“I watched my uncle struggle as [he] nearly lost the family farm, then we had a couple of farmer suicides that really rocked the community,” says Frakes, who is now the project director of Farm Well Wisconsin, which offers behavioral and wellness services across the state. “So, farmer mental health has been this concern that I’ve had my whole adult life.”

The pandemic and all its challenges, along with mounting anxiety about the impacts of climate change, have triggered another series of crises, in and out of the agriculture community. As a result, demand for mental health services, especially for anxiety and depression, has seen a massive uptick. A poll conducted on behalf of the American Farm Bureau Federation found that 61 percent of farmers and farm workers said they experienced more stress and mental health challenges in 2021 than they did in 2020; new NIH research indicates that they may have an elevated risk of suicide to boot.

And yet, folks who work in ag are often loath to admit they need emotional support or more concerted behavioral care, let alone to ask for it. “Seeking out mental health services, therapy, that’s certainly not within a lot of farmers’ up-bringing,” says Lisa Misch, director of farmer outreach and technical assistance at Rural Advancement Foundation International-USA (RAFI-USA). “Their mindset is independence and autonomy.”

Nevertheless, an increasing number of farm-related groups are actively working to reduce the stigma around mental health services and to increase farmer access to resources that will help them, before feelings of hopelessness become overwhelming.

Peer-to-Peer Support

The Wisconsin Women in Conservation (WiWiC), a three-year collaborative project among several organizations, just this year decided that the time had come for them to act. In addition to the project’s efforts to boost the profile of Wisconsin’s 38,000-plus women producers, WiWiC has started offering courses in a behavioral health strategy that may well be uniquely suited to farmers: They’re training their members in peer-to-peer mental health support.

In five two-hour initiatives throughout the state over the course of two months, WiWiC will coach up to 30 women at a time to recognize signs of stress in farmers, teaching them how to actively listen for clues that an emotional crisis might be brewing. To do this, they’re using a program called Changing Our Mental and Emotional Trajectory (COMET), which was developed in 2014 at the High Plains Research Network, and which serves eastern Colorado’s rural and frontier communities. These regions, like Wisconsin’s, have a preponderance of people working in ag and a dearth of mental health care providers. “So, it’s up to community members to help fill some of those gaps,” says Chris Frakes, who took the COMET training in 2021 and whose organization has since trained about 150 farmers and rural community members; Farm Well Wisconsin is also facilitating WiWiC’s COMET workshops.

Through COMET, farmers and other locals—for instance, the owner of the hardware store and staff at the public school—learn to ask gentle but probing questions of their friends and neighbors during the normal course of conversation. They may tell a socially isolated farmer that they’ve missed her at the diner lately, then ask, “How are you, really?” says Maret Felzein, a member of HPRN’s Community Advisory Council who helped fine-tune the COMET curriculum. Questions culminate in asking the person who’s struggling if they’d be open to hearing a story about a similar challenge, or if they’d be willing to talk again. “It’s an invitation to engage,” Felzein says.

Sara George, a WiWiC regional coordinator, says this kind of strategy lines up with the very particular needs of the farming community. “There are farmer helplines out there; there’s mental health support groups.” (Farm Aid, for example, maintains an online list of resources.) “But I think building up a network in a community is so much more relevant,” George says.

Part of this, she says, has to do with the fact that the person on the other end of a crisis hotline might not have a background in ag, or understand its pressures. “Truth be told, even family [members] and friends can be like, ‘Why are you working every weekend? Why can’t you leave the farm for vacation?’” George says. “[They don’t understand that] you’ve got irrigation pipes that are breaking, animals that are dying, and crops that have an infestation of bugs. You’re always in triage mode on a farm.”

Sara George at a WiWiC Field Day. (Photo courtesy of Wisconsin Farmers Union)

When it comes to support groups, Misch says competition between farmers can also be an inhibitor. “You don’t always want to tell another farmer, ‘We are facing issues,’ because that can lead to certain farmers knocking on the door asking to buy your land. There needs to be a level of confidentiality.” Isolation, and the can-do ethic that makes many farmers determined to suffer in silence, compounds the challenge of getting folks the help they need.

An Arsenal of Mental Health Tools

The organization’s lead farmer advocate—himself a survivor of the 1980s farm crisis—lends an ear, then counsels a farmer on what options might be available. Says Misch, “If it’s a loan acceleration, maybe they could [reorganize their finances by filing a] Chapter 12 [bankruptcy], which would allow them to keep farming [on their land]. Sometimes the goal is to retain assets when they get out of farming, or it’s, ‘We’re keeping this land no matter what.’”

After meeting with the advocate, farmers often say, “They got the best night’s sleep they’ve had in a long time because they had a way forward,” Misch says. An additional benefit: A farmer who’s learned how to navigate a complex array of farm regulations is now able to pass that info on to other farmers, creating what Misch calls a multiplying effect.

The North Carolina Agromedicine Institute has been developing mental health services in the ag realm for about 10 years—including with migrant farmworkers, who experience another series of challenges when it comes to getting any sort of help, including language and financial barriers. The Institute’s focus on farm stress in particular all started, says director Robin Tutor Marcom, “with a farm woman who said to me, ‘All the work you do in agricultural safety and health is important. But if you don’t address farm stress, all your other work to prevent illness, injury, and fatality doesn’t mean anything.’”

The institute offers free substance abuse programming, as well as a limited number of free therapy sessions to those who need them. They’ve trained 140 cooperative extension agents in Mental Health First Aid. And they use another sort of peer-to-peer training, called Farmer-to-Farmer. When a farmer is referred to the institute they are screened for depression, stress, and anxiety. Then they’re matched with a peer, if that’s what’s in order.

“We try hard to match on their agricultural commodity, and whether they have children or not,” says Marcom. “Maybe they are a person of faith and want someone else who has that background.” A bit of physical distance is essential, so there’s no perceived competition; peers live several counties away, and conversations happen by phone or video call. And although both farm men and women take the peer training, “It’s our farm women who are taking ownership of the program,” Marcom says.

The program helps farm women feel like they’re lending critical support to their communities—and in time, and with additional training, it could lead to paid work. But this kind of “third shift” work also comes with a downside. “We’re already doing the childcare, cooking, shopping, cleaning, and working a fulltime job and adding [mental-health support] to it feels heavy,” says WiWiC’s George. The COMET training, however, will allow women who participate “to put a focus on how to recognize mental health flags and know what to do with them, so we don’t carry that and lose sleep at night.” They’ll learn to help with care, and a bit of “professional” detachment.

The Quest for Sustainable Funding

The Farm and Ranch Stress Assistance Network (FRSAN), which is overseen by the USDA’s National Institute of Food and Agriculture, provides competitive grants for distribution through four regional agricultural hubs for the purpose of connecting members of the ag community to programs that offer behavioral health counseling. It awarded $25 million in grants to 50 projects in 2021, up from $19 million in 2019; COMET training has been funded in some places in this way. There has also been grant money from the Department of Health & Human Services Substance Abuse and Mental Health Services Administration (SAMHSA).

But funding otherwise comes from the states and from private coffers. Marcom’s institute, for example, has received master settlement money from the North Carolina Tobacco Trust Fund Commission and the Corn Growers Association of North Carolina, in addition to FRSAN, to fund behavioral health programs. The need to seek out new funding periodically leaves the future of COMET and other farmer mental health programs uncertain.

Perhaps even more important to address, though, are the core causes of anxiety and depression. “We need funds . . . to get more farmers services upfront,” so they don’t get to a point of crisis to begin with, says Misch. “At some point, there has to be some attempt to address [the roots of] farm stress itself.” Real estate bubbles that cause insecure land tenure, the unpredictable commodity markets, climate extremes, poor access to health care, rural isolation, and exposure to pesticides could all play a role. USDA’s Sustainable Agriculture and Research Education office (SARE) is funding a RAFI-USA pilot project on farmer financial strain, which is an important step in that direction. But for the time being, a more detailed roadmap—let alone the funding to build it up—has yet to manifest.

Mental Health Resources

If you or someone you know needs immediate mental health support, there are a number of national hotlines available:

• Farm Aid Hotline: 800-FARM-AID (327-6243) – Monday-Friday 9 a.m. – 5 p.m. ET
• National Suicide Prevention Lifeline: 800-273-TALK (8255) – 24/7/365
• 211, a comprehensive hotline that connects callers with local resources
• 911 in an emergency

Farm Aid has an extensive list of resources on its Farmer Resource Network website, and the Rural Health Information Hub also maintains a detailed page dedicated to farmer mental health and suicide prevention.