The Yellow & Blue Podcast | Mental Health in Agriculture | S1E5

Listen on Spotify

Associate professor and Extension specialist Andrea Bjornestad is researching key mental health issues affecting individuals in the agriculture industry. Her research has gained regional attention, prompting others to take action and work to provide resources to farmers, ranchers and families. Learn more about her research, outreach and what's available in a critical time of need. 
 
Sensitive content: The following content discusses mental health, suicide and related topics, which may be distressing. If you are feeling overwhelmed or in need of support, please seek help from a mental health professional or contact a crisis hotline.
 
Suicide and Crisis Lifeline: 988
SD Help Line Center: 211
Avera Farm and Rural Stress Helpline: 1-800-691-4336
 
[Andrea] 
I was speaking at an event and the spouse took the microphone with tears running down her face, and she said, “I'd rather lose the animals than lose you.” 
 
[Heidi] 
Hello, Jackrabbits Nation. My name is Heidi Bushong, and this is the Yellow & Blue Podcast. We are back in Yeager Hall in Yeager Multimedia Studio, which has received a new look, and we're excited to be talking about a topic today that is very important to all: mental health. At South Dakota State University, associate professor and Extension specialist Andrea Bjornestad is researching key mental health issues affecting individuals in the agriculture industry. 
 
[Heidi] 
She is here to talk about her research, outreach and resources. Thank you for being here today, Andrea. 
 
[Andrea] 
Thanks for having me. 
 
[Heidi]
Andrea, you said you have a very unique position here on campus because you work both for SDSU and for Extension. Tell me a little bit about what you do here at SDSU. 
 
[Andrea] 
Well, most of my work is in SDSU Extension. So, since we are a land-grant university, we do a lot of outreach across South Dakota, and most of our outreach is research driven. So, I combine both of them. And I'm an invited speaker across South Dakota as well as within the region and nationally on agriculture, behavioral health. So, I travel and work with producers on their mental health, talk a lot about stress, depression and anxiety, what those things look like and how to manage some of that, and also when to know when to seek mental health services. 
 
[Heidi] 
Yeah, absolutely. When you hear mental health and agriculture, people may not necessarily think it's something that like goes hand in hand, like, “Farmers don't have time to think about it,” or, you know, “They don't necessarily seek help.” How did you decide to get into your work? 
 
[Andrea] 
Well, my first year as an assistant professor at SDSU, my department chair asked me if I wanted to be part of Extension, and so I said, sure, why not? And a lot of, a focus of Extension is within agriculture. And my dad is a farm machinery dealer. I grew up in small town South Dakota, and so farmers were constantly on our yard. 
 
[Andrea] 
And so, I thought, I wonder what the mental health is like. Yeah, with farmers and ranchers. So, I could combine my area of expertise. I'm a licensed professional counselor with a big focus and in Extension. So, I actually conducted my first study, I think, back in 2015, on social support and depressive symptoms in farmers and ranchers, and my sample was included South Dakota farmers. 
 
[Andrea] 
And what I found was concerning. And I published the results, and it gained regional attention, because people weren't really aware at that time that there was a concern. And so, all of a sudden, I'm being invited across South Dakota. I traveled numerous times. Sometimes I'd hit Rapid City, Pierre and Sioux Falls all in one trip because everybody wanted to talk about the increased suicide rate in farmers and ranchers. 
 
[Andrea] 
So that's kind of what led me into my work. And, so I started speaking, in front of farmers and ranchers and started talking about stress. But when I started, people told me, you'll never get ... You'll never get farmers to talk. Never, never. And what I found is completely opposite. Yeah. And so, granted, I am a counselor, and so I'll stand up there and I start with stress. 
 
[Andrea] 
Let's talk about stress. What does that look like? What does that feel like in our bodies? Because we all experience stress. I'm pretty sure you've had some stress today, too. 
 
[Heidi] 
Oh, absolutely. Yeah. 
 
[Andrea] 
So have I, and so being able to recognize, OK, what are my physical symptoms? What are my emotional signs? All these sorts of things. But I'll stand up there and I'll say, “Well one of my signs is I'll start forgetting things.” I already forgot something this morning, you know, and, so once I disclose my stress signs, they start thinking, “OK, well, she's a counselor. 
 
[Andrea] 
She's got stress. Well, I can share my stress, too.” So, they actually pass the microphone around and start talking about their stress. Yeah. And it's really cool to see. And then somebody else raises their hand. It'll pop into their mind. “Oh, yeah, I understand.” And then they'll want the microphone. Yeah, they'll talk about it. And then I lean into, “You know I'm not so great at talking sometimes. 
 
[Andrea] 
How are you guys? How do you cope?” 
 
[Heidi] 
Mhmm. 
 
[Andrea] 
And then we talk about depression, anxiety. They'll talk. 
 
[Heidi] 
You just, you just need to know how to get there. 
 
[Andrea] 
Yes. 
 
[Heidi] 
And that's where the counseling skills come in. 
 
[Andrea] 
It is helpful. Yes. Yeah, absolutely. 
 
[Heidi] 
So you said you started your research back in 2015. Tell me a little bit more about your research and the studies you complete here at SDSU. 
 
[Andrea] 
Sure. So, every research study is kind of built off of each other. So, my first one focused on social support and depression, depressive symptoms. And what I found is that family support is important in reducing depressive symptoms, as well as community support. Then it led me into regional study with colleagues from Michigan, Kansas, Missouri, and we also surveyed South Dakota farmers. 
 
[Andrea] 
And what we found was, we had a sample size of about 600 [people], and 29% reported mild to severe depressive symptoms or depressive symptoms, and 27% reported mild to severe anxiety symptoms. So, when you think about that, it's a little over one out of every four farmers reporting on some type of, you know, mild to severe anxiety or mild to severe depression. 
 
[Andrea] 
And, so when I present, you know, I bring that up in the room and I say, look around the room, you aren't alone if you are struggling with these things because you're, you know, … one out of every four of you are struggling. Yeah. We also found 7.6% risk for suicide, which doesn't seem that large. However, when you're talking suicide, any type of percentage, you know, feels like a great amount. 
 
[Andrea] 
What was significant about that study, though, is that we ran multiple linear regression analysis, which is just a fancy term for trying to figure out what factors were most related to suicide risk. And the unique part of this study is mental illness was not significant. So, when you think about mental illness, you know, we measure depression and anxiety. 
 
[Andrea] 
They were not significant. The only factor that was significant was self-blame, self-blame. So, then I talked to farmers and ranchers about “How do we see self-blame?” Self-blame is blame, is a very internal part of us, right? We might have some language that suggests we're having some self-blame, right? But I could have done that differently or, you know, those sorts of things. 
 
[Andrea] 
But how do you see that someone is suffering and struggling with self-blame? It's very hard. So, my study is very unique, and it has kind of initiated a global conversation on, OK, where should prevention efforts be? Do we focus more on coping? Because a lot of programming is thrown out about depression, anxiety. Let's educate on those sorts of things. 
 
[Andrea] 
And I'm not saying we shouldn't because, again, depression, anxiety we know are related to suicide. Depression is just not a great predictor of suicide. So, that was that study. My last major project has been a comprehensive needs assessment across South Dakota. So, we interviewed key informants, so key leaders in agriculture. We interviewed farmers and focus groups. 
 
[Andrea] 
We had 115, which is rather large for focus groups. And then I mailed 10,000 surveys. And so right now I'm analyzing all that, starting to share some of the preliminary results. But this study is unique because I have 60% males and 40% females. Wow. Yes. And you would be surprised because most of the females indicated that they are primary operators or partner operators on the farm. 
 
[Andrea] 
Good. 
 
[Heidi] 
I love to hear that. Yeah. 
 
[Andrea] 
Which is not typically thought of. However, I think people need to be aware of the fact that spouses are more engaged on the farm than what is typically thought of. Oh yeah, what's also interesting is with preliminary findings, I can't say for sure if they're significantly different because I'm not that far into my analysis. But females are struggling just as much as males are. 
 
[Andrea] 
Yeah. So a lot of our work in Extension has focused on, and I'm not just talking about South Dakota work, I'm talking about regional work. Most of it has been focused on males in agriculture. But we need to start working more on a systemic level of thinking about the farm family and the interaction within the producer, spouse and children. 
 
[Heidi] 
Yes. You bring up a lot of interesting points, and I can't wait to get into them. Let's talk a little bit about the unique stressors. Obviously, mental health is a very complex topic to begin with, but it is especially for those within the ag industry. You talked about elevated suicide risk. The National Rural Health Association says that farmers and ranchers are three and a half times more likely to die by suicide than the general population. 
 
[Heidi] 
And that is a very unfortunate statistic. Why do you think that is something that exists like the unique stressors? I feel like, common thing that people may hear is, “No one understands, like what the farming and agriculture life is like.” Let's talk about some of those unique stressors and things that you hear from your samples. 
 
[Andrea] 
I actually hear that quite a bit from farmers that they referred to the townsfolk or city folks, even small towns, you know, the differentiation between what they do during the day compared to what townsfolk do or city folk do, and they don't understand what we do. They don't understand how food gets to the table, that sort of thing. 
 
[Andrea] 
So, some unique stressors are, you know, things such as weather. Oh, yeah. Market prices, tariffs, input costs. They're looking at high for example, high cost for pesticides. You know, time on the farm is tight, and it's very time intensive if you think about it. Their farm is their family, it’s their business. 
 
[Andrea] 
It's their individual identity. And so, when you get that where it's all interrelated together, you don't really, you don't really have an escape. But some farmers will say, “I love that I step outside, I'm in nature.” Yeah. “I get to watch my crops grow or I get to watch my animals, from little to big,” and they'll reflect on that. 
 
[Andrea] 
That's one of their most favorite things. However, they don't escape the stress. Like we work on campus, we get to go home, and maybe we have a different kind of stress at home. But our work essentially can somewhat be separate. Yes, theirs is not separated. There's that interrelatedness. So, but out of all those, so we have some issues with succession right now, too. Some of the younger generation, they don't want to take over the family farm. 
 
[Andrea] 
Yes. Because of the financial situations that are happening within agriculture. So, there's some tension there, some family tension of, I had 96-year-olds completing my survey who are still farming. Yeah. So, maybe we have grandpa who still wants to farm. Then we have dad, and then we have whether it's sons, daughters, spouses, all of these people together wanting a voice so you can end up with some tension on the farm. 
 
[Andrea] 
But out of all those things I talked about, a lot of their stressors are outside their control. Yeah. So how do we help them control things they can't control? Yes. And that's a challenge in mental health because a lot of our work is OK. Focus on what you can control. Well, when most of my job is out of my control, that makes it hard, right? 
 
[Heidi] 
Yeah. Well, most of your job is out of your control. Your family livelihood could be involved. And also, when you're farming, you're probably in a very rural environment. And it can be very isolating. 
 
[Andrea] 
It can be. Absolutely. And that's why, you know, social support is important whether it's, you know, friends, family, community support, all those things are critical. 
 
[Heidi] 
Through your research and your surveys of people who are working, you try to understand these unique stressors better to kind of like empower other counselors, right? 
 
[Andrea] 
Yeah, absolutely. 
 
[Heidi] 
Tell me about that. 
 
[Andrea] 
Well, one of, the largest concerns that I've encountered as I've been speaking across South Dakota as well as within my focus groups I conducted is mental health providers don't understand agriculture. So, this with grant funding. Two of my colleagues, Dr. Jay Trenhaile and Dr. Naomi Timm-Davis and I, we actually offered a seminar on mental health in agriculture this summer where we trained mental health providers on agriculture, and graduate students also attended. 
 
[Andrea] 
But we had a panel of farmers talk for about an hour and a half and share aspects of their lives, and some of it, you could see the eyes popping in the audience of one farmer said, “You can lose $50,000 in one decision.” 
 
[Heidi] 
Oh 100%. If not more. 
 
[Andrea] 
If not more. And so, there was just a lot of astonishing reactions because counselors aren't aware of all the decisions that go into agriculture. And one of them reflected, “I almost didn't make it here today because I had to chase a calf back into the pasture. And I was getting a little nervous, you know, just being like, ‘OK, where is he?’” 
 
[Andrea] 
Yeah. Yeah, and they had to chase the calf back ,and so we had a farmer panel, we had an Extension panel where my colleagues in agriculture talked about various aspects of their work, but also what to consider when interacting with farmers, like there's a difference between West River and East River. 
 
[Heidi] 
And they’ll let you know it, too. 
 
[Andrea] 
Yep. So, it was a really exciting training. And I'm hoping with grant funding I'll be able to offer it again, but agriculture is its own culture. It's different. And we need to understand that it's different. And that was my hope with training counselors within that area. 
 
[Heidi] 
What was some feedback you got from different counselors and health professionals? 
 
[Andrea] 
Oh, they thought it was great. They it was eye opening for them that they didn't realize some of the different stressors. And how, kind of how severe the suicide risk is. And, you know, I talked a lot about how there is a hypothesis out there right now that farmers go through the suicide cycle faster. So, we talked a lot about that. 
 
[Andrea] 
And it's important for counselors to understand farm family dynamics, too, that it's different than other families, especially when you have multiple generations interacting together and maybe even living on the same farmstead in different houses. So, we talked a lot about that, too. 
 
[Heidi] 
Absolutely. When we're talking about mental health professionals, there's like a series of reels on Instagram. I've seen where it's like. It must be two nurses at a nurses station in the E.R., and they're kind of doing a spoof video, and it's like, “Yeah, this farmer called said he was gonna come in,” and they're like, “Did they say, like, his wife should tell him to come in?” 
 
[Heidi] 
And you're like, “No, he just said that he was having some issues.” And then they're like, things are not so nonchalant. And then they're like, “Oh no, it's a farmer asking for help. Like, this must be really serious.” I feel like there's a really big stereotype and a really big stigma about farmers and people in agriculture asking for help. 
 
[Heidi] 
How do we combat that stigma, so to speak? 
 
[Andrea] 
I think we just need to keep talking about it. I feel compared to when I started in this area in 2015, there has been a lot of federal funds provided for different programming in different states on mental health and agriculture. And since 2015, I think that we've helped normalize that you're not alone. If you're struggling with various aspects of farming, maybe your mood is up and down. 
 
[Andrea] 
Maybe you feel like your heart's racing all the time, or you can't sleep at night because you're worrying about too many different things. You're not alone. And so, the more we talk about it, the more they realize that. And we just need to keep talking about it. I do feel like COVID, you know, COVID actually to me helped a little bit because I don't know if you remember, but a lot of social media was about mental health. 
 
[Andrea] 
Because everybody was struggling with mental health. I don't know about you, but there were times I was laying on my bedroom floor trying to breathe because I was trying to school, you know, educate my kids. They were doing their online training, online school while I was trying to do my job. You can't really leave the house. This is, you know, when it kind of first started, couldn’t really leave your house. 
 
[Andrea] 
So, there was a lot of education being pushed out about mental health and stress management and that sort of thing. And everybody was talking about it. Yeah, you're right. Everybody was talking about it like, oh, I wish I could leave the house. And there were memes everywhere. Funny stuff. Some not so funny stuff. Yeah. And I think that helped as well as we continue to talk about mental health and, and I think we, we also have to realize that mental health is our optimal state of well-being. 
 
[Andrea] 
It is not depression. It's not anxiety. It's where we work to strive to be, have adequate wellness. 
 
[Heidi] 
Yes. 
 
[Andrea] 
So as long as we keep talking about that from a wellness framework, that helps.
 
[Heidi] 
Absolutely. We kind of mentioned the rural aspect. Has that been part of your research at all? In terms of like resources available, you know, in some rural areas, they may not have direct access to what they need or, you know, they may be 50, 100 miles better from a hospital or licensed therapist. What does that look like in South Dakota? 
 
[Andrea] 
Well, it’s definitely a challenge. We know that mental health access is limited in certain areas in South Dakota. If you look across the state, most counties are in a state of low access of mental health care. So, there are different two state communities that I serve on where we talk about, well, how do we solve this issue? 
 
[Andrea] 
You know, broadband access is also an issue in certain areas. You know, I presented on Pine Ridge a few years ago, and there are so many dead spaces out there that, you know, even having any type of telehealth service would be very challenging. So, we need to, you know, start working on that as a state. How do we solve these issues? 
 
[Andrea] 
I do think I'd like to see more work on combining health care, mental health care. So, for example, you know, small town South Dakota, maybe there's a medical doctor or PA, NP that serves, you know. Think, for example, I grew up in Canastota. Yeah. So you know, there's a mental health provider or doctor in Canistota. Well, why not pair it with a mental health provider and provide both services or expand, you know, offer more services within these small towns that already have medical providers that are traveling to these areas. 
 
[Andrea] 
So, oh, cost is also a concern for mental health care. Depending on what insurance companies do or do not cover, we do know with producers that one of the things that they'll stop investing in is health insurance. If they're really desperate on the farm with their finances. Yeah. So costly expense. Yeah. So, if they eliminate their health insurance, that takes away any opportunity, probably for mental health. 
 
[Andrea] 
And if they're struggling with their finances, they're not going to invest in their mental health. So those are things that we're aware of. About two years ago, I worked with the Department of Social Services and the Department Ag and Natural Resources, and we developed an agriculture voucher program, which was free counseling across South Dakota for farmers and ranchers and their family members. 
 
[Andrea] 
It was very successful. We issued 92 vouchers, over 500 sessions. Each person averaged about six sessions, and I secured funding to offer it. Well, depending on if the funding comes in for it to offer next year again. So, I'm very excited about that. To try to offset some of the cost as well as working on that access component. A lot of places offer tele mental health within that program, too. 
 
[Heidi] 
So when you did that voucher program, and you said that people were doing six sessions or more like that was kind of the retention? 
 
[Andrea] 
Six was about the average. OK. Yeah. 
 
[Heidi] 
But the fact that, like, there are repeat visits is a huge deal, and I don't know, I think that's really encouraging. And when you say that you're securing funding for future programs, I think it shows that you are making a difference and that these things can work. 
 
[Andrea]
Absolutely hope so. With mental health, it's really hard to understand what kind of impact you're having because, you know, I don't know how many people are thinking about suicide, but I do know, you know, whether I speak to a room of five people or 500 people, I sure hope I'm reaching somebody who's struggling. And I would say most of the time after presentation, like I just presented out in Rapid City last week, I had six, seven, eight people waiting in line to talk to me afterward, and some of them shared, “I know this person struggling. 
 
[Andrea] 
Do you have any resources for this person?” Or, “My, family just went through two suicides” and sharing their personal story, so I don't know who I'm reaching, but I sure hope that whoever is listening to me speak, understands that the process of, seeking help and when they need to. I do. You know, I received a phone call. 
 
[Andrea] 
Gosh, this was a few years ago where I had a producer call me and say, “I was at your presentation. I realize I need help. I live in such and such place. Where can I got to receive some help?” So, I gave some options. And here's the kicker, though. He called numerous places, and it was going to be like a two-month wait. 
 
[Andrea] 
So, what's going to happen between the time he talked to me and two months from now a lot? Yeah. You know, he might talk himself out of going. Maybe he's at a very, very bad place. I did, you know, I always assess, OK, how immediate is this that sort of thing. But when we have issues with access to mental health and we have long waiting times to be able to see a counselor, that's a big issue. 
 
[Andrea] 
People talk themselves out of seeing a counselor within that time frame. So. 
 
[Heidi] 
Yeah. And I think it's really unfortunate, but you never know what the need is. There's never, it seems like, there's never enough resources. We can always have more. 
 
[Andrea] 
Well, we'll definitely, definitely, again, on these statewide committees and initiatives that I'm working on. I think they're trying to figure out how to solve the issue of access in South Dakota. And trying to decrease the wait times. But, you know, we're short on inpatient units across South Dakota. And, so overall, it's just a challenge that, maybe, higher powers in South Dakota can start maybe assessing. 
 
[Heidi] 
So, let's talk about some things that are available, things that can help in a critical moment. I know you have, a list of certain things, that can help. What are they? 
 
[Andrea] 
Well, 988 is important, in that if you're in a suicide crisis, that would be the three digits I would dial. 
 
[Heidi] 
Or you can text them. 
 
[Andrea] 
Or you can text them. Thank you. Avera started a hotline a few years ago. It’s called the Avera Farm and Rural Stress Hotline. And so, if a farmer or rancher is struggling with anything related to mental health, and sometimes they call about other things, other stressors, to see what kind of options are available, but that number is 1-800-691-4336. 
 
[Andrea] 
So, I would encourage anyone to contact that hotline. They have somebody on staff 24/7. Everything's completely confidential, and they make referrals to different counselors. Or maybe if somebody needs some inpatient care, obviously they're connected with Avera Behavioral Health to be able to make those assessments, too. So that's a great resource here in South Dakota. 
 
[Andrea] 
And then, you know, 211, the helpline is important as well for various resources, not just with mental health care but maybe, different, basic needs. Sure, too. 
 
[Heidi] 
Absolutely. Here at SDSU, obviously, we have a lot of students who are pursuing careers in agriculture, or maybe they come from an agriculture background and their family’s back at the farm working with that. Do you have any advice for students or advice for producers as to how to handle that stress of working in ag? 
 
[Andrea] 
Sure, what's really needed, some of the agriculture professors are starting to invite me in to talk about stress and mental health, and it’s a little challenging because undergraduate students are hesitant to chat during class and share stress. But I've started planting the seeds of, OK, this is what it looks like in agriculture right now. And, you know, there are, let's talk about strengths that are within the field and let's talk about the areas that are really challenging and how does that relate to mental health, and it’s so important in college to find some method of managing your stress. 
 
[Andrea] 
Hopefully it's in a positive method in managing stress. Whether it's social events, maybe some groups on campus that you can become involved in, physical health is very important. We know it's closely related to mental health. You know, if our physical health is declining, oftentimes our mental health does, too. And it goes the other way. 
 
[Andrea]
Mental health declines, physical health tend to decline. So, I entered some form of exercise. Now I am not a runner. Yeah. So, somebody told me you need to go run 2 miles and you'll decrease your stress. No. Probably increase my stress. I don't know about you. 
 
[Heidi] 
Point out the fact I can't run, so. 
 
[Andrea] 
So, I talk about finding something that works for them. Yeah. So, I don't know what you do for exercise. I do a lot of strength training because lifting weights kind of clears my mind. But my older sister does yoga. Sure. So, figuring out what works for you, there's mindfulness meditation. A lot of people really get into that as well. 
 
[Andrea] 
But you can't just tell somebody to go do something that they don't enjoy doing, because then it'll increase their stress even more. But some type of journey with your physical health is important. Some form of exercise or meditation. So, I don't and I talk about some of those sorts of things. Yeah. 
 
[Heidi] 
Yeah, that's a very fair point. And one thing that I didn't necessarily realize until after speaking with some students in the college and faculty in the College of Agriculture, Food and Environmental Sciences, you know, typically they graduate in May or they start working even earlier before they graduate. Students that are going into the ag industry, they are like launching their careers during planting season and or in the spring, which is an incredibly stressful time. 
 
[Heidi] 
And they're navigating other things as well as, you know, like adult life. Maybe they're moving, you know, trying to navigate this new career. Their life looks entirely different, and relationships. Oh, yeah, absolutely missing their friends. Yeah. How do we try and control maybe some of these or how do we try to destress or like, do some things, to keep things in control when we feel like we can't control other things? 
 
[Andrea] 
I talked a lot about, honestly, it's a challenge. Yeah. You know. 
 
[Heidi] 
There’s probably no straight answer. 
 
[Andrea] 
It really isn't, because, you know, as a counselor, we want to focus on what we can control, right? So, but when a major part of your operation is dependent on weather, you know, so what kind of. And there are different and my colleagues in Extension would be able to speak more about those sorts of things, but there's different tools and technology that help, you know, alleviate some of those concerns. 
 
[Andrea] 
My colleagues would talk about a farm business management plan. Yeah. And making sure you have some kind of long-term plan in place for managing your business. So, there are different, I would say there are different tools on our website, extension.sdstate.edu, that people can go and check out from my wonderful agriculture colleagues who work in whether it's soil health or. 
 
[Andrea] 
Yeah, or farm and ranch business management, agronomy, all those different areas. 
 
[Heidi] 
Perfect, and you're in the unique position where you are a licensed counselor and are trying to work with people in the health industry. What would your advice be for students, maybe, who are here considering a career in health or counseling, and they plan on working, like in a midwestern or like a rural setting. What would your advice be for them to, like, kind of look out for some of this stuff? 
 
[Andrea] 
Yeah, I would just educate myself the best I could, and I think we do a nice job of that in different classes. I'll speak for our counseling graduate program of talking about the challenges in rural mental health and thinking outside the box. You know, there's a lot of conversation in South Dakota from counselors, you know, maybe some grant-funded initiatives of mobile clinics. 
 
[Andrea] 
My research, my last research study, the comprehensive needs assessment, 95% reported they were somewhat religious or very religious, 95%. So, what more could we do within churches? And again, I just spoke at a health equity conference talking about, well, how can maybe do a blood pressure check after church one day and maybe the pastor goes first as an example, because, you know, the pastor or someone they might feel like they can connect with or talk to and, you know, it's similar to me disclosing my stress first. 
 
[Andrea] 
Well, maybe someone important discloses, you know, goes through the blood pressure check. So how can we do more, more work in that area? For most of them, again, it was just one sample across South Dakota. But thinking outside the box is important. I've heard of counselors providing counseling services in the tractor. Yeah. Or they connect. They connect depending on broadband, but on their phones and, you know, there are HIPAA stuff that we need to think about with those sorts of things. 
 
[Andrea] 
But connecting on their phones where they're driving and they talk at the same time more or something like this, where they can play it and listen to aspects of mental health. My farmers talked a lot about some of the social media presence related to mental health that farmers are putting out there that are funny. 
 
[Andrea] 
I can't think of any off the top of my head, but just more stuff like that that they can listen to as they're working in. Yeah. You know, in agriculture. 
 
[Heidi]  
Getting creative for sure. 
 
[Andrea] 
Yes, creative. 
 
[Heidi]  
And that's a good point with social media. I mean, it can definitely be attributed to negative mental health things, but sometimes if you see someone else going through something similar or like something that's relatable, it just kind of, I don't know, relieves is relieving a little bit. 
 
[Andrea] 
It does. But how many times do you look at social media and you're like, oh, they look like a perfect family. Oh yeah, for sure. So, it's kind of depends. I mean, there are pros and cons to social media, but I do think that, you know, a lot of farmers still listen to the radio. So how do how can we do more spots on the radio about mental health or short articles in the newspaper? 
 
[Andrea] 
My dad still reads the newspaper. You know, a physical copy is needed. 
 
[Heidi] 
Delivered straight to the mailbox. 
 
[Andrea] 
Yes, exactly. But a lot of that is important to them. So how do we make a short article that is, someone engaging that they'll read and maybe have some type of takeaway from? Yeah. Yeah, absolutely. 
 
[Heidi] 
Is there anything else that you want to add? Anything that you want to point out? 
 
[Andrea] 
Well, I just think it's important to realize that not just the farmer is struggling. The entire farm family is struggling and thinking about how do we support the females in agriculture as well. For example, I'll share the story that I was speaking at an event and the spouse took the microphone with tears running down her face, and she said, “I'd rather lose the animals than lose you.” 
 
[Heidi] 
That hits. 
 
[Andrea] 
“I'd rather the animals die than you die.” I've had other stories, too. I had a producer share that. So, so again, the spouse and the producer are both struggling. I had another producer share during one of my talks. He stood up in the back and said, “We just had a friend who died by suicide, and, yes, we saw him withdrawing. 
 
[Andrea] 
We saw him drinking more, but we always thought he would come talk to us. Yeah, and he didn't.” And so, we can't make assumptions that people are just going to come forward and share that they're struggling. So, there are certain signs to look for. And obviously withdrawal from friends and family is one of them. I talk about how that's a big red flag, increase substance use, like you said, any type of change in mood or behavior. 
 
[Andrea] 
Going back to the self-blame that I talked about earlier, listening for some of those statements, I should have done this differently or, maybe you're better off without me and this farm would survive if I made the right decisions. And, so, we can't assume that our friends and family are going to come forward and share when they're struggling. 
 
[Andrea] 
I don't know about you, but occasionally I'll check in with friends and just say, “Hey, I haven't talked to you in a while. How are you doing?” And, you know, about a month ago, I had a friend share that her son tried, attempted suicide. And so, I think it's important to just have those random check-ins with the people that you care about. 
 
[Andrea] 
And, you know, your friends, family, that sort of thing. 
 
[Heidi] 
Yeah. Anyone in your life? Really? Yeah, and I know when you said in your studies, 1 in 4, like, especially in South Dakota or anybody in the Midwest, it's probably someone, you know, it's just kind of a stop check, see the signs and make sure that they're OK or that they have access to what they need. 
 
[Andrea] 
And what's challenging with suicide is not everybody. Odds are you don't have all the signs. Like maybe this person has one sign, maybe this one person has a sign. And this person, and most of the time after it's happened, that's when they come together and they realize, oh, wow, there was more to it than what we what we individually knew. 
 
[Andrea] 
It's a challenge. You don't know. So that's why I'm hopeful with the work that I'm doing across all to Florida, that even if I reach one person in a talk, it's worth it. 
 
[Heidi] 
So, it's a great way to end. Thank you so much for being here today on the Yellow & Blue Podcast. Thanks for listening.