Practice Profile

Growing up on his family's Iowa farm, Michael Rosmann, PhD, spent most mornings milking cows and gathering eggs and many weekends cleaning chicken manure out of the hen house.

He also saw firsthand the toll farming and ranching can take on mental health. One incident in particular is burned in his memory. A classmate's father and fellow farmer, overwhelmed in part by a sour grain-futures market, killed his wife and three children before taking his own life.

Such tragedies are all too common in agricultural communities, Rosmann says. In fact, a 2002 study in the American Journal of Public Health (Vol. 92, No. 7) suggests that rural men have about twice the suicide rate of urban men.

"Farming is a noble calling," says Rosmann, and many farmers see their occupation as a key part of their identities. When that occupation is threatened—by drought, flooding, disease or a down farm economy—people can feel like their meaning of their life is disappearing.

For nearly 30 years, Rosmann, now a clinical psychologist and owner of Rosa Blanda Farms, in Harlan, Iowa, has been working to address the unique challenges farming and ranching families face. They've always confronted capricious weather and changing demand for their products. But because they tend to be a self-reliant group who keep their concerns bottled up, they may isolate themselves, which only exacerbates their concerns and can sometimes lead to depression and substance abuse, Rosmann says. In addition, there's a dearth of behavioral health-care providers in rural areas, and most aren't trained in the culture. Many family farmers who do seek care find it difficult to pay for.

That's why in 2001, Rosmann founded AgriWellness Inc., a nonprofit organization that links farmers and ranchers in seven states with behavioral health services as well as free legal advice and financial management. The organization coordinates a hotline that responds to 12,000 to 14,000 calls a year and offers community education, support groups, educational workshops and behavioral health services across the Midwest. The organization's four staffers also provide disaster behavioral health training and, since 2005, have certified more than 60 Iowans to provide crisis counseling and referral assistance after natural disasters.

AgriWellness's work became even more far-reaching last year when passage of the 2008 farm bill created a national assistance network for farmers and ranchers based on the AgriWellness model. The organization is now asking Congress to fund that network. If that happens, Rosmann says, the network plans to develop behavioral health supports for the agricultural population in two stages: first in a seven-state region of the upper Midwest, New York and neighboring states and Texas, and second, throughout the nation's remaining agricultural areas.

"My hope is that this will lead to healthier farmers and ultimately a more stable food supply," Rosmann says.

An endangered species

Growing up, Rosmann didn't plan on an agricultural career. He studied psychology as an undergraduate at the University of Colorado at Boulder, and after finishing graduate school at the University of Utah, Rosmann spent five years as a psychology professor at the University of Virginia, where he researched juvenile delinquency and crime prevention.

But in 1979, when Rosmann and his wife, Marilyn, started a family, his farming roots called them back to Iowa.

"I found myself thinking a lot about how farmers produce essentials for life, and yet they are an endangered species themselves," Rosmann says.

They took over a small family farm, where they raised corn, soybeans, oats, hay, cattle, turkeys and chickens, Rosmann says, though three years ago, they sold their last cow and now only produce prairie grass. He also opened a private psychology practice that took off. He quickly became overwhelmed by the community's psychological needs, so he joined a local mental health clinic so that he had some backup.

Those years of farming help him put mental health in terms his clients understand. For example, rather than preaching about the importance of psychological wellness or the mind-body connection, he compares behavioral health to livestock feed rationing: Just as cattle feed should have optimal levels of protein, carbohydrates, sodium and zinc, Rosmann says, farmers must allow adequate time for sleep, recreation and social interaction to function at their best. Such analogies take the mystery out of mental health and make it less threatening, Rosmann says. Colleagues and clients agree, noting that Rosmann's practical approach to behavioral health has helped farmers understand that their frustrations are normal, and there are places to turn when they need support.

"Mike's efforts are helping farm and ranch people realize that accessing services for behavioral health is every bit as important as accessing care for medical needs," says Charlie Griffin, president of the AgriWellness board of directors and a research professor at Kansas State University.

In fact, says Griffin, farmers in Canada and Ireland have taken note of Rosmann's success, and he's now helping them build behavioral health programs for farmers in those countries.

For his part, Rosmann is perhaps most proud of helping farmers in his home state.

He recalls one farmer in particular who called AgriWellness after reading about the organization in a farming magazine. Under some financial stress, the client had been forced to sell some livestock and was having a tough time parting with his cows.

Over the course of their discussions, Rosmann says, it became clear that "the client was so depressed that he could hardly get up in the morning." Rosmann helped him work through his challenges by encouraging the client to keep just a few cows for himself, easing him into the next step of figuring out a way to gradually sell some land to pay off his debts.

"He often tells me he wouldn't be alive if he hadn't contacted us," Rosmann says.