Know the Signs, Ask a Question, Save a Life

Farming can be an extremely rewarding profession, but it is also a lifestyle fraught with uncertainty and stress. Couple that with a farmer’s general reluctance to ask for help and you have the potential for a dangerous buildup of psychological distress. More to the point, the National Rural Health Association reports that farmers are 3.5 times more likely than the general population to die by suicide (Eisenreich & Pollari, 2021).

But there is hope. As more farm families have been willing to talk about suicide, agencies—including Penn State Extension—are making resources available to help farmers and farm families recognize the signs of distress and intervene to save lives.

Factors

Uncertainty and a feeling of helplessness are often the leading causes of farm stress. Events such as bad weather, market fluctuations, pest outbreaks, large debt loads, government regulations, high interest rates, and livestock illnesses are largely outside our control. But we are still forced to deal with them. Add to those a host of non-farming events—such as a family conflict; being fired; or a loss of a significant relationship because of death, divorce, or a move—and it’s no wonder things begin to feel hopeless.

Often, this is where it can help to talk with a professional. Unfortunately, there still tends to be a cultural stigma in rural areas when it comes to seeking mental health treatment. Because of this, a farmer who is in serious distress may be reluctant to seek help. This is reflected in a study released by the Center for Rural Pennsylvania (Mallinson et al., 2021). This study found that the rural counties in Pennsylvania had a 25% higher rate of suicide than urban counties. There isn’t an easy solution to the current crisis, but there are some things each of us can do to help those who are struggling. First, learn to recognize some of the warning signs; next, intervene if you see them; and, finally, refer them to professionals who can help.

Warning Signs 

One of the most direct ways we can help is simply by being attentive to the warning signs of someone in distress. The QPR Institute, a national suicide-prevention organization, teaches us in its suicide prevention Gatekeeper Training (Quinett, 2019) that a distressed person often feels relief and hope when someone reaches out to help.

Here are a few behaviors you should look for:

• talking or posting about wanting to die
• talking about feeling trapped or being in unbearable pain
• feeling like a burden
• increasing their substance use or relapsing after a period of recovery
• exhibiting extreme mood swings
• isolating themselves
• giving away prized possessions
• putting personal affairs in order

In addition, the Pennsylvania Department of Agriculture (n.d.) reminds us of some farmer-specific warning signs:

• a decline in the quality of care for their crops, animals, and farm
• an increase in farm accidents
• uncharacteristic changes in routine
• an increase in physical complaints

Intervention

Remember that these warning signs may or may not be an indicator of suicidal thoughts. But, as awkward or difficult as it may be, you should reach out to the person to check. Approach the individual, address your concerns about the behavior changes you have observed, and offer to listen and help. During the conversation, it is important to find out if they are suicidal. The clearest way to do this is compassionately to ask, "Are you thinking about killing yourself?" or "Are you thinking about suicide?". By asking them directly if they are thinking of suicide, there is no confusion and, if they say yes, you can take action to support them, keep them safe, and connect them with resources to help.

Referrals and Resources

The last step in the intervention is referring the person to professional mental health care. Stay with the person and keep them safe by removing access to lethal means, such as guns, medications, car keys, rope, etc. Then, reach out to available suicide-prevention resources, such as the ones listed below.

Resources:

• AgriStress: 1-833-897-2474. They are a suicide lifeline dedicated to agricultural, forestry, and fishing communities trained to understand farmers' specific stressors. They have a translation capability of 160 languages, and all calls are answered within 30 seconds. Callers also are offered a connection to helpful resources.
• Pennsylvania Department of Human Services: 1-855-284-2494. They offer free crisis counseling for anyone feeling stressed or overwhelmed. TTY call 1-724-631-5600. Text "PA" to 741-741. They are available 24/7.
• The National Suicide and Crisis Lifeline: 988. It is staffed by a crisis counselor and is available in English and Spanish. You can also text 988 or chat at 988lifeline.org. TTY is also available. It is available 24/7.
• Plain Communities Helpline: 1-717-989-8661. They are available through WellSpan at Philhaven, an outpatient clinic that provides high-quality mental health care that is sensitive to the values of the Plain Community.

Among the greatest strengths of farming and rural communities is how tight-knit and supportive community members are to each other. Farmers are often the first to help another farmer in need, and, in small communities, neighbors are usually always willing to lend a hand in a time of crisis. Let's continue to build on that strength and support those in distress by asking the questions that may save their lives. Don't wait to act if you notice a change in your friend, family, or neighboring farmer. Reach out and ask if they need assistance or are having suicidal thoughts. Your courage to ask the question can save a life!

Do you want to learn more about how to help others through times of mental health distress? You can find additional training resources offered by Penn State Extension.

Sources:

Eisenreich, R., & Pollari, C. (2021). Addressing higher risk of suicide among farmers in rural America. National Rural Health Association.

Mallinson, D., Yoo, E., & Cruz, B. (2021). Suicide trends and prevention in rural Pennsylvania counties and schools. Center for Rural Pennsylvania.

Pennsylvania Department of Agriculture. (n.d). Mental wellness resources for the agriculture community.

Quinett, P. (2019). Question, persuade, refer: Certified QPR gatekeeper instructor's manual (4^th ed.). QPR Institute.