By ANN HINCH

Associate Editor

INDIANAPOLIS, Ind. — Farmers already know their occupation is unlike almost any other, but the science of mental health reinforces it.

Indiana Agriculture Director Bruce Kettler pointed out farmers frequently feel like they carry the weight of the world on their shoulders in providing basic needs to keep society running. “It’s important for farmers to know it’s okay to ask for help,” he said during this month’s inaugural Rural Mental Health Symposium in Indianapolis.

Contributing to this particular career stress is worry the job itself could disappear – Farm Bureau research done this year shows fear of losing the farm has great impact on producers’ mental health.

When people think of mental health and psychology in the Western world, they may think of Sigmund Freud, who began research in the late 19th century. But Iowa farmer and rural behavioral health specialist Dr. Michael Rosmann said it wasn’t seriously studied until years after his death, following World War II when soldiers returned home with what was then called “shell shock.”

“We’ve come a long way (in behavioral study), but we’re not nearly as developed as the physical and chemical and biological sciences,” he said, though researchers can now measure behavioral health by scientific metrics.

Twenty years ago, he said researchers studied Kenyan sheepherders and found the more successful ones – with the most animals and who could find the greenest pastures and best conditions – tended to have attention-deficit/hyperactivity disorder, or ADHD. In fact, farmers are four times as likely to have ADHD than the general population.

What this means on a practical level is they are the kind of people to take risks – beneficial in trying new things and working hard, but also behavior that can lead to shortcuts around safety measures. It also means they may overreact to perceived threats and feel high stress.

“That tendency to overreact to alarms makes us good farmers, but it also makes us vulnerable to being overwhelmed,” Rosmann explained, adding it also leads to higher rates of depression in ag workers than among the general population.

Higher suicide rates are common among ag workers, as well. He said unique to agriculture is that alongside stress, exposure to some toxic pesticides can work on nervous systems in negative ways. These include classes of organophosphates, organochlorines, and perhaps also neonicotinoids.

The latter has been determined to help kill bees by interrupting the insects’ nerve relays and inducing hyperactivity and confusion. Does it have a similar effect on humans? Rosmann said this is not known, since we lack studies – so far – on the long-term buildup of toxins in the environment.

He did say more training in ag medicine for med students is needed, since knowing about farmers’ daily lives could keep doctors from prescribing something that could hurt their mental health further. For example, some common antidepressants mix poorly with these pesticides and may heighten ill effects on the brain.

Mental worry is common

Another speaker at the Summit was Emily Owens, executive director of Clinical Services with Hamilton Center, a regional health system serving much of Indiana. She noted in the Farm Bureau study, 46 percent of farmers said they find it difficult to find a counselor or therapist in their community, as rural areas in general find it hard to attract and retain mental health professionals. Telehealth – computer or phone consultation with medical pros – can help with this, but more rural areas require broadband internet access for it.

She said there’s also a lingering stigma still attached to mental care, and that people who support treatment for a physical illness they see may be less understanding of mental health issues. Because of this, people with such problems may be afraid they’ll be judged “dangerous” or “crazy” or “unstable,” or their reputation will suffer.

But Owens said it’s been proven as many as 1 in 5 Americans struggle with their mental health and 1 in 25 live with serious mental illness. It’s also been shown that 90 percent of suicides had an underlying mental health issue.

Farmers experiencing mental problems often display signs of hopelessness, increased worry, disturbed sleep and irritability, and/or substance abuse, primarily of alcohol or methamphetamines.

Rosmann said another sign people should watch for in loved ones for evidence of depression or possible suicidal thoughts is verbalization of hopelessness; another is lack of laughter for a prolonged period, even as little as three weeks. Deterioration in personal appearance or care of livestock and property are also warning signs.

There’s help out there

The good news, he said, is while this is the worst economic recession since the 1980s farm crisis, rates of bankruptcy, farm loss, and suicide are lower now. Back then, many banks foreclosed on farms without providing options for payback, but now he sees more lenders, and courts, willing to work with farmers to try to save their livelihood.

A loan officer in Special Accounts for Farm Credit Mid-America, Ashley Harker said her job is to work with its clients in financial distress. Employees undergo training and refreshers on how to have difficult conversations with borrowers behind on their loans.

“We want them to feel like we are coaching them along the way and going with them along the way, rather than lecturing them,” she explained.

Rosmann said there is improved understanding of mental and behavioral health, and more support systems for farmers who feel they’re underwater, including phone, text, and online hotlines and helplines.

Angela Sorg, a licensed therapist with Purdue University extension’s Mental Health First Aid and Farm Stress teams, said they have several programs that address mental health, and Purdue tries to make sure its employees are trained to recognize what kind of help someone needs.

For anyone wanting to seek therapy but uncertain what to expect, she said it’s “not mind-reading,” but “a guide to help you weed through the situations” one is in. “And, you’re really just going to talk about (your problems). That’s really all it is.”

If you know someone you feel may be depressed or suicidal, talk to them kindly, but don’t be afraid to be direct. “Until we make it our business to care about others, we’re going to keep losing people,” said Bill Field, Purdue farm safety specialist, explaining he used to not want to “get into other people’s business” either.

American Foundation for Suicide Prevention Indiana Area Director Kelsey Steuer advises it’s important to ask direct, clear questions, if you’re worried about someone. “Are you thinking of ending your life?” is clearer than, “Are you thinking of hurting yourself?”

If you know the person’s routines and they feel “off” or disrupted in some way, let them know that you’ve noticed and are concerned about their health. Above all, more than one expert at the Summit advised people to not be afraid that by mentioning suicide, you’ll “put the idea” in someone’s head to do it – in fact, you may be providing them relief to talk, and to seek help.

Field recalled a dairy farmer he knew, who had multiple problems, who once told Field he had felt overwhelmed and tried to take his own life – but that the attempt failed. “Why are you telling me?” Field wondered, and the farmer replied: “Because I think you might listen.”

So, now he figures, “I can’t solve everybody’s problems. But I can listen.”

The Rural Health Information Hub is funded by the federal office of Rural Health Policy, and is a clearinghouse on rural health issues. Learn more about rural mental health, suicide, and related topics at www.ruralhealthinfo.org