USDA grant pays for stress counseling for ND farmers

FARGO, N.D. — A federal grant undergirds “Farm to Farm Services” — a counseling partnership with North Dakota State University that delivers “telehealth” aimed at farmers and ranchers struggling with mental or emotional health issues.

Sean Brotherson, an NDSU Extension family life specialist, said the program is offering a range of needed help.

“We all know that — for example — suicide rates and rates of stress-related physical and mental health concerns for folks working in agriculture are much higher than any of us would like to see,” he said. North Dakota’s suicide rate increased 57% over the past 20 years, and farmers are part of that.

The program’s telehealth sessions are used by about 40 to 50 clients a month through Farm to Farm, a branded program of Together Counseling, a group of therapists. Clients can be a range of individuals, from youths to adults.

The therapists can meet with clients virtually, without incurring transit time and transportation costs. They use the government grant to pay the often-substantial deductible on health insurance.

“They can visit with you on your smart phone in the cab of your pickup truck on your farm,” Brotherson said. “You don’t have to drive to Fargo from a place that is distant in the state.”

U.S. Department of Agriculture established a Farm and Ranch Stress Assistance Grant Network after stressful years in agriculture from 2014 to 2015. North Dakota was part of a 12-state group of land grants that applied in 2017. The group got a $7.2 million, three-year grant. North Dakota gets $400,000 of that, spread over three years. In a related effort, another two-year grant totaling $500,000 was funneled to NDSU Extension through the North Dakota Department of Agriculture.

Brotherson said the source of stress in agriculture varies with the year. Sometimes it’s worry about the weather, commodity prices, input prices, supply chain interruptions, or even rail service interruptions.

NDSU received its first money in the grant in 2020, running through 2023. Over the first 18 months, counselors served about 60 to 70 unique clients. Clients average six to eight counseling sessions.

“Typically we’re focused on individuals who are directly involved in agriculture, or who are working in and around agriculture,” Brotherson said.

There are three partner entities. NDSU Extension delivers education. FirstLink of Fargo, North Dakota, provides suicide prevention training, and mental health first aid training. And finally there is Farm to Farm Services. Farm to Farm counseling involves therapists with a connection to agriculture. The service is mostly delivered via smartphones or office computers, so travel can be minimal.

Not all 12 states provide the same things, Brotherson said. For example, only North Dakota, Wisconsin and Missouri provide counseling services through the USDA grant. (The University of Wisconsin at Madison provides vouchers for clients to go to counselors. The University of Missouri at Columbia offers their university counselors.) Minnesota has its own counseling support program for farm and ranch populations, through the Minnesota Department of Agriculture. (Minnesota separately has another program — “A Changing Way of Life” — that helps farmers transition out of the business.)

Brotherson hopes the funding can continue. He expects USDA will learn lessons from the programs and he hopes Congress will again see fit to support it in the farm bill that replaces the one that will expire in September 2023.

Becky Kopp Dunham is one of the counselors through Farm to Farm. She lives on a Clay County, Minnesota, farm that her husband, Brian, operates in addition to an off-farm job with the county highway department. They have three young children.

Kopp Dunham said many farm families have high-deductible health insurance. The grant funds for stress counseling can offset co-pays and deductibles, which helps them address other health services.

“I’ve seen some farm families where their deductible is $13,000,” she said. “They don’t go in (to the doctor) for anything except catastrophic issues."

Kopp Dunham said all of the counselors in the program understand farming and know how to fit their therapy work around a client’s planting, harvesting, calving or other work imperatives.

“A general theme is often the financial stress of farming and ranching, coupled with the unpredictability of things that impact that — market value, weather.”

Very often, initial sessions were at the urging of a wife or partner.

“This is getting serious, you need to see someone,” she said, describing the typical start.

Therapists can help clients get out of harmful thought ruts. One key is to acknowledge simple truths — things like, the weather is simply out of their control. They may nudge a client to see a primary care doctor. They may urge finding help for business succession, or help cope with illnesses, births, deaths and divorce.

“Sometimes it’s the other aspects of life piling on top of the ever-changing farming and ranching situations that has just tapped people out,” Kopp Dunham said.

“I hear a lot about competition for land,” she said. "There is concern about the expense, and being able to stay afloat.”

Some are concerned because they don’t have someone to pass the farm to. Some are concerned that they do and whether their children will be able to handle economics and stress.

In 2019, the grant wasn’t well known, but more referrals came in in 2020 and 2021. Many clients are with counselors for six to eight sessions, and then unplug. Contacts often are every week or every two weeks. In exceptional situations, a client may meet with the counselor several times in a week.

The sessions are designed to help people live happy and successful lives, in a career where farmers and ranchers often fear appearing weak or vulnerable. There is a “suck-it-up” and “pull yourself up by the bootstraps,” mentality that may not be sustainable, Kopp Dunham said.

But she said she has a “feeling” that the stigma of mental health might be lessening. There seems to be less “arm-twisting” than there used to be to get farmers in for help.

Counselors in the program do an “intake” to learn the history and build a relationship. She said farmer-clients are telling them they have fewer trusted confidants.

“Having someone who is neutral and the privacy involved where they’re able to speak freely, and they feel safe and comfortable to do so” is important.

“I’m hoping I’m seeing more acceptance and understanding, that ‘Of course this hard, and of course you would seek help when needed,’” she said.

Farmer clients seem to be happy that the counselors understand the rhythms of farming and rural life. Kopp Dunham grew up in Bismarck, North Dakota, but spent time on family farms and ranches in the area. She studied social work at Minnesota State University in Moorhead and completed graduate work online at the University of Minnesota.

In 2004, she met Brian Dunham, a farmer whom she would marry. They made a home on his home place in Clay County, Minnesota, and now have three young children. Brian works for the Clay County road department, but he also raises cattle and soybeans, corn, wheat and alfalfa.

It’s important to model healthy behavior, she said.

“The future generations of farmers are watching us, all of the time, for the good and the bad,” she said. “I hope we’re going to a better job of modeling how to handle this stress.”