Long distances and stigma: Telehealth seen as way for farmers to access needed mental health assistance
By Marissa Plescia, Midwest Center for Investigative Reporting December 8, 2020
Last month, Illinois farmers in a handful of counties received a new option to help alleviate their stress.
Southern Illinois University School of Medicine and the Illinois Department of Agriculture introduced a helpline for Illinois farmers on Oct. 28 — the first farmer-specific helpline in Illinois. While only available in six counties now, the plan is to extend it across the state.
The helpline comes as more and more telehealth options are being made available to farmers, who are among the most likely to die by suicide, according to a January Centers for Disease Control and Prevention study.
Along with farmer-specific helplines, farmers across the country can now seek help for mental stress through virtual counseling and online training, according to interviews with health professionals.
The COVID-19 pandemic forced many people to receive help virtually. According to a June report from the American Psychological Association, about 75% of clinicians were only treating patients remotely.
But the telehealth options for farmers have little to do with the pandemic. Instead, experts said, teletherapy can make mental health services more accessible and more confidential for farmers.
They don’t have to travel potentially long distances to receive help. Nor do they have to risk being seen at therapy, because there is a stigma of mental health issues in the farming community.
“Sometimes there will be more confidentiality because they’re not having to park their vehicle in front of the counselor’s office or have other people know that they’re even attending counseling,” Jessica Beauchamp, a Wisconsin Farm Center therapist, said about teletherapy.
Farmer-specific helplines and hotlines
Several Midwestern states — including Wisconsin, Nebraska, Minnesota and Iowa — also have a hotline or helpline specifically for farmers.
Illinois’s helpline is part of Southern Illinois University’s Farm Family Resource Initiative, which is focused on outreach, education and training to improve mental wellness for farm families. In addition to the helpline, the initiative includes free webinars and mental health first-aid training, which aim to help people spot warning signs of stress.
To start, the resources are available in Christian, Logan, Macon, Macoupin, Morgan and Sangamon counties. Depending on funding, it will expand to the entire state. However, there isn’t an exact timeline of when that will happen, said Karen Stallman, the university’s continuing education and professional development director.
Stallman said the calls to the helpline are answered by mental health specialists at the Memorial Behavioral Health clinic in Springfield. The staff members have all been trained in farm mental health.
If callers are interested in a follow up with an agricultural resource specialist, the staff members will forward them to Stallman, who can help them with additional resources in their county.
Virtual counseling
Wisconsin Farm Center recently introduced a new pilot program that includes a 24/7 hotline for farmers, as well as free, unlimited telecounseling sessions with Beauchamp. The hotline is meant for people who need immediate care, while the telecounseling services are for those who need ongoing care.
Beauchamp said the services are helpful because many farmers live in rural areas and often have to drive long distances in order to attend a session. Taking that much time means they’d have to figure out who will do the day’s work, she said.
Beauchamp also said teletherapy can be easier for family and marriage counseling. Oftentimes, one spouse works off the farm. Teletherapy allows them to attend services together from different locations.
Monica McConkey, a counselor in Minnesota, is also doing many of her sessions virtually, but she said most of her clients prefer speaking on the phone rather than via Zoom or Facetime.
McConkey agreed that virtual counseling is easier for those who typically have to travel long distances to access care, especially in the fall when people are harvesting. She also said some people feel more protected on a virtual platform compared to in-person counseling.
“If emotional things do come up, they’re not sitting face-to-face with people,” McConkey said. “We know a lot of our farmers, even just showing the emotion of crying is really hard for them when there are other people present.”
When internet connections become spotty, a familiar experience in rural areas, people can call on the phone, McConkey said.
However, some people need face-to-face care. Recognizing this, McConkey and Beauchamp both said they’re still seeing people in person while social distancing. To make their services more convenient, they often drive to their patient rather than make the patient travel and take time away from work.
McConkey isn’t just doing one-on-one meetings virtually. In August, she started a farm suicide support group for those who have lost loved ones to suicide. The group meets once a month online. The group is confidential because everyone who joins has to register first, she said.
While she’d like to have occasional in-person meetings once it’s safe, McConkey said meeting online is beneficial because people from all over Minnesota can join without driving long distances.
Online training
Online training programs are also available for people in the farming business.
McConkey launched an online course in November to help farm couples for a fee of $179. It’s meant for engaged couples and newlyweds, and it touches on farming basics, communication and stress.
Many couples enter farming not realizing the toll it will take on their marriage, she said. Oftentimes, one of the spouses did not grow up on a farm and isn’t as familiar with the business, she said.
Clients often discuss their marriage problems with her, she said, and the course is intended to help people understand farming’s stress before they start experiencing problems in their marriage.
“By the time they reached out, one of them was already heading out the door,” she said. “What I heard from them over and over and over was, ‘I had no idea it was going to be like this.’”
There are also online resources for people who want to learn how to identify warning signs in others. For instance, the USDA’s Cooperative Extension System, the American Farm Bureau Federation and the National Farmers Union created, with input from several universities, an online course titled Rural Resilience: Farm Stress Training.
The course contains three units: managing stress, communicating with distressed farmers and suicide awareness. The course is free and can be completed on the participants’ own time.
The course is based on in-person training sessions, but the online version was created to reach more people, said Courtney Cuthbertson, a University of Illinois assistant professor who helped develop the curriculum.
About 1,500 people have enrolled in the course since it opened in June, they* said. They stressed that people don’t need to be a mental health professional in order to help someone in need.
“I think that with the amount of stigma around mental health, sometimes people are really hesitant to offer help. They don’t know what to say or do, they’re worried they’ll do the wrong thing,” Cuthbertson said. “So the course is really important to be able to normalize these conversations and make it easier for people to reach out and ask for help when they need it, because it is so difficult to reach out and ask for help.”
Beauchamp, the Wisconsin therapist, is hopeful that the virtual options will allow more farmers to seek help.
“I think in the past,” she said, “we haven’t been able to reach farmers for a lot of these services, even though they want them and need them, because there was no way to be able to leave what they were working on to come in and get services.”
