Mental Health in U.S. Farmers and Ranchers

Examination of mental health of agricultural workers in the United States shows that the agricultural workforce suffering from mental illnesses and disorders is widespread. A 2018 report highlighted the fact that male farmers, ranchers, and agricultural managers were nearly twice as likely to die by suicide as the general working population (32.2 suicides per 100,000 people compared to 17.3 suicides per 100,000 people, respectively).  Note, in 2020 male suicide rates are 3.88 times higher than female rates.

Background

Farming is defined as "the science and art of cultivating plants and livestock." Thus, the agricultural workforce includes farmers, ranchers, and workers engaged in agriculture. In addition to the workforce, the agricultural community also includes family members of workers, in particular, spouses and children.

Mental health, or mental well-being, is defined by the World Health Organization (WHO) as "a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community." On the other hand, the terms mental illness and mental disorder refer to a broad range of illnesses that often include "some combination of disturbed thoughts, emotions, behavior and relationships with others."

While sometimes used interchangeably with mental health, the term behavioral health, or behavioral well-being, specifically refers to the connection between individual behaviors and health. Behavioral disorders include conditions that have a genetic or biological component (e.g. Attention Deficit Hyperactivity Disorder, ADHD) as well as behaviors, such as drug and alcohol abuse, gambling, or other behaviors that can have negative consequences on an individual health and quality of life. The latter category of behavioral disorders often develop as a result of mental illness, and are therefore often considered together.

The fields of mental and behavioral health focus on 1) promoting, supporting, and sustaining mental and behavioral well-being and 2) reducing the presence, severity, and impact of mental and behavioral disorders.

Epidemiology

Mental illnesses often stem from multiple sources but as an occupation, agriculture ranks as one of the most stressful occupations and one that experiences high suicide rates.

For example, in a 2019 international review article, 71% of studies that compared farming to non-farming populations found that farmers showed worse mental health.  In the US, a 2019 study among young Midwestern farmers found that 53% and 71% of study participants met criteria for Major Depressive Disorder and Generalized Anxiety Disorder, respectively.  This is compared to the general population, where 2.7% of US adults suffer from Generalized Anxiety Disorder and another 7.1% suffer from Major Depressive Disorder.

Each of these conditions has the potential to lead to suicide. As previously indicated, 2015 data from the U.S. National Violent Death Registry System (NVDRS), maintained by the Centers for Disease Control and Prevention (CDC) reported a suicide rate of 32.2 per 100,000 farmers, ranchers, and agricultural managers. This report also highlights a suicide rate of 17.3 per 100,000 people for both agriculture employees and the general working-age population, indicating a much higher risk to farmers compared to the general population.

History

The early days of research on mental health on farmers, their families, and farmworkers was predominantly focused on alcohol and drug abuse.  Rural individuals were recognizing that there were members of their communities that were mentally ill (depression, schizophrenia).  Due to a lack of medical/psychiatric network in rural U.S. many of these cases would go untreated and uncounted.  In 1963 there was an attempt at surveilling mental health of youth and young children by Jenkins. He found that there was lower incidence of "mental disturbance" and "mental illness" amongst rural youth.

In interviews of rural leaders, Bentz et al. (1971) found that participants recognized mental illnesses such as schizophrenia and depression within their communities, but families could not do much to help them.  A 1978 Rural Task Force on Mental Health report to President Jimmy Carter noted a lack of understanding of the mental health needs of rural communities as well as lack of research into the causes and barriers to treatment.

Also known as the 1980s U.S. farm debt crisis, sudden shifts in federal fiscal policies, export declines due to a Soviet Union embargo, and record production left farmers largely based in the Midwest saddled with debts they could not repay. In response to the challenges faced by farmers and the epidemic proportion of suicides.  As a result of farmer suicide, research on farmers’ mental health increased sharply with a focus on financial difficulties farms faced during the 1980s and depression.  A spotlight on rural mental health and specifically on farmers led to calls for more mental health access in rural communities along with government action.  Likewise, the U.S government passed the Family Farmer Bankruptcy Act in 1986 to help keep farmers on their land, and rolled out subsidies and loans to provide some economic relief to struggling farmers with the 1990 Farm Bill.  Responses to mental health challenges came from state agencies of agriculture, university extension, and farmer organizations through suicide hotlines, fundraising to support household needs, and family mediation services.

Published research pertaining to farmer suicides and mental health more generally waned in the late 1990s and through the 2000s.  However, there was a gradual shift to include migrant farmworkers within the narratives of agricultural mental health.  Research on migrant farmworkers has focused on stressors, presentation of stress, depression, anxiety, violence, and the impact of the lack of medical care.

Following the 2008 economic recession, there was another peak in agricultural mental health research to assess the effects of the Great Recession on farmer stress.  However, the evidence for an uptick in worsening mental health and suicides was inconclusive. Soon after the recession, a near-decade-long drought in the Western United States and particularly in California brought to the forefront the woes of climate change.

         https://en.wikipedia.org/wiki/Mental_health_in_United_States_agricultural_workers