When the severity of the opioid epidemic in rural places, and among farm and ranch communities in particular, revealed itself, leaders of national farm groups worked together to raise awareness and to work toward ending the stigma around mental health. Years later, those efforts paid dividends when the COVID-19 pandemic further ratcheted up stress levels. 

But challenges remain.

Farm Town Strong, launched in 2018 as a partnership between the National Farmers Union (NFU) and American Farm Bureau Federation (AFBF), went beyond merely collating resources for farm communities — though it did do just that. The website has sections for immediate care (Call a Hotline), treatment, help with preventing addiction, and drug disposal. But the organizers also used social media, member communication and conference sessions to expand the conversation around mental health and substance abuse disorder. The goal was to reduce the stigma often associated with them.

Roger JohnsonRoger Johnson, former president of the National Farmers UnionFarmers are “not unique, they’re like everybody else,” said Roger Johnson, who was president of NFU at the time and retired in 2020. They battle stress, addiction and other mental health challenges. What’s different, he said, is that historically, farmers have been reluctant to talk about anything related to mental or behavioral health, and often just as reluctant to seek out help. But as overdoses and suicides connected to opioid addiction grew in numbers, he recognized that farm communities were experiencing a new tragedy. “Every one impacts so many people,” he said of the lost lives. So he reached out to AFBF President Zippy Duvall. “We wanted to be sure that this was an absolutely nonpartisan, nonpolitical effort,” Johnson said.

Just a few years ago when the farm economy was struggling, Farm Credit Council President and CEO Todd Van Hoose said lenders started talking about how stressed many of their borrowers seemed. In response, Van Hoose said Farm Credit reached out to the university extension services that had developed training for USDA Farm Service Agency employees.

The material was designed to equip the employees with tools to recognize signs of stress in farmers and guide them to resources. Van Hoose said with about $115,000 from Farm Credit, the Michigan State University and University of Illinois extension services modified the training for lenders and then for the general public. The Rural Resilience: Farm Stress Training is available for free to anyone.

 "We were really after something different” than a crisis line, Van Hoose said, which was “to knock that stigma off, to let people talk about” their stress so they could get help before they reached a point of desperation.

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While it’s hard to measure impacts, Johnson said by the time of his last NFU convention as president — held immediately before the pandemic began in 2020 — sessions on mental health or farm stress drew crowds. “We had really, really good participation from our membership in those workshops,” he said. And NFU “agreed to kind of integrate [mental health] into our regular communication,” he added.

Todd Van Hoose, Farm Credit CouncilAs AFBF holds its annual convention in Atlanta this week, Ray Atkinson, director of communications, said the effort to normalize conversations around farmer mental health has become part of many aspects of Farm Bureau’s programs and services. When the pandemic hit, he said virtual options replaced some training that had been in person, but demand remained strong. This year’s convention featured a panel discussion about farmer mental health and offered a suicide-prevention training.


In pockets of the internet, some farmers began to open up about their personal experiences. One of them is Iowa dairy farmer Kevin Dietzel, who operates Lost Lake Farm. Working mostly alone with the cows and making their milk into cheese, Dietzel found the stress of starting a new business that required taking on significant debt and working seven days a week, often with little help, was getting to him. Now, he manages his anxiety and depression with a variety of tools and he’s also found support on Twitter.

Iowa cheesemaker and farmer Kevin Dietzel "I was having a really down day, and I just felt like I needed to blare out to the world that I'm hurting,” he said of his first tweet about depression.

It was a fresh outlet for his venting, and he said he immediately got very positive support. People sent him direct messages with their phone numbers and encouraged him to call if he wanted to talk. Others thanked him for being open about something they also experienced but weren’t “bold enough to say it publicly,” he said. 

Only once did he get a negative response “where somebody basically said, ‘quit complaining, life is hard for all of us.’” Dietzel said quickly his followers “jumped on this guy and just, virtually in the Twitter sense, beat him up and said ‘that's not cool.’”

Dietzel said his occasional tweets about his mental health have buoyed him during some of his tough times. He’s not engaged with many farm groups but said he’s noticed Practical Farmers of Iowa is including more programming around mental health “because they've been hearing from their members that that should be a priority.” PFI’s upcoming conference features a session called Stress on the Farm: Resources and Support.

In neighboring Nebraska, John Hansen, president of the Nebraska Farmers Union, says a hotline established in response to the 1980s financial crisis has been in service ever since. More recently, a program to offer farmers, ranchers and other rural residents a voucher to cover their first appointment with a mental health provider in their own community has expanded dramatically.

In 2019, he says flooding in the state lead to a “huge spike” in vouchers, to 2,263. In 2020 the number grew to 3,435; through November 2021 (December data is not yet in), that year’s tally was 8,118. He said this partly reflects a growing network of providers who accept the vouchers, but it also speaks to the increased need.

Hansen said the decades-long history of the Nebraska Rural Response Council, which sponsors the hotline and voucher program with many partners and is now under the auspices of Legal Aid of Nebraska, means it gets grant funding from various state and federal programs.

“That longevity has given us some real operating advantages because we have a track record,” he said. “We can actually get money out the door and get it to people who need it.” The Nebraska Department of Agriculture recently received a federal grant that Hansen said will send $360,000 to the mental health voucher program.

The federal Farm and Ranch Stress Assistance Network, launched by the 2008 farm bill, is currently funding four regional programs with $4.8 million each. In the prior round of grants, David Brown at Iowa State University coordinated the eight-state North Central partnership that he says provided "stress assistance programming" to 14,000 farmers and ranchers or their advocates.

As a licensed marriage and family therapist, Brown had an interest in getting more educational materials to rural residents. He now offers online trainings such as the evidence-based suicide prevention Question, Persuade and Refer (QPR) short program from the QPR Institute (the same one offered at the AFBF convention) and a longer Mental Health First Aid course, which teaches participants how to engage with people who are experiencing substance use disorder or other mental health conditions.

Currently, he said he’s distributing thousands of “farm stress packets” to agribusinesses so information and resources about mental health and substance use are ubiquitous in farm country.

Even with these ongoing efforts, a national survey conducted for AFBF and released in December found only modest improvement.

“Stigma around seeking help or treatment for mental health has decreased, but is still a factor,” the data show, “particularly in agriculture.”

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