Why more and more farmers struggle with depression

Farmers face constant uncertainty: weather, politics and market fluctuations are all factors out of their control. Clinical psychologist Adri Prinsloo spoke to Lindi Botha about how this, combined with relative isolation, contributes to worrying levels of depression and suicide.

Why more and more farmers struggle with depression
According to one study, mental illness is often seen as a stigma in a typical small farming community, where everyone knows each other and there is little opportunity for privacy.
Photo: Lindi Botha
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Studies conducted globally on farmers’ mental health have one thing in common: they show that farmers suffer a higher rate of suicide than any other working group.

While no studies have been conducted in South Africa on suicide and depression among farmers, studies in several other countries all show similar results.

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A 2014 Australian study, ‘Suicide and accidental death in Australia’s rural farming communities: A review of the literature’, found that farmers had a suicide rate one-and-a-half times that of the general population.

Another survey, the HUNT study performed in Norway, found that both male and female farmers had higher levels of depression symptoms than those of the general working population.

In addition, the differences in these levels between farmers and the general working population increased with age.

This study also found that few occupations had undergone more profound changes in recent decades than farming, and the number of Norwegian farmers had decreased.

Despite geographical and political differences, the same trends can be seen in most industrialised countries, and the demands and stressors that farmers face appear to be similar across borders.

In South Africa, as in Norway, occupational stressors unique to farmers, such as the physical environment, family structure, farm economy and bureaucracy, have in recent years been aggravated by structural and economic changes in agriculture.

Adri Prinsloo, a clinical psychologist at the University of Pretoria, who specialises in gender and mental health, says farmers are required to have a broad base of knowledge and Illnessskills, from crop or livestock production, to engineering and economic skills, as well as public relations.

“This is a big task. They are responsible not only for production but often also for the payment of salaries. A lot of people depend on the success of the farmer, and this translates to pressure and expectations.”

Unpredictable elements play a greater role in the psyche of farmers than in city folk, as farmers are exposed to the vagaries of the weather, fire, pests and diseases and fluctuating markets, according to Prinsloo.

South African farmers also face “the increasingly worrying prevalence of farm attacks and negative statements made by politicians surrounding land”. All of this adds up to a “toxic mix that most people would struggle to cope with”.

Prinsloo says that while most people know that life is not predictable and completely in their control, they like to feel that things go well most of the time, and that they can deal with the unpredictabilities and have a sense of control over their environment and what happens to them.

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Feeling in control is important for mental health, and farmers with high job demands, but little flexibility in decision-making, have higher levels of mental distress.

“For farmers, feeling in control may become very difficult when faced with a myriad of unpredictable issues. It affects their sense of self-worth and self-efficacy negatively when their coping strategies seem to be failing, the plans they had for practical solutions don’t work, and when they feel unsupported by government or threatened in any way.”

She adds that government could make more of an effort to acknowledge the plight of farmers as “they are left with emotional trauma and uncertainty after a bad harvest, drought, flooding or armyworm infestation”.

The decline of the farming community
Both Australia and South Africa have seen a steady decline in the population of many farming communities due largely to vulnerability to unpredictable climatic extremes and long-term agricultural restructuring.

This has, in turn, resulted in a gradual amalgamation of agricultural holdings, an increase in single-household properties, and reduced opportunity for social interaction and mutual support.

Additional effects include threats to the viability of small business, reduced employment opportunities, higher rates of poverty, the withdrawal of critical services such as banks, business and health care, and population drift of young community members to metropolitan areas.

This collective impact is considered to have the greatest impact on health and well-being.

The HUNT study found that mental illness appeared to be particularly stigmatising in farming communities, and farmers seemed reluctant to contact the healthcare system for help for mental health problems.

The Australian study, too, found that the small, tight-knit structure of a rural farming community created an environment in which anonymity was rare and the consequences of social disruption were likely to be severe.

It also found that farmers were averse to seeking help for mental health problems for two reasons: the social stigma associated with them, and the traditional masculine paradigm of farming.

This includes its heavy, unrelenting work demands, lack of access to health services, and a focus on ‘practical’ problem-solving as opposed to ‘seeking help’.

An extreme outcome of these characteristics is an elevated suicide rate.

According to Prinsloo, masculinity plays a major part in the way men experience, express and cope with depression.

“Men in general tend to mask depression, which is why, when they commit suicide, it is often unexpected. Masking manifests through behaviours such as risk-taking, overworking and withdrawal.

“Using or abusing alcohol is an ‘acceptable’ social practice and serves the ‘added benefit’ of providing the depressed man with a community-approved way of dealing with depression.”

However, drinking makes matters worse on all levels: physiological, interpersonal and emotional. A hangover can also affect work performance and increase the risk of accidents.
Prinsloo says that men seek help for health-related problems less often than women do.

“This is especially true of the depressed man, who may be self-stigmatising or may experience real or perceived public stigma. This is probably worse in a small community.”

The situation is exacerbated when the challenges persist and support is inadequate or non-existent. It is also difficult for some men to admit they are not coping.

“Men tend to have a difficult time knowing what they feel and putting words to their emotions; admitting to something such as depression is a threat to their pride, self-esteem and self-worth. But it takes more courage to admit ‘I am depressed’ than it takes to suffer in silence.”

Finding support
Farmers who arrive at the point of seeking help are at a further disadvantage due to their isolation and limited access to the options available to city dwellers.

Prinsloo says that stigma also makes establishing a support group in a farming community difficult. “Psycho-education is needed, not only in rural communities but in urban spaces, as people have many misguided notions and Google-informed opinions that may or may not be accurate.”

Those close to a farmer should take changes in behaviour seriously.

“[These include] what they say and do: sleeping, eating or drinking more or less than usual; moods and attitudes such as a negative mood most of the time, hopelessness and sadness. Be caring and honest in approaching a person you suspect may be depressed.”

She stresses the importance of listening.

“Hear what your spouse, partner or friend is saying. Be with them in what they are saying as well as those issues or people they don’t talk about. For heaven’s sake, don’t tell someone that ‘things will get better’ or ‘I understand exactly what you’re feeling.’ If it’s not your life, then you’ll never understand fully what they are going through.”

Being empathetic and asking what kind of support you can offer is important.

“Be open to, but gentle, about the issue of suicide. When darkness, pain or worry is brought out into the open and becomes acknowledged and shared, it’s easier to face. It loses its potency.”

She advises farmers to consider coping strategies that worked for them in previous difficult circumstances.

“However insignificant or irrelevant it may seem now, doing woodwork, reading, listening to music or playing an instrument could lift your mood.

“Seek healthy support where you feel a sense of belonging, such as at a church or fishing club. Focus on getting things done that need attention and that you have control over, no matter how small. If it’s the phone call to someone you’ve been putting off, the bakkie that needs a wash, the beard that needs a trim; the small steps build momentum and positive energy for the bigger challenges.”

Even the most innovative and resilient farmer is vulnerable to emotional challenges. “If left unacknowledged, these will at best be left unresolved and negatively affect a farmer’s relationships and well-being. At worst, it can, sadly, lead to suicide.”

Email Adri Prinsloo at [email protected].