Human Risk Emotional Health in Farm Populations Rebekka
Human Risk: Emotional Health in Farm Populations Rebekka Dudensing, Ph. D Extension Outlook Conference, Atlanta, GA, September 25, 2018
I am NOT: A psychologist, sociologist, or heath researcher Collaborators: Samuel D. Towne 1 and Carly Mc. Cord 2 2 Research Assistant Professor, Texas A&M University School of Public Health, Department of Health Promotion & Community Health Sciences, 3 Director of Clinical Services, Licensed Psychologist, Texas A&M University School of Public Health, Texas A&M Telehealth Counseling Clinic, Center for Community Health Development
Farmer and Farm Worker Suicide, Mental Health, and Substance Abuse • Farm workers rank 3 rd in suicide completions (~50/100 K) (CDC 2016) Suicides, 2008 -14 Source: CDC. • Overall US suicides trending up (CDC 2018) • Above average selfreported substance abuse (10. 5%) (SAMSHA) Opioid Rx, 2016 Source: CDC.
The Issues • Stressful occupation w/ factors outside control • Hard economic times • Isolation • Unique skills • Business-farm-home blurred lines • Sense of responsibility to family, including prior generations • Independent, self-sufficient mindset • Stigma around mental health
Other issues • Lack of rural mental health providers • Possible neurological effects of pesticide exposure • Access to lethal means • Women more likely to experience stress • Children may act out, be sick, or experience symptoms like bedwetting
Prevalence of Binge Drinking Among US Adults, 2015 Intensity of Binge Drinking Among US Adults, 2015
Meatingplace Magazine, January 2017
• Getting people back to work quickly after an injury prevents depression • Employer treatment referrals for substance abuse have better success rates than self-referrals or family-referrals • Meatingplace Magazine, January 2017
Many farmers are self-employed • Who gives them the ultimatum? • Who takes care of the farm while they get help? • Who takes care of their family if they don’t? • Who lets them know their struggles are not hidden and don’t need to be suffered alone?
Resources and Considerations • The Rural Community – “taking care of each other” • Extension • Bankers • Cooperatives • Neighbors and family • FSA/NRCS • Programming to address causes and effects of hard times and reduce shame • Programing and resources to recognize signs and toss out lifelines
Signs and Symptoms of Stress Feelings or behaviors: • tension • exhaustion, restlessness, • anxiety • irritability • drug/alcohol misuse Physical symptoms: • headaches or dizziness • changes in appetite • upset stomach, • diarrhea • backaches Managerial changes: • ineffective management • reduced productivity Lubbockonline. com
Signs and Symptoms of Depression • Sadness, discouragement, or hopelessness • Reduced activity and pleasure • Withdrawal or feelings of isolation • Guilt • Reduced self-esteem • Physical symptoms as with stress Outward Signs of Depression • Changed routines (e. g. , avoiding the coffee shop) • Sad or unkempt appearance • Reduced care of livestock or farmstead • Increased accidents resulting from fatigue or inattention • Distressed family members, including children
Signs of Alcohol and Drug Abuse • Drinking more than intended • Being unable to stop or cut down on drinking • Drinking more to get the same effect • Finding that the usual number of drinks doesn’t have the same effect • Getting into risky situations after drinking • Trouble with family or friends stemming from drinking • Drinking or hangovers interfering with work or other activities --National Institute on Alcohol Abuse and Alcoholism, 2016
CAGE Alcohol Screening CAGE=Cut down, Annoyed, Guilty, and Eye-opener 1. Have you ever felt you ought to cut down on your drinking or drug use? 2. Have people annoyed you by criticizing your drinking or drug use? 3. Have you felt bad or guilty about your drinking or drug use? 4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?
Warning Signs for Suicide • Anxiety • Depression • Withdrawal from friends and activities • Alcohol and/or drug abuse • Refusing to take or hoarding medication • Aggressive behavior or irritability • Making a will or final arrangements • Giving away possessions • Talking of or hinting at suicide • Suggesting people would be better off without him/her • Frequent thoughts of suicide with a plan in mind
QPR Suicide Prevention QPR = Question, Persuade, Refer • Ask a question. Save a life. • Asking will not give someone the idea to commit suicide.
Have you considered suicide?
I’m noticing some things that worry me. How are you mentally and emotionally?
I care about you, and I’m here if you need to talk.
Then What? • “Ask them if they are thinking about killing themselves. • Listen without judging and show you care. • Stay with the person (or make sure the person is in a private, secure place with another caring person) until you can get further help. • Remove any objects that could be used in a suicide attempt. • Call SAMHSA’s National Suicide Prevention Lifeline at 1 -800 -273 -TALK (8255) and follow their guidance. • If danger for self-harm seems imminent, call 911. ” --SAHMSA Suicide Prevention Website
Then what? • National Suicide Prevention Lifeline: 800 -273 -TALK • Farm Aid: 800 -FARMAID (800 -327 -6243)
Then What? – Rural Reality • Help your neighbor contact local medical or mental health professionals, Mental Health and Rehabilitation Services (MHMR), or substance abuse center to find resources and make a plan, recognizing there may be wait times. • Travel to regional service centers • Farm support during hospitalizations or in-patient programs • Non-judgmental support for family members • Veteran-specific resources (e. g. , Military One. Source)
Programming • Understanding external factors that affect farm economics and explain farm statistics • Transmitting farm skills to new (or second) jobs • Understanding how stress affects farm management as well as farmers and farm families • Decision making during hard times • Why? What about that? How else? • FCS, Ag Leadership, OD, Community Development • Stress management
Stress Management • Identify sources of stress. • Engage social support systems. • Use new and existing resources. • Stay physically healthy. • Reframe stressful situations. • Make time for fun. • Identify a shared mission.
Resources • Surviving the Farm Downturn • Farm Families and Mental Health • Preventing Farmer Suicides http: //ruralcommunities. tamu. edu • Fetsch and Williams, CO State: http: //extension. colostate. edu/disaster-web-sites/farm-and -ranch-family-stress-and-depression-a-checklist-and-guidefor-making-referrals/ • Personal Nature of Agriculture, WY: http: //www. uwyo. edu/fcs/faculty-staff/weigel/life/personal -nature-agriculture/index. html Email me if you need a co-branded factsheet or slides.
Thank you. Rebekka Dudensing, Ph. D Extension Economist – Community Economic Development Department of Agricultural Economics Tel. 979. 845. 1719 rmdudensing@tamu. edu @rmdudensing http: //ruralcommunities. tamu. edu
Farmer and Farm Worker Suicide, Mental Health, and Substance Abuse Suicides Source: CDC. Opioid Rx Source: CDC. Mental Health Providers Source: Newsweek. Health Professional Shortage Source: RHIHub.
Geographic Economics of Health Services Provision
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