Suicide in Farm Country
A December 2017 front page story in The Guardian brought to America’s attention a harsh reality about its farmers: people working in agriculture in the U.S. — including farmers, farm laborers, ranchers, fishers and lumber harvesters — take their lives at a rate higher than any other occupation. The article highlighted a study by the Centers for Disease Control and Prevention (CDC), which found that the suicide rate for farmers and ag workers is nearly five times higher than that of the general population.
In June 2018, the CDC retracted the study results after the methodology was questioned. Farm Aid issued a statement, which said in part: “Increased calls to Farm Aid’s hotline and our work with partners around the country confirm that farmers are under incredible financial, legal and emotional stress. Bankruptcies, foreclosures, depression and even suicide are some of the tragic consequences of these pressures. America’s family farmers — reduced in numbers since the Farm Crisis of the 1980s — have approached endangered status. Net income for farmers is estimated to be more than 50 percent lower in 2018 than it was in 2013. Rural families, particularly those in agricultural communities, are suffering, no matter which way you slice the data. It is also deeply concerning that farmworkers are so vulnerable to suicide. That points to an urgent need for Congress to pass sound immigration reform policy that addresses the on-the-ground needs of farmers and the needs and rights of farmworkers.”
The Risk Is Not New, and It Is Widespread
While this peril to farmers came to light through the compelling stories shared in the December 2017 Guardian article, it has been a threat since Farm Aid started in 1985. The suicide rate has been higher for farmers than for the general population for decades. It’s also a global phenomenon, and other countries, particularly the UK, New Zealand and Australia, are ahead of the U.S. in terms of bringing awareness to the issue and creating public campaigns to encourage farmers to manage stress and seek mental health care. During the Farm Crisis of the 1980s, social services and rural churches played a major role in supporting and counseling farmers and ranchers. Some of the mental health programs that were designed to help distressed farm and ranch families at that time are still operating. Today, mental health support services — both professional and church- and community-based — are less available and accessible in rural areas than they were in the 1980s, due to factors such as fewer people attending church, fewer community-building events in which people can interact/establish relationships in rural areas, and a decrease in overall population in rural areas.
Mental Health in Rural America and the Unique Stressors Among Farmers
In general, rural residents have higher rates of depression, substance abuse and completed suicide. However, farmers face additional challenges to maintaining their mental health. Mental health professionals point to the nature of farming as one likely cause — it is a business largely influenced by factors that are beyond farmers’ control, including weather, disease, pests, prices and interest rates, and which can come and go without warning. Farmers can be isolated, geographically and socially, since they often work alone. They are self-reliant, independent and can be unlikely to ask for help. Many come from a tradition of not sharing their challenges, choosing instead to tough them out on their own. They work long, hard days and may de-prioritize their own health and well-being to get the job done. Stress as a concept may be seen by farmers as something that urban office dwellers experience.
Farming itself is unique, and many clinicians don’t “get it.” Farmers cannot be advised to take a vacation or search for a less stressful job. Farmers feel a tremendous weight at the possible loss of their land–the possibility that they could be the one to lose something that has been in their family for generations. Their role as a farmer is at the root of their identity; it’s their culture, not just a job.
Due to the nature of their work, farmers often lack health insurance coverage, or have minimal coverage that covers catastrophic injury only, rather than comprehensive care. If they do have insurance, behavioral health services may be considered “out of pocket.” As people who often keep their personal struggles to themselves, farmers worry about their privacy; it can be a challenge to seek care and maintain anonymity in small, rural communities.
To further complicate matters, farmers and rural Americans face barriers to accessing mental health care. Ninety million people live in designated Mental Health Professional Shortage Areas, per the U.S. Department of Health and Human Services, and a majority of those areas (61 percent in 2011) are in non-metropolitan areas. About 4,000 to 6,000 new mental health professionals are needed to fill that gap nationwide. A dramatic illustration of this shortage can be seen in the state of Iowa, where there are 123 psychiatrists, 122 nurse practitioners and 33 physician assistants that specialize in psychiatry, statewide. That equates to one trained professional for every 11,151 Iowans.
Right now, as farmers struggle with a 50 percent decrease in net farm income since 2013, the incidence of farmer stress is reaching a high point. In 2018, the median net farm income was a loss of $1,548, and prices are not expected to rise in the near future. More than half of U.S. farm households have lost money in recent years. The number of farmers filing for Chapter 12 bankruptcy protection has risen to a level not seen since the 2008 recession. Meanwhile, production expenses and interest rates are increasing, putting family farmers in a vise that is forcing many to call it quits, or consider worse.
Hope on the Horizon
There are some promising developments that may be of assistance. The 2018 Farm Bill reauthorized the Farm and Ranch Stress Assistance Network (FRSAN), which was created by the 2008 Farm Bill but was never funded. The re-authorization and allocation of $10 million in annual funding from 2019-2023 will enable the FRSAN to provide grants to extension services and nonprofit organizations that offer stress assistance programs to individuals engaged in farming, ranching and other agriculture-related occupations.
Farm Aid is proud to support this important legislation. “With net farm income cut in half over the last five years, rural stress levels are dangerously high. We cannot afford to lose one more farmer. This bill is a crucial first step to create a strong safety net for America’s family farmers,” said Farm Aid Executive Director Carolyn Mugar.
Promising clinical developments include the integration of primary and mental health care; telemedicine, whereby rural residents can interact with health care professionals from a distance; and reducing the perceived discrimination against seeking mental health care by training farmers to recognize signs of stress and manage their symptoms proactively. The U.S. agricultural community is taking the threat seriously, with many farm organizations and conferences offering training in recognizing the signs of suicide and in preventing suicide.
What Farm Aid is Doing
At Farm Aid, we believe it’s essential to bring attention to the unique stressors that family farmers face; call for increased mental health resources for rural America; and show farmers they are not alone, and there is help. In fact, managing farm stress is just as important as managing the farm.
Since 1985, we have answered our farmer hotline, 1-800-FARM-AID, to provide a listening ear and resources to farmers in crisis. Our farmer advocates and all Farm Aid staff members have undergone training so that all staff are prepared in the event they are called upon. Ensuring farmers have access to mental health care is one leg of the stool to address the current farm economy. The other two legs are financial and legal resources. Farmer stress is usually rooted in the economic and legal challenges a farmer faces; it can often be managed once steps are in place to address the root problem. Farm Aid’s priority is to connect farmers to all of these services to address farm stress holistically and practically. All three areas of service to farmers have suffered since the Farm Crisis, chipped away over the decades by funding cuts and a systemic lack of investment in rural America. We are at a crisis point once again, and it is essential to reinforce the safety net for farmers and rural Americans.
Resources for Farmers in Crisis
If you’re a farmer who needs to talk to someone directly (or someone who is worried about a farmer), we are here to listen. You can call our farmer hotline at 1-800-FARM-AID (1-800-327- 6243). Joe, Annie and other Farm Aid staff answer the Farm Aid hotline Monday through Friday from 9 a.m. to 5 p.m. ET.
If you are considering suicide, please call the National Suicide Prevention Lifeline to talk to someone at 1-800-SUICIDE (784-2433).