COVID-19 fallout hits farmers

Seven months into the coronavirus pandemic, COVID-19 has shaken farming communities, disrupting supply chains, and exacerbating the financial instability that already hovered over many farm families. As a result, psychologists and other mental health professionals are concerned about the rate of undiagnosed mood disorders and substance misuse in farming communities.

“Farmers are subject to a lot of chronic stress, every day, from different sources,” says psychologist Rebecca Roller, PsyD, LMFT. “Along with contributing to some physical illnesses, that stress can also contribute to mental disorders like depression and anxiety.”

Roller and other rural mental health providers are reaching out to ensure mental health care access to clients in farm communities.

Initially, many farmers didn’t feel the impact of COVID-19, says Meg Moynihan, a dairy farmer and an advisor at the Minnesota Department of Agriculture. Farm life is naturally socially distanced and takes place largely outdoors, after all. But the economic fallout soon made itself known. Meat-processing plants began to shut down due to outbreaks; the supply chain shuddered as restaurants and school cafeterias closed. Farmers suddenly found themselves having to dump produce, euthanize animals, and pour fresh milk down the drain. All of this conflicted with the agrarian imperative, the deep-seated drive that farmers have to produce sustenance, Roller says. The impact is not only financial.

“Having to destroy a crop because there’s nowhere for it to go or having to dump milk, it’s just emotionally wrenching,” Moynihan says.

Because farming is an economically challenging business in the best of times, many farmers hold second jobs, or their spouses work off the farm to provide the family health insurance and extra income. In many cases, it’s the women in the family who hold these outside jobs, says Maridee Shogren, DNP, a certified nurse-midwife at the University of North Dakota. Some have been laid off or furloughed because of COVID-19, further contributing to the financial struggles of farm families. “Women are the forgotten partners in farming,” Shogren says. “We need to do a better job of screening for depression and anxiety symptoms [in primary care and women’s health], because women are pretty stressed.”

The pandemic is also creating extra work for farmers, who must make plans to keep seasonal and temporary employees safe. The sugar beet harvest, for example, starts in October and brings an influx of workers to run heavy machinery in 12-hour shifts. Farmers are figuring out how to sanitize tractor cabs and otherwise keep coronavirus from spreading during the harvest, says Thomasine Heitkamp, LICSW, a professor in the College of Nursing and Professional Disciplines, University of North Dakota.

The pandemic now joins unpredictable weather and fluctuating commodity prices among the uncontrollable external stressors facing farmers. Many farmers and farmworkers cope with these stressors by misusing substances, especially alcohol. “It’s a lot more socially acceptable to have a few beers with someone than to see a local therapist,” Roller says.

Rural areas may be lightly populated, but they’re fishbowls for people who live there, Shogren says. When everyone knows your truck, it’s hard to hide that you’re visiting a therapist’s office. And values such as stoicism and self-sufficiency make it difficult to admit that you need help.

In that sense, some changes forced by the pandemic might be a boon.

“The one [positive] thing that COVID has done is expanded telehealth,” Heitkamp says. “If a farmer is feeling depressed and discouraged, and maybe using a little more alcohol, someone could be available to see him about that when he goes home from the field to eat lunch.”

Flexibility is crucial for mental health professionals who work with farmers and farmworkers, Heitkamp says. Because the work is all-consuming and time-sensitive, appointments need to be available when the farmer can make them -- which may not be during the typical 8-to-5 workday.

Through the Mountain Plains Mental Health Technology Transfer Center Network (MHTTC), funded by the Substance Abuse and Mental Health Service Administration (SAMHSA), health professionals like Roller, Heitkamp and Shogren are reaching out. One major effort, Shogren says, is training primary care physicians to do brief screenings for depression, anxiety, and substance use. Primary care is one of the main entry points to mental healthcare for farmers, she says.

Other work focuses on outreach: Radio interviews to encourage people in farm communities to seek help, collaborations with agricultural extension agencies, public education campaigns. Sometimes farmers and farmworkers need help with emotional coping skills, and sometimes they need practical help with finances or logistics, Moynihan says. Rural mental health providers need to network with other professionals in their area in order to refer their clients to other sources of support.

As challenging as the pandemic is, farmers are used to dealing with problems outside their control, and many have hung on through droughts, floods, and price crashes. “There is no more ingenious group than farmers,” Roller says.

To help them thrive, rural psychologists have to be ingenious, too.