Agricultural producers and farm workers experience stressful working conditions that result in anxiety and depression at greater rates than the general population.

Marianne Stein University of Illinois

Agricultural producers and farm workers experience stressful working conditions that result in anxiety and depression at greater rates than the general population. At the same time, access to mental health care is often lacking in rural areas. In response, the U.S. Department of Agriculture's National Institute of Food and Agriculture funded four regional farm and ranch stress-assistance networks in 2019.

One of those networks is the North Central Farm and Ranch Stress Assistance Center, which provides mental health assistance to agricultural producers, workers and families in the Midwest.

Josie Rudolphi and Courtney Cuthbertson, University of Illinois-Extension specialists and professors, are co-directors of the North Central Farm and Ranch Stress Assistance Center. In a new paper they evaluated the center's services and outcomes during the past three years and provided recommendations for future approaches.

"The (North Central Farm and Ranch Stress Assistance Center) operates in 12 states and partners with about 15 organizations, including Extension, public health and nonprofit organizations. We operate under directives from the USDA to provide services in five main areas, which include training programs, professional behavioral health services, a website clearinghouse, outreach to producers and support groups," said Rudolphi, an assistant professor in the department of agricultural and biological engineering, part of the University of Illinois-College of Agricultural, Consumer and Environmental Sciences and The Grainger College of Engineering.

The 12-state region encompasses Illinois, Iowa, Indiana, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota and Wisconsin, which are some of the most agriculturally productive states in the United States. The region employs more than 300,000 farmworkers, and it is home to almost 40 percent of all U.S. agricultural producers. Farmers and ranchers consistently report high stress levels due to economic conditions, finances, environment and interpersonal relations.

The North Central Farm and Ranch Stress Assistance Center operates a telephone helpline with services in English and Spanish. Hotline staff can respond to calls about stress and crisis; they can also address legal and financial questions and refer callers to appropriate resources. The hotline has facilitated more than 20,000 calls from all 12 states during the past three years.

The center's website -- farmstress.org -- provides more than 170 resources on stress, depression, anxiety, substance use, suicide, centers, services and more. People can search for information on specific topics, locations and audiences, such as women farmers or youth.

A major part of the center's outreach efforts consists of training people who interact with farmers to provide mental health support. Individuals in retail, banking and other agricultural support fields learn about "mental health literacy" -- the ability to speak with people for whom they are concerned, intervene appropriately, suggest resources and refer to professional services.

Co-author Courtney Cuthbertson, assistant professor of human development and family studies, said, "The goal of these educational programs is to provide people who are not mental health care providers with knowledge about mental health issues. Sometimes it helps just to ask someone how they are doing. It can open up a conversation that can lead from a feeling of isolation and hopelessness to a sense of connection, believing there are people who care and can help."

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In the past three years, the network has trained more than 11,000 agricultural supporters in mental health programming, trained more than 18,000 agricultural producers in stress management and mental health awareness programming, engaged more than 850 farmworkers in support groups, and delivered more than 1,200 hours of professional behavioral health services.

Some programs vary by state. Illinois offers a voucher program where people can get three free sessions with a mental health provider without going through insurance.

Nebraska offers social support groups through a program called Bienvenido, which focuses on providing assistance to farm workers. The program has contributed to reduced alcohol and tobacco usage and increased positive coping skills for participants, the researchers noted. There are ongoing plans to expand the program to other states in the network.

One of the barriers to addressing mental health issues is building awareness, Rudolphi said.

"It can be challenging to build a rapport with farmers and farm worker communities who may be hesitant to engage in services and resources with an organization they aren't very familiar with. It helps that we've partnered with Extension services in every state; it's one of the more trusted organizations among farmers, and we've been able to utilize this extensive network to disseminate resources and programs into rural communities," she said.

Another challenge is overcoming the stigma of seeking treatment.

Cuthbertson said, "We're trying to shift the messaging around mental health to normalize asking for help. Farmers often have a sense of problem solving­, an 'I can do it myself' attitude. That's a huge strength, but it can almost become a barrier when it comes to mental health because people may be more reluctant to reach out. One of the messages we try to promote is that asking for help is a sign of strength."

"If you had a concern about your livestock, you wouldn't just try to handle it yourself. You might consult with a veterinarian or an Extension specialist to understand what's going on. You don't have to be alone, and you don't have to be in crisis to ask for help either."

The researchers conclude the North Central Farm and Ranch Stress Assistance Center has been successful in connecting a group of partners to facilitate programs that support mental well-being in agricultural communities. They suggest the network can continue to be responsive by modifying approaches and expanding resources as agricultural circumstances, such as commodity prices, farm policies and climate conditions, continue to change.

Visit farmstress.org for more information.

The paper, "North Central Farm and Ranch Stress Assistance Center: 2020-2023: Outcomes, Lessons Learned, and Recommendations for the Future," is published in OBM Integrative and Complementary Medicine. Authors include Josie Rudolphi, Courtney Cuthbertson, Kimberly Keller and Rebecca Mott.

Marianne Stein is a writer for the College of Agricultural, Consumer and Environmental Sciences at the University of Illinois-Urbana.

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