors that increase the risk for death by suicide. A large majority of people who attempt suicide have mental health issues – but not everyone who has mental health conditions will attempt suicide. Schwytzer said one in four people will experience a mental health condition and most do no go on to die by suicide. But a mental health condition does represent one significant risk factor.

“One other piece that has been identified by research in the last couple of years is the way that the brain works, and how the brain in somebody who dies by suicide could be different … they found a lot of differences,” Schwytzer said. These differences are both structural and functional.

She also said that most people who are suicidal are actually ambivalent about taking their life – part of them wants to die and part of them wants to live. They feel uncertain as to how to fix their situation or make their experience better.

“I think that is huge when we think about prevention because if you recognize someone is struggling and you think that someone may be at risk of death by suicide, that’s your time to intervene,” Schwytzer said. “You have the ability to do it.”

Schwytzer explained the perspective of a suicidal person. A crisis point has been reached. They feel desperate to escape pain – emotional, physical, financial or any combination of these – and their thinking becomes limited.

“When you are feeling stress and when you are feeling overwhelmed, your brain does not function and think through decisions like it does when you are not feeling those stressors,” Schwytzer said. “So when their thinking becomes limited, their perspective is very different from somebody who can handle stressors in a different manner.”

Risk factors for suicide include health, history and environment. Health could include an unhealthy diet, lack of sleep, head injury, uncontrolled chronic health conditions or a health diagnosis or crisis. Mental health also falls under this umbrella, with conditions including depression, bipolar disorder, anxiety disorders, eating disorders, personality disorders, psychosis, PTSD and substance abuse disorders. Receiving professional treatment for mental health disorders is crucial for mitigating this as a risk and as well for quality of life.

Historical factors include family history of suicide or mental health conditions, childhood abuse, previous suicide attempts and loss.

Environmental factors include access to lethal means, exposure to contagion, prolonged stress and stressful life events.

Preventing suicide relies upon building up protective factors. These include mental healthcare, family and community support, building problem-solving skills and relying upon cultural and religious beliefs.

Schwytzer wants people to be more proactive about mental health, such as seeing a professional and receiving an evaluation as needed, feeling open to discuss treatment options and discovering what works best for the individual.

“The law requires insurance plans to cover mental health services the same as physical health services,” Schwytzer said.

In addition, engaging in exercise, eating a healthy diet, getting enough sleep and managing stress promotes proper self-care for strengthening mental health. Referring someone to helpful resources may prevent a suicide.

“The most important thing you can put between a suicidal person and their way of ending their life is time,” Schwytzer said. This could include asking about their means of suicide and asking to remove it temporarily, such as securing a weapon in a gun safe and surrendering the key.

“Because of that ambivalence, they are likely to say ‘Yes, you can hold onto that key,’ because they’re still not sure they want to do this yet, so they might be reaching out and needing that support,” Schwytzer said. Taking the step of limiting access offers the time to call professionals such as 911 for an emergency or texting 988.

Schwytzer wants people to look for warning signs such as talking about ending their lives; saying they have no reason to live or feel like a burden to others; or expressing they feel trapped or that they feel unbearable pain.

Behavior to note could include increased use of drugs or alcohol; sleep issues, acting recklessly; withdrawing from activities once enjoyed; isolating from family and friends; looking a way to kill themselves; and giving away possessions.

Changes in mood could include depression, apathy, rage, irritability, impulsivity, humiliation or anxiety.

Schwytzer said people should “trust their gut” if someone seems “off” and to not assume that someone else will help the person struggling. Talking about the person’s mental health should be in private.

“Listen to their story,” Schwytzer said. “Express concern and caring. Ask directly about suicidal thoughts: Are you thinking of ending your life? Encourage them to seek mental health services.”

It’s important to avoid minimizing the person’s feelings, trying to convince them that their life is worth living or offering advice. For anyone who may make an attempt soon, the helper should stay with the person, help them remove access to their lethal means and escort them to emergency mental health services.

The Suicide Prevention Lifeline is 800.273.TALK. The Crisis Text Line is 988. Both are manned 24/7 with live operators. For emergency help, call 911.

“We want to talk about this,” Schwytzer said. “Talking about this will save lives – to have the ability to have conversations about this, to bring this to as many people as possible, is so important. We are dealing with high rates of suicide and mental health challenges in our community and to be able to potentially be a person form someone is crucial.”

by Deborah Jeanne Sergeant