State agricultural mental health specialists support farmers under rising economic strain

NINA MOINI: This year has been turbulent for farmers. They've face the ups and downs of trade wars, inflation, and the persistent threat of climate change. And it shows. Calls to mental health hotlines for agricultural workers, like the Iowa Concern hotline, ticked up this fall compared to numbers from last fall. And a representative from the national Farm Aid hotline reported that more than 50% of their callers said they were financially stressed.

Tracie Rutherford Self is one of three agricultural mental health specialists working for the State of Minnesota. She's here to describe what exactly the increased need looks like for farmers. Tracie, welcome to Minnesota Now. Thanks for being here.

TRACIE RUTHERFORD SELF: Thanks for having me.

NINA MOINI: You've been in your role I understand now for about six months. But you were serving farmers long before you began this work with the state. Tell me a little bit about your background and if you've personally noticed the change in need this fall.

TRACIE RUTHERFORD SELF: Absolutely. I have been a mental health counselor for over 20 years now. And primarily have worked in rural communities. So I've dealt with farmers for a great deal of time and just the needs and things that they are exhibiting. And so it's been really interesting this year to look at the change, not only in the role that I've had with the state, but also just in the needs that farmers are expressing.

Some things have been typical. So often farmers will have needs around transition planning, how do they deal with that from a family perspective. But this year, we're really seeing a great deal of challenge around the financial picture that farmers are experiencing. Farmers often have some financial pieces that are challenging because there are so many changing needs, weather. But the governmental changes this year, in particular, with tariffs and as we're looking at exports and what that looks have really created a lot of difficult situations for farmers.

NINA MOINI: Yeah. And just like with any group, it's so hard to say all farmers feel this way or all people feel this way because people are individuals. And I want to know from your perspective how much of a role do you think kind of stigma plays within more rural communities or farming communities when it comes to mental health, because I understand you have some thoughts on that.

TRACIE RUTHERFORD SELF: I do. So we use the word "stigma" quite a bit. And we talk about stigma, certainly it exists to some extent. But what I have often found is that when we start using stigma around farmers or around rural populations, that often has happened because we've really had a failure of a system to understand the needs that farmers and ag workers particularly come into this with.

And so my philosophy is and has been for a while, that I'm not really sure we need to focus on stigma as much as it has been circulated in the past. And that's because what I think we really need to start focusing on is how mental health counselors and behavioral health professionals really actually interact with rural populations, and with that is ag families.

And what I believe we really will find is that as we start to establish more trustworthiness from a behavioral health perspective with rural communities, we'll actually start to see an increase in participation. The big issue isn't so much that I hear, OK, rural populations don't believe in mental health. That's not the case at all. What they struggle with is a group of people coming in and not understanding them and their unique needs and strengths, and assuming that one-size-fits-all from an application standpoint.

So for me, we work really hard in all the work that we do to make sure that people understand as they're going in and providing those services what farmers actually need, what's helpful for them, and the cultural context of rural populations.

NINA MOINI: Well, Tracie, don't you think lack of access as well. I mean, I mentioned in the top that there are three people in the type of role that you're in. I could remember when there was just one. I mean, how do you feel like-- is there more accessibility that people are working toward? I mean, people can't just drive down the street and visit their therapist sometimes.

TRACIE RUTHERFORD SELF: Absolutely. There are now three of us, so myself, Monica, and Jenny, and we started with the fantastic Ted Matthews. He really pioneered a lot of this work. But you're absolutely correct. Accessibility is a huge concern for what farmers are able to, how they're able to participate in counseling.

So an example of that is in our role as ag mental health specialists with the state, each of us will go potentially out to farmers. We will meet them where they are. We're not waiting for them to show up in our office. And that's for many reasons. One, we want it to be as comfortable for them as possible and often in their own homes. Seems to be a good way of making sure they do feel some comfort.

I think the other thing that's really important as we start to look at how they have access, is we want to make sure that this really is accessible to everybody. And so this is a service that we provide through the state, but the state legislature has set money aside for it. So farmers aren't having to wait to deal with insurance or to have to bill.

And the other thing that means is we also don't have to make a diagnosis. So often when you do traditional counseling and therapy, it means that someone comes into the office, you have to make a diagnosis, and you have to use that diagnosis to bill insurance. But we're trying to really create something that does not have that barrier for farmers and farm families by not having a diagnosis. And sometimes a diagnosis can be helpful, but more often than not, what people need is support. They don't necessarily need to be classified under diagnostic criteria.

NINA MOINI: Yeah. And so I understand too, Tracie, that a lot of the focus of some of your study area is on suicide rates among farmers that are at least double, I'm reading, that of the general population. What are your reflections on that, or how are you trying to tackle that, in particular?

TRACIE RUTHERFORD SELF: I think the biggest thing is to start having what I call honest and honoring conversations around suicide. So often what we have done as a society as a whole is talk about suicide in really hushed tones. Like it's taboo to talk about. We don't want to have those conversations.

But for many people, thoughts of suicide are actually incredibly common, much more common than people believe. We start to look through some of the data. We know in an average room of 20 people, at least one person at any given point in time is probably having thoughts of suicide.

But instead of just addressing that and starting to have those honest and honoring conversations about it, people are afraid, what happens if I start to talk to somebody about these thoughts that I'm having? Will they hospitalize me? Will this impact my business? Particularly among, again, farmers and farm families. So they keep those conversations to themselves. They don't reach out.

And the truth is the number one thing you can do for suicide prevention is to allow people to honestly speak about it and to talk about it in the idea that this is normal. It's normal from the sense of being common, not normal in the sense that it's good. But for many farmers, they're just trying to figure out, how do I have a way out and if I need a way out?

And most people who have thoughts of suicide, in fact, the vast majority will not go on to die by suicide. So if we can actually get them in those moments when we're starting to look at I'm having these thoughts, once they start to be able to openly have those conversations, it will dramatically decrease the thoughts of suicide.

NINA MOINI: Do you ever focus on group models of therapy, or is that ever helpful to get a bunch of people doing the same thing in the same room?

TRACIE RUTHERFORD SELF: So farmers are challenging that way because, first of all, if they can get into those groups, then I feel like they do a much better job of understanding they're not alone. It can be really isolating in farming in ways that honestly, even 20 years ago it may not have been. And that's really positive in some ways, in that a lot of farmers are really making sure to prioritize family needs.

But what that has done is if they're off at their kid's soccer game or basketball game or volleyball game, they may not be having those same water cooler kind of conversations where they might have all seen each other when they were out. And so that has kind of increased that sense of isolation and loneliness while still focusing very much on a typical farm family value, which is, again, we value our families, we value our kids.

So when we start to look at group options, I think it's ideal. But I also think for some people, there's a lot of trepidation around it. So I don't necessarily want everybody to know I'm struggling because if they know, will that increase competition for land? Will that change the way other people are viewing me?

So there's definitely some options that we have. And I am looking to start a group at the beginning of the year, and that group is going to be specifically for families who are going through transition planning. So transition planning is how do we divide the farm equally-- or not necessarily equally, but equitably, among other all the families, all the kids who have been working.

And one of the hardest things about that is this idea that fair is not always equal and equal is not always fair. But because this is one of the top issues that I end up dealing with, if I can have more people around the table who would say, wait, that's happening in my family too. You're also struggling with that. How do we work through this? It allows them, again, that sense of community and community is care.

NINA MOINI: Just lastly, Tracie, talking about community, it's so important that people know where does our food come from. We're all sort of interconnected in a way with our farmers. So what can people just in our region do to support the well-being of farmers, even if they may not have them in their immediate family?

TRACIE RUTHERFORD SELF: So I think the first thing is really to recognize them for the professionals that they are. So often I think there's this idea of what farmers do and that somehow this is an easy job where people are driving around in tractors all day and there's nothing really difficult about it. But it really is challenging in many ways. Now, challenging in ways that farmers still love. So many people I talked to say I wouldn't have it any other way.

But at the same time, often people still do not recognize them in a professional way that they really are. I always tell people now that farmers are really scientists, and I don't think we've looked at farmers in that light often enough. They're constantly using science for not just their job, but for how they interact with the world. They have a lot of ingenuity. They really are problem solvers. And so I think the first thing people can do is start to actually recognize them for who they are and what they really bring to the table.

And then I think the other thing for me is I often talk about this idea that we have to take care of the people who feed the nation, and frankly, the world to some extent. And so that can happen in a lot of ways. One of the things that's one of my favorite things about the Department of Ag is over the summer, they do postcards for farmers.

So at the state fair, you can come up and you can fill out a postcard just thanking a farmer. It's great. And the Department of Agriculture will then send that out to farmers throughout the state. So just getting those postcards, just having the recognition that you are valued, you are important, I think is really key to making sure we support our farmers and our farm families.

NINA MOINI: All right, Tracie, thank you so much for stopping by Minnesota Now and sharing your insights with us. I really appreciate your time.

TRACIE RUTHERFORD SELF: Thank you for having me.

NINA MOINI: Tracie Rutherford Self is an agricultural mental health specialist for the State of Minnesota. If you or a loved one is experiencing a crisis, you can call or text 988, the Suicide and Crisis Lifeline. You can also call the Minnesota Farm and Rural Helpline at 833-600-2670, or visit minnesotafarmstress.com for resources and support 24/7.