Welcome to State of Mind, a new section from Slate and Arizona State University dedicated to exploring mental health. Follow us on Twitter.
This story was originally published by Georgia Public Broadcasting. GPB is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering the challenges and solutions to accessing mental health care in the U.S. The partners on this project include the Carter Center, the Center for Public Integrity, and newsrooms in Arizona, California, Georgia, Illinois, Pennsylvania, and Texas.
Christina Proctor spent many hours during her childhood on the front porches of neighborhood farms in Madison County, Georgia. She had a rough upbringing, she said, and lived in a house scarred by substance abuse. “But we lived on this road that was surrounded by farmers,” Proctor recalled. “So if anything was going on in my house, I would walk across the street and sit on my neighbor’s front porch, who was a farmer, just to get away from it all.”
Now a clinical assistant professor at the University of Georgia studying rural substance abuse and mental health, she’s revisiting Georgia’s agriculture community for a different reason: to get the farmers she relied on for support to talk about their own mental health challenges.
Proctor and her team spent time conducting in-depth interviews with 15 farmers across 10 counties. Initially, some questioned whether it was a task that could be done. “When I first proposed this, people laughed at me,” she said. “They were like, ‘You want to go sit down with farmers and talk about mental health and substance use? No one’s going to talk to you.’ ” But Proctor said a crucial component to her interviews was meeting farmers where they were—from fields to shops to dining tables in their own homes. Her visits gave direct insight into the lives of the people who feed America.
“One thing that struck me was their phones were just ringing nonstop,” she recalled.
“There was always a problem. In the northeast part of the state, people were calling about cows getting out … or something was going on in the chicken house, the temperature wasn’t right. In the southeast part, sprayers were messing up, equipment was messing up. There was always something happening.”
Little is known in the academic world about the level of stress that farmers and producers carry on their shoulders and how they cope with it. Anecdotal evidence over time suggests that strained family relationships, a reliance on drugs and alcohol, and a rising number of suicides are the results.
In 2019, Anna Scheyett, dean and professor at the University of Georgia School of Social Work, studied 106 farmer suicide cases from 2008 to 2015 and found that strained relationships and health and financial problems were the most common stressors associated with suicide. “It’s important that we acknowledge the reality of stress and the far end of the spectrum, which can be death by suicide,” Scheyett said at a May conference in Tifton, Georgia. “But these studies give us information on ways to intervene. And for me, at least, give me hope for what we can do.”
Getting the farming community to talk to strangers about their most personal struggles with mental health issues—symptoms of anxiety, depression, and thoughts of suicide—seemed nearly impossible for other researchers hoping to help.
The pandemic held a mirror up to prevalent but often overlooked issues around mental health. Georgia lawmakers dubbed the 2022 legislative session “the year of mental health” and passed sweeping reforms that advocates hope are just the first step in creating mental health parity in health care. Still, in Georgia’s agriculture community, “people may not be willing to park their truck in front of the mental health center in town,” Scheyett said.
Researchers are taking different approaches to the problem. Stephanie Basey, a doctoral student at Mercer University School of Medicine, and her mentor Anne Montgomery, an assistant professor and biostatistician, reached more than 1,600 farmers and farm workers in almost all of Georgia’s counties through a detailed survey.
Their statewide survey results painted a startling picture: Farmers living a brutal reality of isolation and loneliness. A persisting dissatisfaction with their jobs while they were struggling to manage stressors like extreme weather and hiking supply prices. About 29 percent of responding farmers reported thinking of dying by suicide at least once per month, according to the survey, and 42 percent at least once in the past year.
“Obviously, the goal (of the study) would be to improve the mental health of all of our farmers through farmer-specific interventions,” Basey said. “But if we can guide those interventions to help a farmer before they get to the point of even thinking about suicide or trying to complete suicide, that would be obviously the biggest, most impactful part of the study.” But that begs the question of where can farmers go to get mental health support. Scheyett’s research suggests farmers’ top trusted confidants are spouses, friends, other farmers, faith leaders, and local doctors.
The Mercer survey revealed another brutal reality: 60 percent of farmers reported they do not have access to basic medical care. More than half said they didn’t have insurance of any kind. “We found that (farmers) said that they did not have access to the service, but they wanted to access service, and that was a big finding for us,” Basey said.
The Mercer researchers said they found something they didn’t expect: an eagerness within the farming community to talk and seek out mental health treatment, but the challenge being knowing where to go. “That’s the first and most important intervention step that we have to take,” said Chris Guy, director of special projects at the Georgia Rural Health Innovation Center at Mercer. “Because we can capitalize on that eagerness in order to open the doors and really tear down those barriers of stigma.”
But normalizing conversations around mental health and bolstering health care access in rural areas can’t happen overnight—and until then, farmers are often left to cope in their own ways. One farmer interviewed by Proctor, of the University of Georgia, put it bluntly: “It’s easier to drive through the beer store than to seek out treatment,” they said when talking about relying on alcohol to cope with persistent stress.
Researchers are hopeful that their work can guide a new response to the severe mental health needs of Georgia’s agriculture community—whether that’s providing training for farm loan officers to spot signs of severe stress or setting up support networks through trusted doctors and faith leaders. “The farmers just wanted to talk to us,” Proctor said. “They were happy that somebody was there to listen to them.”
If you need to talk, or if you or someone you know is experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call or text 988 to reach the Suicide & Crisis Lifeline.
State of Mind is a partnership of Slate and Arizona State University that offers a practical look at our mental health system—and how to make it better.