Science by the Slice

Rural Mental Health Part 1: Perspectives from the Farm

May 26, 2021 UF/IFAS PIE Center
Science by the Slice
Rural Mental Health Part 1: Perspectives from the Farm
Show Notes Transcript

Rural and agricultural populations are more stressed than the general population. So how do we know when this stress becomes dangerous? May is Mental Health Awareness month, and this episode of Science by the Slice delves into stories and research surrounding mental health in agricultural and rural populations. First, we hear from Marshal Sewell, the son of a strawberry farmer with first-hand experiences of the mental health struggles faced by agricultural communities. Then, PIE Center graduate assistant Valentina Castano interviews Dr. Anna Scheyett, Dean of the School of Social Work at the University of Georgia. Dr. Scheyett discusses her research which uncovers the unique struggles among farmers and ranchers and highlights the importance of community involvement when discussing mental health awareness.

To learn more about Dr. Scheyette's rural mental health efforts visit: https://extension.uga.edu/topic-areas/timely-topics/Rural.html

If you or someone you know has immediate mental health needs visit: https://www.ruralhealthinfo.org/topics/farmer-mental-health

Music: Corporate Motivation by Asepirawan20 from Pixabay https://pixabay.com/music/search/theme/podcast%20music/  

 

Episode One

Thu, 5/20 11:16AM • 1:06:17

SUMMARY KEYWORDS

people, farmers, mental health, farm, suicide, thinking, farm worker, community, stress, rural communities, talk, conversation, struggles, warning sign, georgia, hear, point, piece, important, rural

SPEAKERS

Ricky Telg, Phillip Stokes

 

Ricky Telg  00:04

This is science by the slice, a podcast from the University of Florida's Institute of Food and Agricultural Sciences Center for Public issues education. In this podcast, experts discuss the science of issues affecting our daily lives revealed the motivations behind the decisions people make, and ultimately provide insight solutions for our lives. 

 

Michaela Kandzer 00:28

Hi, this is Michaela Kandzer communications specialist at the PIE Center, and the host for this series of Science by the Slice, I want to welcome you to this two-part series which will focus on rural mental health. We are going to hear from industry experts on this topic, but first we're going to hear from Marshall Sewell. Marshall is from the winter strawberry capital of the world, also known as Plant City, Florida. Marshall grew up there on his family farm where he helped grow and harvest strawberries. As a son of a strawberry farmer Marshall has first hand experience of the mental health struggles faced by rural communities. After we hear from Marshall, we will hear from Valentina castano, a graduate assistant with the PIE Center as she shares her conversation with researcher Dr. Anna Scheyette, Dr. Scheyette will discuss her studies related to rural mental health and farmer suicide. Keep listening to hear Marshall story and his conversation with PIE Center’s education coordinator, Phillip Stokes.

 

Marshal Sewell 01:23

Within the strawberry industry, our general rule of thumb was we wanted to try and have our strawberry plants in the ground by Halloween and like my mom and my dad used to say, if they're in the ground by Halloween, then we'll start seeing our first strawberries by Thanksgiving. It was early November, and we already had all of our plants in the ground. And we're getting excited, right because harvest was coming up, it was right around the corner, we we knew we were going to be harvesting some strawberries soon. And for a farmer, that's great, you know, anytime you got all your money out on the table, essentially when you're getting ready for the crop. And it's not until the harvest that those checks actually start rolling back in. So we were we were looking forward to it and out of the blue. We've been out in the farm and we've been watching these crops and everything was looking good. And we sort of received this industry update. And we found out that there was this outbreak of anthracnose, which for those listening anthracnose is a disease that a lot of times it is found in strawberries and comes from the the nursery or the original plant operation where the plants came from. And it's a really bad disease, essentially, it gets into the plants and shuts off all their functions. So it's sort of a crown rot. And it stops the plant from being able to take up any nutrients, any water or anything. And it's terrible disease. But we received this update and our family, you know, we felt really fortunate really blessed because we go and we check on this field every single day and everything's looking good. And we're doing great. And we thought we had sort of dodged a bullet. But unfortunately, we showed up to the farm one day and it was almost as if overnight, we just started seeing these plants wilting down. And it was at that point, we realized that the plants we received, apparently had anthracnose, the plants were wilting down. And you could tell they were almost being choked out. They just progressively got worse, you could go and just gradually they wilted down and nothing dried out. And at the time, you sort of scratch your head and you wonder what do you do? And you know what makes sense. And I've had a lot of people ask, well, couldn't you have just sprayed them? Or Couldn't you have done this? Or Couldn't you have done that? Why didn't you replant? And at the time, there wasn't a replanting, we were getting close to harvest time. If we, if we had replanted, then we would have been set outside of our window, it wouldn't have made sense, just spending all sorts of money on trying to apply crop protection products or anything like that, it would have been throwing good money at a bad situation. And we just were at a loss of ideas for what to do. As a farmer, it was a really tough situation just to see that and see your, your entire livelihood, just sort of vanishing in front of you. So that was sort of what we were going or we're dealing with at the farm operation. And then on top of that, we also were raising some cattle at the time. And we were expecting a load of hay. It's November time, like I said, and pretty soon we're going to be in winter grass is going to be dying back a bit. And so we wanted to go and have a load of hay ready for these cows. And, of course, wouldn’t you know, with everything else going on the load of hay was running late, and we stayed over there just waiting pretty much all afternoon long for this truck to show up. And it finally showed up late at night. And we were all there just ready to be done with work for the day. And so we started after it and we were unloading hay and you know my dad, he was running a forklift at the time, I believe. I was running a tractor and is trying to with the hay for sticking loads of hay and moving them back and forth and, you know, putting them where they needed to go and all of a sudden the forklift broke down, and we had no idea how my dad was gonna react. Was this gonna find might be the straw that broke the camel's back what was gonna happen and he was just super laid back about it. And he just stopped everything and told us he said, It's late. You know, it's a Saturday evening, we're done. We're let's just go to dinner, let's get cleaned up. And I still feel up to this day, that sort of thing where he took us to Applebee's as a group, and we all sat there we had dinner. And, and we just had a good evening. And the next day, I woke up, and it was Sunday morning, November 18. And I had in my mind that I was going to just put in the work boots and everything Get ready, I was going to go back over there, and I was going to help them fix the forklift. And we were going to move the hay and do everything we needed to do, right. And I just remember him stopping me. And he told me that he would rather me go to church with my mom. He said that he was going to take care of all the hay and he would get it all sorted out. And I didn't really think anything of it. So I went to church with my mom that day. And we when leaving, we were all supposed to meet up for lunch. And so we're we're gonna head to lunch and go see him and my grandparents, they usually ate lunch with us on Sunday, as well, we were all going to meet up. And I remember we had the Nextels, the two ways. And I can remember beep and, you know, trying to get ahold of them and see where it was. I couldn't get ahold of him. At some point, I just kept hitting the button. And I don't know if you remember if you had one or not, but I had the Nextel two way and I push the button down. And I started talking into it. And I was asking him where it was. And at some point, he finally just turned it off. And it just, it wouldn't even beap through or anything. It was kind of radio silence. And just that was weird. And so we went we had lunch, and he never showed up. Very strange. It was very strange. So we just assumed you know, he was so busy working that he must have got caught up and didn't even make it to lunch. So after lunch, we went over and then we went to check the forklift and everything had been done forklift was forklift was fine, they had been moved, and came home went over to the other farm to check on the strawberries, like we could not figure out where he was. It was that afternoon that we really started just trying to figure out where he can be we started calling anybody he may have gone to see or anybody who he may have been doing some work with or work for, couldn't figure it out. And to try and make the long story a little shorter. We we went through this whole process for two days, we finally notified I believe it was late that Sunday evening, we notified the sheriff's office that we had a missing person. So the sheriff's got on that. And it wasn't until Tuesday morning, though that we got the call that a farmer down at the south end of the county, he actually found my dad's truck. And for some reason, my dad had decided to go to this farm operation that was owned by one of his mentors in the farming industry like this, this was a guy that my dad really looked up to and admired. For some reason, my dad decided to drive all the way to the south end of the county, he had turned off his phone so that none of us could get ahold of him. And he decided to take his own life at that farm. So yeah, two days of trying to just wait and figure out what might have happened or where it might be. And then. So that's, that's more or less the story of what happened with our family. And it's just a really big snowball effect, this whole idea, because we think a lot about mental health and suicide and things like that in the ag industry. And we think a lot about the people that it impacts who are dealing with it and struggling with it. But then in the event of farm suicide or rural suicide, there's also a whole domino effect on the people who it then impacts later on. And I remember my mom telling me, after all that happened that, you know, it's up to us to decide what would make out of the situation. And we can sit around and let it build up, or we can try and do something with it. And that's sort of what's compelled me to want to use this platform. And rather than dwell on a really negative event in my life and sort of using it as a crutch or using it to negatively impact my life or those around me. It's why we're here and having this conversation, I just like to try and break apart the stigma that goes along with the topic of mental health and hopefully advocate for a topic that's really played a huge role in my life and the life of my family.

 

Phillip Stokes  09:13

Thank you so much, Marshall, for sharing that story. I think at this point, we can go ahead and kind of get to some of these questions. And some of the things that, you know, get your perspective on what you were just talking about, with when you said your mom mentioned that there's some things we can do about it. And and I think that what you're doing in the industry and in agriculture is very admirable, trying to help others and benefit others. So, you know, I appreciate your efforts in that and just want to say that that's a very admirable thing to do. In your story. You mentioned the anthracnose, crown rot, of course, different diseases, different pests, natural disasters, these are things that agriculturalists deal with All over the world, right? In general, what are some of the factors those or others that might add to potential mental health concerns for those in the industry.

 

Marshal Sewell 10:11

So when we discussed the topic of mental health, and mental well being within agriculture, when within productions specifically, I think that a majority of it can just be attributed to the overall stress and risk and volatility that goes along with the industry. We work in a marketplace and in an industry that is so dictated essentially, by the environment, by the weather by trade and tariffs and things like that, that are a lot of times beyond our, beyond our scope, or beyond our control. And so I think that there's just so much inherent stress within our industry and within our businesses, that that can definitely be a huge factor on mental health, how it pertains to agriculture, specifically, because I've had people tell me before will, you know, everybody deals with stress, it's not just farmers, you know, we deal with it in our day to day lives, what makes it any different? I think that the levels of stress or the levels of anxiety and things like that, that we can battle within the businesses that we work in, are magnified, again, because of the marketplace. But also, I touched on my own family story, a multigenerational operation, that I've talked to plenty of people who have had very similar stories, this family, or this farm has been in my family for three generations, five generations, seven generations, however many. And it seems like the topic continues to come up of when we run into issues and run into problems. I carry the burden of whether or not this farm operation or this business succeeds or fails, it's on my shoulders. I think that multi generational piece adds another layer another dimension. And then, on top of that, I think, too, that there's just a historical indifference to a traditional conservative group of people, you know, this real grassroots group of people wanting to talk about a topic like mental health, you know, it historically, it's just something that we've never touched on. Nobody really takes the time to get to into the nitty gritty. And I don't know if it's just that if it's a matter of people not wanting to take the time, or if it's more so just a matter of people not wanting to seem weak, or people not wanting others to think that they can't deal with issues on their own. I think there's so many different factors that go into ag related mental health specifically, a lot of times, our first go to is to just say we're doing all right, doing fine. And we move on along and and I think that is just a mask. You know, a lot of times there's so there's so much more going on. And it reminds me I don't I don't know if you're in the literature or anything. But one of my favorite authors is Hemingway and Hemingway always talked about his writing style being like an iceberg. He only saw really the 10%. But the rest of it was below the surface. And he had to dig deeper to understand and I think that's our mental health is sometimes in conversation, you know, we, we might just show that top 10% or we might put on a happy face. But deep down beneath the surface, there's, there's so much more going on. My mom is a huge advocate for that concept that, you know, her take on this whole thing that we've been through is that you never understand what somebody else may be going through. So always try to be kind and always try to check in on one another.

 

Phillip Stokes  13:45

So you mentioned that sometimes you've heard people say that stress and anxiety and things like that happen in any profession or just with everyone. But to that same point, you said that your mom mentioned, if people don't, aren't in the industry, they're not experiencing it. They can't fully understand kind of the volatility of agriculture, like you were just saying, what could be some different messages and some different things that maybe should be shared to the general public and just to others about agriculture and some of the unique stresses there.

 

Marshal Sewell 14:24

On the subject of mental health specifically, that's something that I've spent a fair amount of time thinking about. And also, it seems like these people who say, Well, everybody deals with stress, you know what, so different? A lot of times we also have that similar mentality when we start thinking of solutions to the issue. And I'm just going to just share a few thoughts here all together. But do we need just want access to psychologists or more access to therapist and, you know, or I've had people say, Well, it's because farmers are in rural areas, we need access to telehealth so that they can call a psychologist or call a therapist. To me, it's not really going to push the envelope that much if you don't have a resource on the other end, who is actually knowledgeable and understanding of what goes on at the farm gate, farmers that I talk with and spend time with right now, they don't want to talk to you or interact with somebody who doesn't understand the struggles that they are actually dealing with on a day to day basis. But to simplify it even more, it's not just a matter of providing therapy and counseling and, and access to psychologist or psychiatrist, I think that what you and I are doing right now, or just general conversation at the very surface level, that's a step in the right direction of just Destigmatizing the entire topic. And just helping people to understand that it's these conversations, just general day to day conversations with family members, friends, people within your community or within your professional network. That's the starting point, actually opening up about things you may be dealing with. And also then on the flip side of that actually, being an active listener, and open to those ideas and willing to communicate.

 

Phillip Stokes  16:14

Yeah, I mean, it sounds like the solutions, if you will, are not as simple and as clear cut as some might think. It sounds like maybe some of the possible ways forward. And I've said the word solutions. I don't love that word. But some of the ways forward, maybe aren't available right now. Right? We don't have all of those tools right now to address some of these issues that you've talked about. So maybe what are some things in addition to what you've said, that could be done to sort of help.

 

Marshal Sewell 16:47

So at a very basic level, I'll go back to what I just touched on, I think first step is starting out at the individual level, and just continuing to use these platforms and raising, raising advocacy and awareness of the topic of the issue itself and encouraging others to try and start having those conversations at home in their communities on a very small scale. But once we start kind of entering that threshold that you're kind of alluding to, what are the next steps? How do we continue moving forward? I've been impressed with some of the things that Farm Bureau has brought up, I look at County Extension, University of Georgia, they were they were trying to come up with some protocols for some local county programs where they could sort of do outreach at a community level, I think there's still some dots that need to be connected on those topics. But it's a step in the right direction. When we start thinking about rather than just encouraging people to go to random therapists or psychologists or counselors, how do we go ahead and start generating resources and my resources, I mean, a specialist in the field, who is able to have these conversations, or interact with people who has credibility, who has validity whenever they are going and interacting with growers, who understands the struggles, understands the nuances of the business, and could actually be somebody a grower is willing to interact with. And it's really going to start with destigmatizing the whole topic. And getting to the point where we're all at least somewhat willing to address the idea.

 

Phillip Stokes  18:26

What are some other things? As we're kind of concluding our conversation here? What are some things that you would like people to know personally, based on your experience? What would you like people to know about the general topic of mental health and mental well-being?

 

Marshal Sewell 18:41

So just as concluding thoughts and to talk very generally about mental health. First and foremost, a lot of times, we mistakenly discuss mental health and mental disorders. I think that a lot of times we, we use those synonymously. And they are not one in the same. So when we talk mental health, everybody deals with mental health, it may be just daily stress, or a little anxiety here and there. But everybody's dealing with it, it is going to touch somebody, at some point time. And so I'll point that out just to say that as we're all dealing with this shared issue, I just want to point out that it doesn't impact somebody's value. I think that's a concept that I would like to make sure resonates that in this topic of mental well being and mental health, just because you may be struggling, it doesn't make you any less valuable. It doesn't make you any less successful. And so therefore we should not be concerned to talk about it. And on that subject of it not being indicative of your your value or your success as a person a common question that has come up since I've started opening up more about what's happened to my family and with my dad, is I always get asked what would you have said what would you What would you have done differently if you could go back in time and change that that Sunday, November 18. And I've spent years thinking about what would the perfect answer be? Because so often we hear that, you know, I want to talk to somebody, I want to have this conversation with them. But I don't know what to say. So I've spent a lot of time thinking about that. And the story that I use is that I wish I could have just told my dad, you know, just pointed out any great thing about that day, no matter what it was, if it was, you know, bright, sunny day, beautiful clouds in the sky, just what whatever might have been great about that day, I would have told my dad just pointed out and said, you know, how impressive is it, that we have a creator who decided to make all of this for us? You know, how great is it that all of this was given to us? And how impressive is it that that same creator decided that this world needed you in it. And I say that to sort of touch back on the value piece, it doesn't take much to just remind somebody that they're valuable. And, and nobody is less valuable because they deal with a mental health related struggle, or stress, anxiety or any of those things. So I'll leave that with anybody who may be listening and may be having a hard time you're valuable, you're impressive. And I think that that's something that we also need to make sure to remind one another of.

 

Michaela Kandzer 21:24

Hi, Valentina, I'm really glad to have you on the podcast for the second segment of the episode. I know that we just heard from Marshall Sewell, about his experiences with mental health. And now we will get to hear from you and our next guest more about mental health in rural populations. Can you tell me a little bit about who you talk to and what you talked about?

 

Valentina Castano 21:43

Yeah, absolutely. So I actually recently got to meet with Dr. Anna Scheyette. Over at the University of Georgia. Dr. Scheyette has a background in psychiatric social work. And she currently serves as the Dean of social work over at UGA. And she's recently done some research that looks at farmer stress and farmer suicide in rural populations.

 

Michaela Kandzer 22:04

I look forward to hearing more about this topic and to hearing what Dr. Scheyette has learned from her studies on this topic.

 

Valentina Castano 22:09

Yeah, I'm really excited for everyone to hear it. Here's Dr. Scheyette describing how she became involved in rural mental health research.

 

Anna Scheyette 22:18

It was actually fairly serendipitous. I was at a meeting. And the Dean of the College of Agriculture here at Georgia came to me and said, Have you seen the most recent CDC report that talks about farmer and farm worker suicide? They've got really high rates. And he was, you know, obviously distraught about this. And I said, No, I know, I haven't seen it, he sent me the reports of what's going on. I said, I had no idea. But I have an idea for a way we can find that out in Georgia. The CDC has this thing. It's really useful database, it's got a terrible name. It's the violent death reporting system. And for a number of different states, it's like 32 states, I think they keep data on all the homicides, and suicides that happened in the state along with a lot of different variables about the characteristics of the individual. But the part that's really interesting is they have these narrative summaries of the police report, and the medical examiner reports, you get these little snapshot stories. And I use the database for something totally different years before, so I went and got the Georgia database. And so that's how we started looking at what's going on in terms of suicide rates in farmers and agricultural workers in Georgia. And that became part of a larger conversation about So what can we be doing collaboratively in Georgia. And I think, for me, one of the things that's been most exciting, you know, you don't usually think of social work and ag as collaborators. But this area of mental health has been something where we are all, you know, deeply concerned and feel passionately about and been learning from each other and working together and collaborating with extension at UGA. It's just been phenomenal. But so the first step was getting this data set and doing the analyses and then talking with folks about that. Initially, we had a group of people from the College of Ag, both extension and sort of, you know, university based faculty together and I would bring as I was doing these analyses, I'd bring my findings and start with start talking about that. And we started talking about rural stress and about the different kinds of things that we can do. And one of the things that came up early on was this idea of just increasing awareness because people are not aware of the level of stress that farmers and farm workers are under and how that puts them at increased risk for suicide and not just suicide, but all sorts of stress related illnesses. So, you know, for example, in the study, when I did the analyses 21% of the cases, the individual had made prior suicidal threats, and had not gotten into treatment. And that's not a critique of the person's family and friends, it just indicates, I think that there's not a lot of knowledge about how serious this can be, or about what you do when somebody says something like that. So awareness became something that we really wanted to talk about, and thinking about, who could we be talking to about this was part of the conversation also. So that was what the group of us started talking about.

 

Valentina Castano 25:43

I think it's so interesting, kind of how you came upon this research, and this problem was presented to you. And then you started looking through these documents, right, and finding all this information. It's, it's like, almost investigative, you know, you're just trying to get to the bottom of something. And I think that's really fascinating. Was there anything early on, when you first jumped into this? I know, you mentioned, you know, some people made threats before it actually happened. Was there anything else early on that was really surprising to you that kind of made you want to keep digging into this?

 

Anna Scheyette 26:15

I guess a couple of things struck me One was that, in a lot of situations, the reasons that somebody died by suicide are similar to what they are for anybody, relationship conflict, and relationship loss was a huge issue. And if you think about rural areas, and how isolated people can be those relationships become even more important, because you may not have as many of them, loss of spouse was something that I saw repeatedly. So that was on the one hand really interesting, and kind of had a unique twist in rural, but was something very common. One of the things I think that surprised me the most was, the number of times someone had died by suicide, and it was associated with a serious health condition, either chronic pain, and maybe there was a quote from a family member saying he just couldn't take it anymore, or a loss of functioning, I don't want to be a burden on my family, or a new diagnosis, that was clearly something where you were going to be a burden over time. And I think, again, if you think about this population, and how admirably independent and self reliant they are, the thought of not being able to work, and not being able to function can be really devastating. But I hadn't really thought of it that way. And so that was surprising. The other thing that I found surprising was that overt financial problems, which I thought would be the number one reason we're not necessarily associated directly in that many cases, maybe a little less than 15% of the cases. Now, that's not to say that, because of health reasons, there weren't financial problems, or you know, because of something else, there weren't financial problems, but in the narratives that we got, it wasn't he knew he was gonna lose the farm. And therefore, you know, he ended his life, that was not as common as I thought it was gonna be, which I thought was kind of interesting. 

 

Valentina Castano 28:19

You bring up a really good point about how in these in these communities, your work is your life, or, you know, your ability to to work is your life. And we see that especially in farmworker communities, you have people who take such pride in their ability to work and contribute to their families. And I think your research really highlights that and points that out how that is such a big factor that was surprising to me the first time that I read your work, because I never even thought about that. And I think that maybe part of that is just my own background, my own, you tend to only think about these things from your own perspective. But thinking about them from someone else's perspective is really interesting. You kind of touched on this already. But I did want to ask about some more of the internal and environmental factors that you've seen that can lead or contribute to suicide. So you know, the inability to work or being a burden on your family, I would you call those internal factors. Is that or would that be an environmental factor?

 

Anna Scheyette 29:12

Well, I think it's a combination, because it's the internal factor of your health condition, with the relational factor of your relationship with your family, and your community. One of the other things, as I've been talking about this, in rural communities, that I've heard really loud and clear, is that these are communities that pride themselves on taking care of their own. And so a piece of what I think is important in this research and in the work that we do, is not that we come in for the university going Hey, here, I've got the answers. But here's what I'm seeing. What are you seeing community and then how can we give you the tools so you can keep taking care of your own, just take care of them better because you know a little bit more, you know, not trying to say that the community isn't doing a good job. They're trying to take over the role of the community, but trying to build on that amazing resilience that exists in rural communities. Because one of the other things that not necessarily in the suicide study, but in some other work, that colleagues at the farm bureau have done in in some other work that I did with Farm Bureau in Georgia, it was real clear that talking about this, and the stigma associated with stress and mental health issues, and suicidality was a real barrier. I did another study where the Georgia Farm Bureau very kindly let me be at their statewide conference and just have a booth there for a couple of days and hand up surveys. And one of the questions I asked was, if you knew somebody who was very stressed out, to the point, maybe even thinking about suicide, how confident are you that you would know what to do? And about two thirds of them said, I am not confident, you know, it'd be like, less than confident to absolutely not confident that they would know what to do to help somebody. So I think that's another area that we can focus on is getting people information and helping them learn how to help. 

 

Valentina Castano 31:13

And so how how would some of that look to you, you know, what are some things that people can do? What would that kind of look like? What's a good way to go about that?

 

Anna Scheyette 31:24

You know, as a social worker, I always believe that you start in the community. So for example, we have a project we've been working on in Colquitt county in South Georgia, and the Regional Extension person and the local Extension person, and someone from a group called our twip partnerships, which is like a community Business Development Group, and the local hospital, and the local minister, and actually one of my alums, who's a therapist in town, we all meet together. And we started talking about this. And we've started strategizing about how are acceptable ways to get this out. Because it's the other thing is that you have to present this information in a way that respectful and acceptable and accessible. So they did this wonderful thing where the extension agents during their production meetings, the local hospital had a blood pressure screening booth at the back of the room. So you could get a free blood pressure screening, the while you're getting your blood pressure screen, they're talking to you about stress, because it's related to your blood pressure, and they're handing you information about that. So it was a way to get mental health and stress information out. But without stigmatizing people at all about it, and just normalizing it. Health, stress, mental health, it's all part of the same thing. And here's information. And I think those kinds of initiatives have been really helpful. So for me thinking about moving this forward, I would want to think about sort of generalized education like that. And then the other piece, which we were just starting to talk about, then COVID. And hopefully, we'll be getting back to that work soon. is thinking about sort of targeted places where our points of contact for people who might be at higher risk, and how do we get information to them about how do you recognize somebody who may be thinking suicidal thoughts? What do you do? How do you get them to help? And there's some really basic trainings, there's Mental Health First Aid, there's something called QPR question, persuade, and refer. And these are evidence based trainings that you can get online even, that we could encourage people to get that would help them know what to do, where to refer people. And I think the hardest part for anybody, not just, you know, in this rural settings, is asking the question, and I think a lot of people are afraid that if you say, you know, you look like you're in a really dark place, are you thinking about hurting yourself? You're gonna put the idea in somebody's head. But if you're picking up the vibe, that that might be a good question to ask. That's already there. So you know, what you're doing is you're giving permission to talk about it, which will save somebody's life. So one of the things that we that we thought about was, you know, given some of the things that I'd found, I would love to in rural areas work really closely with primary health physicians and health clinics. Because if somebody is in chronic pain, or they've got a diagnosis, those are going to be filled with people that will see them. What do you think about loss? Well, what about clergy? What about funeral home directors? What about nursing home directors? If you have to put your spouse in a nursing home? Can we get those people trained? Can we get people who are just community leaders, you know, and in a lot of the communities I was told about the feed store where everybody hang out, well, how do we get the information there? How do we get it to the diner where everybody goes, so that it's normalized? The thinking about these leverage points, bankers was another one we had talked about. If you're the loan officer that has to say, No, you cannot get another loan. And that puts the farm at risk of loss. That's a huge risk. So how do we get those people trained to understand what are the warning signs and what to do so we can create this sort of community safety net for folks?

 

Valentina Castano 35:28

Something that you said that kind of stuck out to me was when you spoke about especially in these farmworker communities, there's a certain stigma associated with suicide. And that kind of leads to a barrier in communication, right? You also talked about a permission to ask, right, there's that barrier there. And a lot of people we know someone who seems very stressed out, but there's that barrier there and bringing it up. Can you talk, I just thought that was really interesting. Can you talk a little bit more about that? And why there is that kind of stigma among this population? How that leads to bad communication, and some more things that people can do to bring that barrier down and encourage that permission to ask?

 

Anna Scheyette 36:11

Absolutely. And I guess I want to clarify that I think this is a stigma across the board period, it may be a little more intense in rural communities, again, because of this fierce level of independence and self reliance, which overall is a strength. But at a time, when you need to ask for help. It's even harder, because you've got this strong value of self-reliance. And my job is to take care of myself and my family and my farm. But I think just being able to frame it as, hey, I love you, I care about you. So I'm asking this. You seem to be in a really bad place, you seem to be really depressed. I'm just gonna ask, Are you thinking about killing yourself? Are you thinking about hurting yourself? And just saying it really simply, I think not apologizing for it not a lot of hoopla around it, just saying it that in and of itself destigmatizes it and somebody can go, No, I'm fine. You know, I'm just tired or, yeah, yeah, yeah. And they can start talking. One of the other things that we talk about, is trying to find local champions, because, you know, I'm coming from the university, nobody's going to talk to me, I have not from a rural community. But if somebody that they grew up with asks that question, that somebody who they trust to begin with, I think that's going to have a whole different valence to it. There's some wonderful folks in extension here really reframed this, for our initiative. And we have something called rural Georgia growing stronger. And that's kind of how we've been couching all of this. And we have a website with all sorts of information on health and mental health and everything about being healthy and strong as an individual and a family. And one of the things this guy does, and I did it at a training that I did, and it worked really well. And I had a slide up of all sorts of different farm equipment. And my question was, what's the most valuable asset on your farm? And of course, They all laughed at me to the city girls, like if you have to ask you can't afford it, is that they were saying different stuff. And I'm like, No, the most valuable asset on your farm is you. And just like, you wouldn't treat that equipment, like crap, you can't treat yourself like that. Either. You have to take good care of yourself and give yourself a tune up and make sure that you're, you know, you're you're taking good maintenance for yourself, you are the most valuable asset on the farm, because if you're not strong, the farm can't be strong. And that seemed to be something I wish I thought of it. But it wasn't it was Mark mccannon extension, but it seemed to resonate. And that seemed to be a way that people can hear that message. 

 

Valentina Castano 38:58

That's profound. And it's absolutely correct. You know, you aren't, you can't replace yourself. I know a lot of these things are really specific to agricultural workers, right, especially when you're talking about harvest season. And those are stress factors that seem to be really specific to that population. But as we talk about this, it seems as though a lot of these things, you know, when you talk about loss, financial stress, losing a partner, putting a partner in a nursing home, those stressors, you know, a lot of times can be shared with the general population, too. So it seems like, you know, even though we're talking about farmworkers, specifically, there's a lot of themes that occur when we talk about these things that seem like they really are applicable to everybody. And so this topic of mental health, you know, it's such a wide umbrella, and there's so many things that fall underneath it. Is there anything else that you kind of saw through this research process that you know, is not specific to just farm workers, and this is something that the more we learn about it, the more it benefits everyone?

 

Anna Scheyette 39:53

Well, I think a lot of it is as you're saying very similar. It might be very And degree depending on the cultural setting that you're in, and rural is just one of them. But yes, stigma i think is common all across the board. You know, it's really interesting getting into this work, I've gotten very sensitized to language. Because it's very common in our culture, we talk about people committing suicide, well, what else do people commit, they commit crimes, they commit bad things. So people in this sort of destigmatizing this community are trying not to use the word commit, they're trying to use the word died by, you know, killed themselves died by suicide, things that will destigmatize the choice, or the or that, you know, the action that people engage in. But I think the stigma is pretty common. I think that sense of having to be self reliant, can be very, it can be seen all over the place, I think there's a gendered piece to this farming is a predominantly male occupation. In general, while more women attempt suicide, more men die by suicide. So there's a whole gendered piece there as well with that, and just this idea that having support and having safe places where you can talk and where you feel like you can turn for help and for support is it's a universal need.

 

Valentina Castano 41:31

And I've noticed a little bit as we talk, you have so many stories, so many specific stories of situations that you've seen, right? Is there anything else just out of curiosity, that comes to mind any other stories that you'd like to share if specific situations or scenarios where you feel like, you know, they really had an impact on you are something that you really remember,

 

Anna Scheyette 41:50

Right? I guess the one that came to me, and it was through the stories that came out of the research through the narratives that I read, had to do with one of the warning signs that I had not thought of, of people who are contemplating suicide, which had to do with getting things in order and giving things away. So there was, I came up with the daughter or spouse, with someone who talked about how he had shown me where he kept his insurance papers. And I thought that was odd. Or someone else who had started giving, like gave away a watch that belonged to his father, you know, getting their papers in order, there was one person who left a voicemail on his neighbor's phone, and it just said, My wallets on the mantel, and please take care of my cows. And that was his last message. So I had never thought of that. But this idea of getting everything straight. So that after you're gone, things are in a good space for your family. I found that just incredibly sad and moving and touching and not something I would have thought of as a warning sign necessarily. But then I started reading about it. And apparently in the literature, yeah, that is a warning sign

 

Valentina Castano 43:09

that wallet story in the cows, as you said it, I just got full body chills, because I think it's, it's really telling to for that specific population, the farm worker population, we said earlier, you know, when these populations get sick, it's really hard on them, because they are so focused on providing and that's such a big part of who they are. And I just think that it really speaks a lot, you know, when someone is in a situation where they know what they're about to do. And the last one of the last things they do is make sure that their farm is taken care of their cows are fed.

 

Anna Scheyette 43:41

Yeah, exactly. And, you know, I think another piece that we haven't mentioned in all of this, but that we need to acknowledge is the additional impact that COVID has had on farmers and farming communities. And while I haven't done research directly in that area, the American Farm Bureau Federation did do a survey on that. And they found that, you know, in general, in rural areas, something like three and five rural adults, said that the pandemic had impacted mental health negatively, a lot in their communities, over half of rural adults that they thought more about their mental health during the pandemic, social isolation, which is hard already in rural areas became much worse. And so thinking about the impact of COVID and if you think about it, the social isolation, the added stress of not knowing what's going to happen health wise, and then just the economy. In terms of the interrupted supply chains, the Meat packing plants that have had to shut down the trucks that aren't running. So you've heard all these stories about, you know, dairy people having to just dump their milk or fruit is rotting and pile or people having to sacrifice animals that aren't going to go to a slaughterhouse? And just how devastating that's been for farmers on top of everything else? How do you handle your farm workers? How in heaven's name, do you have people working in fields socially distanced in and still able to breathe and do their jobs and what happens when one person gets sick and you've got a quarantine, everybody keeps picking your blueberries, or whatever. So I think COVID has added a whole additional layer of stress to everybody, because it's just been a horrific year for everybody. But the unique characteristics for farmers I think, have been pretty intense.

 

Valentina Castano 45:40

You're absolutely right. COVID has had such an impact on our distribution chains or supply chains. You know, I've seen the videos of farmers having to pour milk out and and you know, we've had a lot of conversations about farmworkers in the field having to wear masks, and it's such a difficult situation. One of the things statistics that and I might maybe I wrote this down wrong, but you said that half of adults reported that they thought about their mental health more during Coronavirus. I wonder I wonder if there's, you know, maybe that can be a point to start that conversation then with that public if they're thinking about it? You know, that's just the hopeful part of me. But if that's something that we can use to maybe have them, have this population be more willing to have these conversations? And it's a little glimmer of hope, maybe?

 

Anna Scheyette 46:25

Absolutely, I think so. I think so. One of the other things that I found really hopeful was, as I was having these conversations, one of the first places that the Dean of College of Ag took me was to the Sunbelt ag Expo, which was in South Georgia, and I got to meet a lot of the head of the different commodity commissions. And anytime I started talking about this, they were like, yes, we need this. This is important. Our farmers are under so much stress. And people at that level, were really open to it. That's how I ended up getting the invitation to the Georgia Farm Bureau State Conference was because the pet of the Georgia Farm Bureau was there and he's like, Oh, you need to come to our conference. I think that that's really hopeful. And that's another way to get information to farmers and farm workers from a source they're going to trust, again, not going to trust the you know, middle aged lady from the university, but they're kind of the head of their their commodity commission. And one of the other things that I did in that survey that I did with the Georgia Farm Bureau was I asked them, How would you What do you think are effective ways to get information to farmers and farming communities about taking care of themselves during times of high stress? I didn't know what would work. And I was it was really interesting, because the top four by far were social media, which I wouldn't have thought of necessarily, but that's what they said. The second one was newsletters and magazines, and every Commission's got a newsletter. And so that's the way we could be pushing information out. Extension classes was something else people mentioned. And then websites. Again, this idea of using the organizations that already exists as a way to share information and the fact that they were that open, and that enthusiastic about the fact that Yeah, we need to talk about this, I took us a really hopeful sign.

 

Valentina Castano 48:26

Absolutely. I mean, I think that's fantastic. Because the you know, even though there's a stigma associated with talking about these kinds of things, the fact that they were so receptive to you and your work and understanding how important that is. I think that that is fantastic. And it definitely brings a lot of hope to the to the topic. I'm going to go back a little bit. And we have talked about this already. So I just want to give you the opportunity to expand on it if you would like talking about identifying the factors and how they can, you know, talking about why is it important to identify these factors, maybe they can be used in points of intervention. And I know we've said that a little bit, especially if you know, now that we have this understanding that these farmers associations are involved, or they would like to, you know, help in any way possible. Would you like to talk more about that?

 

Anna Scheyette 49:10

Sure. I mean, I think one of the things that I think is really important to understand is that what you might think stereotypically of as a suicidal warning sign isn't necessarily so a lot of times people will think about someone who's weeping and sobbing and overtly depressed. Yeah, that can be a piece of it. But it can be lots of other things that are much more subtle. There can be conversation that's just a little more hopeless, a little more I wonder if the farm would be better off if I weren't running it. Those kinds of conversations. Some of it can, instead of sadness that can manifest irritability, people with much shorter fuse, a lot more anger, more easily frustrated, those can be warning signs that people are really feeling intensive levels of stress. Another one can just be neglect. If people lose interest in what they used to do, they're not going to church, they're not going to the diner where they used to hang out, they're not visiting with their friends, they're not doing the things they used to do. They're not taking care of themselves, they look disheveled, unkempt, you know, particularly if you've got somebody who normally was a nice dresser, and you know, prided himself on always having a good clean shirt and that goes away, or the farm starts looking bad, the animals get neglected, the farm starts looking rundown, they're not taking care of the farm, either. Those can be warning signs as well, that you might not think about, and then the one that I haven't really mentioned. And that's true, not just in rural areas, but across the board is increased substance use people who are drinking more, or using more substances, a lot of self medicating when people get really anxious, really depressed. So you want to be looking for that, because not only is it a warning sign, but substances are a disinhibitor. So whereas when you were sober, you might not engage in a particular action. If you are really using a lot of alcohol, you your judgments impaired, and you might end up engaging in an action that's really dangerous. The other thing, too, that I think is important to realize in suicide, is that there's an awful lot of unidentified suicide. There are accidents on the farm. I did a presentation on this for a group of medical examiner's, and coroner's and several of them said, If I had any, any any any doubt whatsoever, I don't put down suicide, I don't want to do that to the family. So there's a lot of things that got get called other stuff that may well be suicide that were missing, also, because you don't want to you don't want the family to have that stigma. You don't want to break families apart. pragmatically, in some cases, there's insurance money involved. So just realize that when we look at the data, we're looking at, maybe what might be the tip of an iceberg. We're not looking at all of it.

 

Valentina Castano 52:18

That was the first thing that came to mind when you said that was even the data that we do have is probably not very complete. Right?

 

Anna Scheyette 52:25

Exactly. And you were asking about warning signs and what to do a couple of other things, recognizing the warning signs asking the question, if somebody gives an indication that they're thinking about that, then don't leave them alone. Okay, then you and I are going to go together, and we're going to go talk to somebody who can get you some help. And then taking them to an emergency room, the local mental health center, if you don't know what to do, there's something called the National Suicide Prevention hotline. And I'm going to give the number, which is 1-800-273-8255. And that's national, and you could call and wherever you call from they will find you somebody close by that you can go to and get help. And and you can call them. If you don't know what to do, I've got a friend, I'm worried about them. And they can give you advice and guidance also. So that's really important to know. But once you do get a sense that somebody might be in danger of self harm, saying, you know what, I'm just going to stay here with you, and we're going to go together. Or if I've got to go, I'm gonna make sure that I get you to your daughter's before I leave, so that you're not just having somebody say, yeah, I'm thinking about hurting myself. And then, and then going, Oh, okay, that's interesting. And walking off, you know, you've really got to make sure you get them someplace safe. 

 

Valentina Castano 53:56

Absolutely. We have talked about this a little. So I'm just going to ask a very brief in case there was anything else you wanted to say? Why are these points of intervention and identifying these champions, so important? What is the biggest thing that comes from from understanding what these points of interventions and these champions are?

 

Anna Scheyette 54:12

Well, I think because it's the opportunity, whereas I may understand things, but I have no way to share that information and to act on it in a way that will help people because I am not there and be I don't have a relationship. I'm not trusted. These are trusted, safe places where people interact, and they get lots of care from them from their minister from their physician, their banker, so they have the opportunity to use that relationship in a way that can save people's lives. And not just from something you think about suicide, which is the most dramatic thing, but not just that, because if people were feeling hugely stressed, they're at risk of all sorts of other things. You know, all sorts of health related issues. There's a woman here at the university of Georgia named Zoe Stoneman, who does the research. And she actually did a study that looked at stress levels in fathers and youth risk taking behavior on the farm, and found that the more stressed the fathers were, the more the adolescent children who are working on the farm, were engaging in risky behaviors and ending up with farm related injuries. If you think about it, dad's really stressed, I'm going to work really hard, maybe I'm not being as careful as I should be, or I'm working past the point that I'm tired, or I'm working faster than I should or whatever. And it ends up impacting the young people. So it isn't just the individual, it's the whole family.

 

Valentina Castano 55:42

And it seems like there's this whole cultural aspect of it too, right? And what some of these behaviors are maybe learned, and maybe some farmworkers watch the way that their fathers dealt with stress, and they didn't talk about it, they didn't ask for help. They didn't cry. So they feel like it's their duty to do the same serve responsibility. So I think that that just goes back to the other things that we've said earlier on.

 

Anna Scheyette 56:03

Exactly. And I think it's all part of I may not have it exactly right. But I think it's called the agrarian imperative. And it's like this sociological construct. And it's the idea that if you are a farmer, you do everything you can to take care of the land and keep the land. And that is your number one priority. So it's this multi generational sense of responsibility and sense of being having to be self reliant. Like you were saying, you learn it from your father. But it's, it's something gets passed on from generation to generation. And if you've been a farm in your family for five generations, and you're the one who loses it. I remember at the Sunbelt ag Expo, I was talking to a young woman, and she had grown up on a farm and it had been in her family for I don't know, four generations or something. And she had gone into the city and gotten a job. But she and her husband had saved enough money and they come back. And they had bought the farm and actually said, I was at the bank. And as I was signing the papers with the banker, he knew my family for forever. He said, Well, you know, you can't ever lose it now. Right? And she said, and I was 35. And I had the weight of five generations worth of land dumped on my shoulders, and I have never felt so heavy in my life. And I think that kind of responsibility is a piece of all of this too. So and then the flip side of it is what do you do if none of your kids want to farm? Right? 

 

Valentina Castano 57:28

That's, that's equally as difficult problem. Right? Right.

 

Anna Scheyette 57:30

Right. succession planning is a big one. So there's, there's all these really complicated inner weavings of sense of responsibility and should and ought. And then there's just the reality that human beings can only do so much. And so much of this is out of farmers control. I think that was the other thing that was really interesting. In the survey that I did with the Georgia Farm Bureau is I asked them to list the top three stressors for farmers in Georgia, weather, finances, and commodity prices, they have no control over any of those. So all these things that stress you out that are the biggest impinges on your farm success, you have no control over it, which adds to the stress. So this whole idea of self care, and of being able to take care of yourself and kind of think about things in a certain way and not have the way to five generations on your shoulders becomes really important, because there's so much that's out of your control. 

 

Valentina Castano 58:30

Absolutely. I want to give you the chance to bring up if you know of anything else that can be done to address this issue and help this farm worker population in terms of mental health? 

 

Anna Scheyette 59:02

Well, I think a lot of it I've said before, having conversations in the community that are destigmatized, that are normalized, having these points of contact and having community leaders and community champions, doing what can be done around the things that seem outside of people's control. So you know, having the commodity conditions and having the Farm Bureau's that are advocating for farmers and for farmer well being becomes really important. I got this sense, and again, not a farm girl at all. But when I spoke to people in the rural communities, there was this kind of sense that we're in it alone. And I think for the rest of us to acknowledge that everything we eat and everything we were somehow or another is grown by a farmer. And that similar to the way that we to veterans, they thank you for your service because they've kept us safe. I think saying that top farmers more might be really helpful to let them know they're not alone and that we see what they do and we know that we literally owe our sustenance to them is an important piece of the message.

 

Valentina Castano 59:54

And I also kind of get this feeling from talking to you that when you when they say that they feel like they're alone? Oh, maybe there's also a sense of they feel like they're the only one struggling, you know, and you're, you're not alone in terms of in that aspect a lot we understand now. And that comes out as we talk about this. Right. A lot of farm workers are struggling with this. And I definitely don't want the farm worker listening to those who think that that there was something wrong with them. And I don't know if that's actually a part of it. But I do know that it is really stigmatized, and people don't talk about it a whole lot. So I also feel like that's maybe another, you know, something that can help to know that they're not the only ones feeling this way. And they're not alone in that sense, either. Their pain is is definitely shared in a lot of ways.

 

Anna Scheyette 1:00:37

Absolutely. And I think I think that's where thinking about, like, peer support becomes really important. There is an unstart, I should have looked it up before we had this podcast, but there is a YouTube video. And it's a gentleman who's a farmer. And he tells the story of about how 10 years ago things were really, really, really bad. And he said his barn on fire, and he walked into it fully intending to die. And for some reason walked out again. And his mission now is to talk to other farmers. And there's a piece in the YouTube video where he's talking with some other farmers that one of the farmers goes, Yeah, you know, I went to the local Counseling Center once and there was this nice lady there. But she didn't know anything about farming. And she didn't know what I was talking about. And I didn't go back if it didn't help. So I think having people who understand farming life 

 

Valentina Castano 1:01:07

And those unique struggles, right?

 

Anna Scheyette 1:01:33

Exactly. And just the language, like I didn't know what a commodity was, before I started doing this work. You know, I had never been to the Sunbelt ag Expo, it's it's been, it's been a really good cultural awakening for me. But I would have been a useless therapist to a farmer. So I think thinking about having people who understand who are themselves farmers who can talk about their own struggles becomes really important than having them as champions to the other thing that I'm really interested in is going into rural communities and finding people who might be interested in becoming counselors, but don't want to leave the rural community they want to help their or their place bound. And, you know, one of the things that we've done is we actually have an online Master's in social work program, and I'm targeting it to rural Georgia, for people who want to stay in help and don't want to be a therapist in Atlanta, because those are the folks who are going to be the most helpful. 

 

Valentina Castano 1:02:38

Yeah, I think that that's fantastic. As we you know, reached the end here, kind of open the floor for you to bring up anything else that maybe you do not have an opportunity to say and just kind of touch on are there any other major takeaways from this research and from things that you learned that you really want listeners to take home after listening to this?

 

Anna Scheyette 1:02:54

I guess the other thing, and I've spoken about it some but that I found really important was that I think if we're gonna move the needle on this, we have to bring together lots of different aspects of the community. And that if I go down there, or even if there is a champion in the community, one person's not gonna do this. It's the thinking about all the different elements of the community coming together. So that it is the schools and for age and extension, and the churches and the faith communities. And the Farm Bureau and the commodities people and the people who sell John Deere and the people at the banks and the hospitals and the primary care physician, everybody, as a community. But this is a community problem. This is not the problem of an isolated farmer, who's got depression, this is a community problem. If so we need to come together to work on it. And then I guess the other piece for me that really struck me is that I always get a little concerned when I have this conversation, that it's going to seem like I'm saying that rural communities or that farmers aren't strong enough. And they are I mean, this is an incredibly resilient, hard working, independent, autonomous, self reliant group of people who I admire in ways to take my breath away sometimes. But that doesn't mean that they don't have challenges and that they don't need support. But it should not in any way be seen as a critique. Because it's not folks are amazing and like I said, they feed us and clothe us, we owe them support.

 

Michaela Kandzer 1:04:44

I want to thank Marshall Sewell and Dr. Anna Scheyette yet for being a guest on Science by the Slice and for sharing their experiences and perspectives related to rural mental health. Rural agricultural communities may have limited access to health and mental health care services, which can make it difficult for farm and ranch families to receive support when they are experiencing extreme stress, anxiety, depression, or another mental health crisis. If you or someone you know has an immediate mental health need, please contact one of these national hotlines, the form aid hotline one 1-800-327-6243 or the National Suicide Prevention Lifeline 1-800-273-8255 or contact 211 a comprehensive hotline that connects callers with local resources. For more information and resources, please visit www.RuralHealthinfo.org. Be sure to listen to part two of this series on mental health. In Episode Two you will hear from Dr. Angie Lindsay as she discusses the impact of natural disasters on mental health and agricultural and general populations. This episode is available for streaming now. I also want to thank everyone involved in this podcast Phillip Stokes, Rachel Raybon, Ricky Telg, Sydney Honeycutt, Valentina Castano, Ashley McLeod-Morin and Alena Poulin. I'm Michaela Kandzer and this is Science by the Slice.