In occupation where stress is ample, farmers have few options for mental health care

Wind turbines spin over harvested corn fields in Lake Benton, Minn.
Wind turbines spin over harvested corn fields in Lake Benton, Minn., on Dec. 21, 2017.
Evan Frost | MPR News

When the co-op that distributed milk from Meg Moynihan's Le Sueur County farm dropped her abruptly in 2016, it put the farm immediately into crisis.

Moynihan and her husband were pouring out milk they couldn't sell.

Moynihan remembers that her husband "kind of snapped." He told her to sell the cows and he went back to driving a truck, where he said he felt more appreciated. Moynihan took leave from her job in the city to work the farm while he was on the road.

"I know dairy farmers who have decided to sell their herds on a snap decision and have been sad about it later," Moynihan said. "I thought, the worst time to make a big decision like this is in the middle of a crisis, so can we limp along."

The sun sets over Vesta, Minn.
The sun sets over Vesta, Minn., on Dec. 21, 2017.
Evan Frost | MPR News

Moynihan described it as a "time of great anxiety." She'd just gone off her state health insurance, and didn't have time to see a counselor.

"There was one point, I emailed the doctor's office and said, 'I don't think I can afford to come to the doctor, but I'm crying and screaming at least once a day, and I don't know what to do about this," Moynihan said.

Eventually, the couple found another organic milk buyer. Her husband returned to the farm and Moynihan went back to her job with the state. Even though Moynihan's immediate crisis was over, she knew other farmers were still struggling and had few outlets to get help.

State reports show that farmers and rural people already lag significantly in access to mental health services. Even more concerning, suicide rates are much higher for farmers than the average worker.

Moynihan's experience helped spur the recent launch of a crisis phone line for rural and farm people. But it can be a challenge to get farmers, who may be both geographically and socially isolated, the resources that can get them through tough times.

'No time they're not stressed'

People in rural Minnesota have much less access to all sorts of medical care, including mental health services. In urban areas and small towns, each primary care doctor serves about 1,000 people. But in rural parts of the state, each doctor serves about 2,700 people, according to a 2017 report from the Minnesota Department of Health.

Farmers are also at greater risk of suicide than other professions, which has been associated with a lack of access to mental health services. A study of suicide deaths for farmers published in the Journal of Rural Health in 2017 found that American farmers in the early 1990s to 2010 had a suicide rate three to five times higher than other occupations.

Study co-author and University of Minnesota epidemiologist Marizen Ramirez said it can be difficult for farmers who live far from mental health clinics to get the help they need. They often also have easy access to firearms, which researchers say is the most lethal method of suicide.

"Certainly the farm is a really interesting intersection of home and life and work, in which many of these elements of personal life do cross into the work life," Ramirez said. "We need to be a little bit more creative and innovative as to how can we reach solo farmers, who often work in operations on their own."

But the daily stresses of farming may be just as important to address as these larger, more complex issues, Ramirez said.

There are economic stressors in every step of farming that take a toll on farmers, from the planting to the harvest to crop prices that fluctuate in international markets, said Brooks Bennett, president of the First Security Bank of Lake Benton.

Farmers often feel like one misstep or disaster could send them into a spiral that feels difficult to come back from. Low prices for crops like corn, soybeans and wheat in the last five years, as reported by the Federal Reserve Bank of Minneapolis, can make recovering more difficult.

"Most of the people that I've spoken with don't really see anything that's going to improve the economy in the real near future. There is a lot of pressure on families," Bennett said. "They've had to cut back on things — and a lot of these things that have driven this, they can't control."

Losing a farm can threaten not only a farmer's job, but their identity. It may have been the only thing they've ever done.

Social conditions have changed on farms over the years, too. Farmers work alone more than they did in the past, which can make them feel more isolated, said Ted Matthews, who has counseled farm families for decades. Matthews said there just isn't as much time for family members to get to know each other and talk.

"Back in the day, a family, if you said, 'Do you eat all your meals together? they'd look at you, like, 'Of course we do. What else would we do?'" Matthews said. "Now, it's rare that a farm family eats all three of their meals together. It's very rare."

Matthews said it feels like the romantic public perception of farmers hasn't caught up with the modern realities of their jobs.

"A lot of people think of farmers as being these low-key guys," Matthews said. "The truth is, farmers have one of the most stressful jobs on the planet. There's no time they're not stressed."

'Don't keep it inside'

Matthews used to make house calls, but says the feed salesman or a lost cow would always interrupt the therapy sessions. Now, as a therapist working through the state Department of Agriculture, he sets up shop around the state, and farmers come to him.

He said part of his job is to convince farmers that getting therapy doesn't mean something's wrong with them. Matthews said much of what he does is help farmers deal with their day-to-day stress in healthier ways.

"When people hear mental health, they don't hear mental health, they hear mental illness," Matthews said. The idea is "to make it better, not to fix it."

The farm and rural helpline launched by the Minnesota Department of Agriculture after Moynihan's stressful experience on her dairy farm takes a similar approach. Counselors at the 24-hour hotline will listen to farmers talk about their problems. But they'll also put them in touch with people who can help.

John Worth talks with another employee.
Bob Worth's son, John Worth, right, talks with another employee on the family farm while loading trucks with corn just outside of Lake Benton, Minn., on Dec. 21, 2017.
Evan Frost | MPR News

"Sometimes you might need some legal help, sometimes you might need some mediation for a loan that's going south, sometimes you need an advocate, sometimes you might need business counseling," Moynihan said. "Helping people with resources is another thing that the farm and rural helpline can do."

Bob Worth, whose family has farmed in western Minnesota for generations, is familiar with the pressures that can make modern farming stressful.

Driving up to his farm in western Minnesota last November, Bob Worth saw thick, black smoke curling out of his workshop. The fire melted a $290,000 combine and destroyed a truck. The steel walls of the workshop were completely ruined.

Worth says he was lucky that he had insurance. But the fire made an already tough fall — of low corn prices, bad weather and high costs — even more stressful. He's learned from hard times in the past, including the farm crisis in the 1980s, that he needs to lean on others when he needs support. His wife is a partner in the business and gets his worries, and he talks regularly with his banker on matters both financial and personal.

Bob Worth sits in his "man cave."
Bob Worth sits in the corner of his basement "man cave" surrounded by memoribilia from his farming career and aerial photos of the family farm he inherited from his father and now works with his son in Lake Benton, Minn., on Dec. 20, 2017. "There's nothing better than farming with your father and working side by side with him all the time, then working with your own son," Worth said.
Evan Frost | MPR News

"Farmers are a unique breed of people. They like to keep everything to themselves," Worth said. "It gets that it starts eating at them over and over again. That sets up a farmer as his worst enemy, in a way."

Worth has lost two close friends to suicide in recent years, and talks regularly to others who are struggling. He tells farmers to just start talking.

"Get it off your chest. Explain the situation. Don't keep it inside," Worth said. "What happens when people just don't talk, the pressure gets to building up inside, and then they do something that's really not good for anybody."

The Minnesota Department of Agriculture's Farm and Rural Helpline is free and open to farmers and rural residents 24-hours-a-day at (833) 600-2670.