Agricultural work can be a source of stress, anxiety and depression due to its unpredictability and physical and mental demands. University of Kentucky College of Agriculture, Food and Environment researchers are helping train Kentuckians to recognize signs of mental distress in members of their local agricultural community. The program is seeing great success.  

Through the college’s Southeast Center for Agricultural Health and Injury Prevention and the Central Appalachian Regional Education and Research Center, Kentuckians who regularly interact with farmers and rural health care providers are learning Question-Persuade-Refer. QPR is a nationally recognized suicide prevention program that helps individuals recognize when someone is facing mental hardship and connect them with health care professionals. UK researchers took the existing QPR program and developed additional materials to help participants identify farm-related stressors and agriculture-specific behavioral clues that may indicate a farmer is going through a difficult time.  

“When the 2018 federal farm bill appropriated money for mental health services for farmers, it really opened up the conversation about mental health in the agricultural community almost overnight,” said Joan Mazur, professor and deputy director of the Southeast Center for Agricultural Health and Injury Prevention. “People really seem to appreciate the opportunity to talk about mental health, use the word suicide and have conversations about struggles they see in their communities.” 

During the summer of 2020, with support from a U.S. Department of Agriculture’s Agrisafe subaward, the Southeast Center trained 17 certified QPR Institute trainers who, in turn, used those skills to train 415 Kentuckians as part of their Agricultural Community QPR for Farmers and Farm Families program.  

“We really wanted to leverage this important policy ‘moment’ and develop a community-based support network to address this difficult issue,” Mazur said. “We asked people to participate who we knew were already embedded in rural agricultural communities, working with farmers on a regular basis and who really cared about farmers’ mental health. We wanted to find ways to break down the boundaries that farmers can put up.” 

Alethea Bruzek, UK Cooperative Extension Service agent, was among the UK and Kentucky State University extension agents and faculty members initially trained in QPR. Since being trained, she has trained others.  

“I have a unique opportunity to reach farm families through my work in extension,” said Bruzek, Boyle County family and consumer sciences extension agent. “This training gave me the tools that I need to start a conversation with someone in my local farming community, who may be struggling. It was a great chance for me to try to help.” 

The centers received additional support from the 2020-2021 Kentucky Legislature through an effort championed by Kentucky Rep. Brandon Reed. The legislature’s allocation provided funding for 40 more QPR trainers to train an additional 300 Kentuckians in the Kentucky Rural Mental Health and Suicide Prevention pilot program. The second cohort of participants are located in counties with high needs for these services. They live in areas with high rates of morbidity and mortality and a large number of farms.  

“It is extremely rare to have support from a state legislature to address rural mental health, and we are so appreciative that our legislators have made this issue a priority,” Mazur said.  

The centers are also studying the effectiveness of the trainings. In the first group of participants, UK researchers surveyed them three days before and one month after the training.  

“Our findings show that the training had a statistically significant impact upon trainees. After the training, participants were twice as willing to intervene with someone who needs help,” said Carolyn Oldham, director of continuing education for the Central Appalachian Regional Education and Research Center. “In our first group of trainers, two had actually intervened with a producer within the first month after learning QPR.” 

The second cohort of participants is in the midst of training. Researchers will survey this group at one month, six months and one year after they complete the program.  

The researchers are also working with the Kentucky Injury Prevention and Research Center to upgrade the state’s suicide hotline so when a Kentuckian calls it, a fellow Kentuckian answers the phone. Callers to the Kentucky hotline are also asked if they are a farmer or member of a farm family, which will allow researchers to track mental health issues in rural communities. 

The Southeast Center for Agricultural Health and Injury Prevention and the Central Appalachian Regional Research and Education Center are funded by the National Institute for Occupational Health and Safety and directed by Wayne Sanderson, a professor in the UK Department of Biosystems and Agricultural Engineering. 

Plans are underway for the project to build on the Kentucky model and extend and expand their agricultural community-based QPR train-the-trainer model to other Southeastern states the center serves. 

The center also developed a video that highlights the importance of suicide prevention education and features some participants from the first co-hort. It is available online at https://drive.google.com/file/d/1cXcmtfN3C6xJ3mapD3xPq-nHGN1B6_nn/view. 

This material is based upon work that was supported by Agrisafe Network Incorporated under award number 20197002830434.