Overcoming barriers to improving the mental health of Minnesota farmers

INTERVIEWER: Don't know if you saw the recent data from the Centers for Disease Control. They show that nearly 60% of Minnesota's gun suicides happened in greater Minnesota. And to help, just last week, the state department of health led a training on mental health for faith leaders. But what more is needed? And what do political candidates and policymakers need to know about people's lives in rural Minnesota to help them?

Monica Kramer McConkey grew up on a farm and is one of two mental health professionals hired through the state to provide free mental health support for farmers. Monica owns Eyes On The Horizon, an agricultural mental health consulting business. She joins us right now to talk about her work. Hey, Monica. How are you?

MONICA MCCONKEY: Hi, good. Thanks for having me.

INTERVIEWER: Great. I'm glad you're with us. Well, how would you describe what you do to folks?

MONICA MCCONKEY: I am a mental health counselor. And right now, my primary role is providing counseling services to farmers and ranchers and their families throughout the state. So every day, I'm either out on the farm, sitting around the kitchen table, talking about whatever the stressors or struggles they're dealing with, or I'm doing some virtual sessions or on the phone with farmers.

And I also do training and education around rural mental health, stress and agriculture, suicide prevention, how to become more agriculturally competent, like for our rural mental health and physical health medical providers. So that when a farmer walks into their office, they can kind of connect and relate in a better way.

INTERVIEWER: Because you grew up on a farm, you are very knowledgeable about what folks on the farm need, right? But for city folks, I don't think they understand. What makes rural behavioral health different from suburban or urban mental health work?

MONICA MCCONKEY: There's a few key differences. One, of course, is just access. Our rural folks often have to drive an hour minimum on average to get to a fair-sized town or city, where there are behavioral health services. And so when you're talking about the workload for farmers, they are hesitant to drive an hour, meet with somebody, drive an hour home, and they've lost half their day.

So access is one we also know that in rural areas, the mental health workforce is limited. It's really difficult for our rural agencies and organizations to recruit and retain therapists, psychologists, psychiatrists. And that they typically go to more urban areas to practice.

I would also say many of our farmers and farm families, they're self-employed. So their insurance often has high deductibles, high co-pays. So there is a financial piece to seeking help as well. And then I don't think we can talk about this without talking about the stigma in rural areas. That in our small towns, you are not anonymous. And so people will see your vehicle or see you. And if you're seen walking into a mental health agency or if people know you're struggling, everybody knows. And so it adds to the feeling that we need to kind of cover up or hide our vulnerability so that people don't know we're struggling. Where in urban areas, it's possible to be anonymous, it's possible to go places and for people to not know you.

INTERVIEWER: I understand. Is there something also about what I've heard termed "farm stress" that plays into this? That it's just something different that other folks can't quite understand?

MONICA MCCONKEY: Oh, for sure. The unique nature of the stress that our egg producers encounter is very different. And that is often not understood by people not in touch with agriculture. So at the top of the list would be all of those uncontrollables that include the weather, that include commodity prices. Like, farmers don't set the rate for what they're selling their product. It's set for them. And they don't have a lot of choice in that whole option.

It's income is inconsistent at times, just depending on when commodities are sold. There's the stress of just continuing the family farm that has been in the family for generations. So I know personally, our family farm has been in the family for now five generations.

And so there is that derive or that pressure to keep it going because there's been generations of people that have worked so hard to keep the farm afloat. And right now, we're seeing, especially as the average age of our farmers is 60, we're seeing the reality of sometimes there's not someone in the next generation to pass the farm to. And so that adds another element of grief and loss into the mix of all of the other stressors.

INTERVIEWER: So you're at the mercy of a lot of different things on the farm that I think people don't understand, the weather, as you say, the markets, corporations, and the stress of just not knowing who's behind you in terms of taking over the farm, yeah. Is that why do you think the gun suicide rate in greater Minnesota is nearly twice as high as the Twin Cities?

MONICA MCCONKEY: Well, I think there's a few factors there. Obviously, out in greater Minnesota, we have a large hunting population. And so many households have multiple firearms for hunting. I don't know that I know a farmer that doesn't have some type of firearm in their possession for a variety of reasons. Sometimes, it's for safety, for livestock. Sometimes, they have to put down animals that are sick or injured. Sometimes, there are predators. It's a variety of reasons, but I think it speaks to the accessibility of means when we're talking about suicide.

INTERVIEWER: So with everything that you've just outlined, what would you hope for in terms of help from, say, the federal government, state government, politicians out on the campaign trail to address some of these issues?

MONICA MCCONKEY: I think Minnesota is really ahead of the game as far as addressing programs to help the mental health of their ag producers. Other states are envious of Minnesota for the programs that we have. Minnesota department of ag is very in-tune to the issues on the farm. So I just-- I want to start with that, that we have a lot of really good things happening.

The trainings for rural clergy, that was a collaborative effort between the Department of Ag and the Department of Health. We are so fortunate to have those relationships across our state departments that can make something like that happen.

Another plus in the state of Minnesota, of course, is the program that funds my position, and Ted Matthew is my counterpart. That this is legislative funding. One of my hopes would be that that, of course, continues. That we are able to maintain our services for our farmers and ranchers.

And I think really looking at when federal monies come in for whatever-- disaster, natural disasters, COVID-- but they're earmarked for rural, I think it's really important that we talk to the stakeholders and the residents of that community to get a feel for what is needed versus making decisions in Saint Paul thinking we know. And I think our state does a good job of that. I think the commissioner, Tom Peterson, is in touch with our farmers. And he's out and about and he's listening.

And one thing for our farmers is there's a lot of criticism in the media today around food production, around care of animals, around care and sustainability of the land. And it's hard when our farmers are really doing the best that they can for not 100%, but by far the most. And they see these things on social media basically painting them as really cruel human beings. And so I think when we can show support to our farmers and ranchers, that goes a long way, too.

INTERVIEWER: There's so much to talk about here, my goodness. I'm so happy you took time to outline some of the problems here for us, Monica. Thank you so much and all best.

MONICA MCCONKEY: Thank you.

INTERVIEWER: That was Monica Kramer McConkey. She's a mental health counselor for Minnesota farmers. And she owns Eyes On The Horizon, that's an agriculture mental health consulting business based in Detroit Lakes. If you or someone you know is thinking of hurting yourself or someone else, call 988. And if you work in agriculture and you're struggling with mental health, I'm going to give you this number to call, 833-600-2670. If you don't want to talk to a person, you can email somebody at farmstress@state.mn.us.