Evaluating Mental Health First Aid for Illinois Agricultural Communities.

Introduction. Mental Health First Aid (MHFA) was created to teach individuals how to identify, understand, and respond to signs of mental illnesses and substance use disorders. Programs like this may be essential for agricultural communities where suicide rates have increased, and mental health stigma has been a barrier to this population. This study evaluated how effective MHFA and Youth MHFA were for participants from agricultural communities. Methods. Participants completed the MHFA (N = 38) and Youth MHFA (N = 66) programs in 2021-2022, and Extension educators offered both programs as a part of outreach efforts within agricultural contexts. Participants completed pre-, post-, and post-only evaluations as standardized by the National Council for Mental Wellbeing. Results. After completing the MHFA and Youth MHFA training, participants increased their knowledge, confidence, and skills in various mental health topics. This includes early indicators of mental health challenges, the ability to have supportive conversations, and how to provide resources to others. For example, most participants felt they became more knowledgeable about MHFA (69%) and the ability to recognize the signs and symptoms of mental health or substance use challenges (65%). Conclusion. This research has implications for supporting agricultural workers through additional mental health training, managing farm stress, and understanding mental health stigma within this community.

Characteristics of suicide among farmers and ranchers: Using the CDC NVDRS 2003-2018.

BACKGROUND: Suicide is among the top 10 causes of premature death in the United States. This study provides details on farmer and rancher suicide decedents, including demographic information, mental health status, history of suicidal thoughts and attempts, and circumstances associated with death. METHODS: Data for this study were obtained from the Centers for Disease Control and Prevention's National Violent Death Reporting System Restricted Access Database for the years 2003-2018. Descriptive statistics and adjusted odds ratios are presented for farm and nonfarm populations in addition to farm populations by age groups and sex. RESULTS: This study found that almost half of the farmer suicide decedents were over 65 years old. Firearms were the most widely used method for farmers and ranchers regardless of age and sex. Young farmers and ranchers that died by suicide were more likely to have had relationship problems and older farmers and ranchers that died by suicides were more likely to have had a physical health problem. Male farmer and rancher suicide decedents were more likely to die by firearm than females, and female farmer and rancher suicide decedents were likely to have resided in a small metropolitan area, however, due to small numbers and suppression in the data, most sex comparisons were not able to be presented. CONCLUSIONS: While no clear risk factor for suicide among farmers and ranchers emerged, results underscore the complex nature of suicide and the need for multifaceted, culturally competent interventions and campaigns that address suicide risk and prevention at the individual and community levels.

Injuries and illnesses to children in commercial fishing in Alaska: A brief report.

BACKGROUND: Commercial fishing is the most hazardous occupation in the United States. While the epidemiology of adult injuries and fatalities are well documented, injuries to children (<18 years old) are not described. The purpose of this report was to describe the characteristics of nonfatal injuries to children involved in commercial fishing. METHODS: Nonfatal commercial fishing injuries to children were identified in the Alaska Fishermen's Fund. The Alaska Fishermen's Fund is an emergency fund payor of last resort. Data on nonfatal injuries to victims aged 17 or younger were analyzed. Descriptive statistics were used to characterize demographics and injury characteristics. RESULTS: Forty-four nonfatal child injury claims were made between 2012 and 2016. The mean age at the time of claim was 15.6 years (SD = 1.8) and 84% were male. The most common types of injuries among children were sprains and strains and the most commonly injured body parts were upper extremities and the trunk. Most injuries occurred in salmon fisheries. CONCLUSIONS: Children are participating in commercial fishing. Based on the results of this analysis, children are also experiencing occupational injuries. The results of this analysis underscore the need for additional safety and health information, guidance for supervisors, and intervention to prevent injuries to children participating in commercial fishing.

Fatal farm injuries to Canadian children.

Children on Canadian farms are at high risk for fatal injury. Ongoing surveillance of these deaths is required to affirm recurrent patterns of injury, and to determine whether historical approaches to prevention have resulted in declines in the occurrence of these traumatic events. We analyzed epidemiological patterns and trends in the occurrence of fatal pediatric farm injuries over 23 years. Records of deaths were obtained from the Canadian Agricultural Injury Reporting system. To contrast more recent data with injury patterns described historically, cases were compared between two time periods. An intentional consensus process was used to finalize key patterns and their clinical or social importance. 374 fatal farm injuries to children in Canada were identified over the 23 years of study; 253 in period 1 and 121 in period 2. While machinery and non-machinery causes of death varied between the two study periods, mean annual rates of fatal injury (approximately 4 per 100,000 children) remained similar. Notably emergent types of injury in recent years included those caused by all-terrain vehicles, skid steer loaders, and drownings. Observed declines in the numbers of fatal farm injuries are most likely attributable to analogous declines in the number of registered farms in Canada. Our findings call into question the effectiveness of pediatric farm safety initiatives that primarily focus on education. Second, while CAIR fatality data are maintained, surveillance of hospitalized injuries has been disbanded and the fatality records require updating. Only by doing so will such surveillance findings provide comprehensive information to inform prevention.

Depression, Anxiety and Stress Among Young Farmers and Ranchers: A Pilot Study.

Agriculture has been identified as a stressful industry and there is evidence that chronic stress may contribute to the development or progression of mental health disorders, specifically anxiety and depression. Young adult farmers and ranchers may be at increased risk of mental health disorders when compared to more experienced counterparts due to additional stressors. The objectives of this study were to identify the occupational stressors of young adult farmers and ranchers in the Midwest and estimate the prevalence of anxiety and depression among this population. An online survey consisting of reliable and valid instruments was used to identify the sources of stress and prevalence of anxiety and depression among the young farming and ranching population. The survey included items related to stress, anxiety, depression, general health, and farm/personal demographics. A total of 170 young farmers and ranchers responded to the survey. The mean age of the sample was 28.9 (SD 4.4) years. Approximately 71% of respondents met the criteria for Generalized Anxiety Disorder (GAD-7 score ≥ 5) and 53% met the criteria for Major Depressive Disorder (PHQ-9 score ≥ 5). Of seven presented stress domains, personal finances and time pressures were the sources of greatest concern. Personal finances, time pressures, economic conditions, and employee relations were associated with anxiety and depression. The burden of depression and anxiety is high among young adult farmers and ranchers. Stressors commonly affiliated with farming and ranching are associated with anxiety and depression. Additional research should further explore the burden of mental health disorders among the population and examine protective factors for mental illness and opportunities for interventions.

Summary of Roadway Incidents Involving Farm Equipment in Five Midwestern States Using the Fatality Analysis Reporting System (FARS).

Roadway incidents involving farm equipment is a growing area of concern among agricultural safety and health and public health professionals. The aim of this project was to evaluate the usefulness of the Fatality Analysis Reporting System (FARS) and analyze the number of roadway fatal incidents that involve farm equipment. Data collected from the FARS through the National Highway Traffic Safety Administration was used to summarize roadway incidents involving farm equipment. Cases from five midwestern states were analyzed from January to December 2020 using SPSS. Incidents involving farm equipment resulted in 25 cases with Iowa, Michigan, and Wisconsin all reporting six cases each. The most common manner of incidents were single-vehicle crashes and rear-ending incidents. Most of the events occurred during busy agricultural seasons, most often occurring in June and August with five cases each. The FARS dataset is a useful tool to identify cases, but it faces limitations, such as only reporting fatalities and lack of information on specific farm equipment involved in incidents. The results from the study are helpful to better understand roadway incidents and guide future intervention strategies.

Stress, Mental Health, and Risk-Taking: Associations among a Sample of Agricultural Adolescents.

Farm stress and mental health research has largely focused on adult producers, even though youths live and work on farms. The purpose of this study is to describe the stress and mental health experience of agricultural youths and describe participation in risk-taking behaviors. Farm families in the U.S. were invited to participate in an online survey that inquired about farm economics, stress (ASQ-S), mental health (PHQ-A and SCARED), parenting, social support, and risk-taking behaviors during the summers in 2021 and 2022. This analysis is limited to adolescent respondents (N = 298). Just over 70% of the farm adolescent sample met the criteria for at least mild symptoms of depression (PHQ-A score ≥ 5). Among anxiety disorders, 62.8% of the farm adolescent sample met the criteria for probable panic disorder, and 70.5% met the criteria for probable separation anxiety disorder. Adolescents reported the most stress around future uncertainty and school performance. The stress scores were significantly associated with more symptoms of depression. Over a quarter (27.7%) of the participants reported carrying a weapon at least 1 day in the past month, and 22.5% reported carrying a weapon on school property at least 1 day in the past month. Violence-related risk-taking behaviors were also associated with increased symptoms of depression. The results underscore the need for community- and school-based stress and mental health interventions in rural and agricultural communities.

A Comparison between Farm-Related Stress, Mental Health, and Social Support between Men and Women Farmers.

Agricultural producers have worse mental health than the general population; however, recent research has not considered differences in stressors and mental health conditions by gender. A survey was mailed to a random sample of farmers in Illinois to screen for symptoms of anxiety and depression and identify sources of stress and social support. Men experienced more stress related to environmental and economic conditions than women, while women tended to have slightly higher levels of geographic isolation stress than men. Overall, there were no significant differences by gender in the proportion meeting the criteria for depression or anxiety; however, the results are higher than what is observed in the general population. Among those farmers who experience higher levels of stress about geographic isolation, the odds for women farmers to experience depressive symptoms are four times more than men farmers (OR 4.46 (0.91, 21.8); p = 0.06). Additional research should examine the relationship between social support and mental health. Interventions to reduce stress by gender should be considered.

Identifying and Describing Mental Health Stigma Among Agricultural Youth Directors: Does Stigma Influence Practices?

OBJECTIVES: This exploratory study aims to: 1) evaluate mental health stigma levels among agricultural youth directors, 2) examine the influence of professional characteristics on stigma, and 3) investigate the relationship between agricultural youth directors' stigma levels and their self-efficacy. METHODS: An online survey was administered from March to May 2022 to 642 agricultural youth directors in Illinois who work with youth aged 1-19. Directors' personal and perceived stigmas toward mental illness were measured using the Depression Stigma Scale. Directors' self-efficacy (perceived level of knowledge and confidence) across 19 mental health topics was measured using a 3-point Likert scale. Analyses were conducted by generating descriptive statistics and performing Mann-Whitney U tests on the data. RESULTS: The median personal depression stigma score was 7.57 (SD = 8.02). Our analyses identified significantly higher personal depression stigma scores among men, FFA advisors, agricultural educators, and those lacking personal experience with mental illness. A lack of self-efficacy correlated significantly with increased personal stigma. CONCLUSIONS: This study underscores the critical need for targeted educational interventions to reduce stigma among agricultural youth directors and enchance mental health literacy. Anti-stigma and mental health literacy initiatives are essential for fostering a supportive environment that encourages open discussions about mental health issues with youth within the agricultural community.

Mental health of agricultural adolescents and adults: Preliminary results of a five-year study.

Background: Work-related stressors common to agriculture have been associated with adverse mental health outcomes among adult farmers and ranchers. However, the mental health status of agricultural youth is unknown, despite farm and ranch youth being exposed to the same occupational hazards as their adult counterparts. The objective of this study was to estimate the prevalence of symptoms of depression and anxiety among farm adults and their adolescent child and examine the correlation between symptoms of mental health conditions and financial indicators described in the Family Stress Model (FSM). Methods: Farm families were recruited to participate in online surveys by mail, email, and social media. One adolescent and at least one adult from each family were invited to complete on online survey. Where available, validated instruments were used to collect mental health, stress, family dynamics, and household financial variables. Descriptive statistics were used to describe sample demographics and prevalence of symptoms of depression and anxiety. Pearson correlations describe associations between variables within the Family Stress Model. Results: Farm families (N = 122) completed the online survey. The mean age of farm parents was 41.4 years (SD = 4.4) and the mean age of farm adolescents was 15.4 (1.2). A majority of farm parents and farm adolescents were male, 58.2% and 70.5%, respectively. The sample was primarily white, non-Hispanic. In this sample of farm parents and adolescents alike, 60% met the criteria for at least mild depression, based on the Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire-A (PHQ-A). Similarly, among adolescents, 45.1% met the criteria for Generalized Anxiety Disorder (GAD), as did 54.9% of adults. As a measure of economic hardship, per capita income by itself showed relatively low correlations, even with other economic measures (r = 0.11 with negative financial events, r = 0.20 with financial needs, r = 0.17 with financial situation, and r = 0.27 with debt). Parent depressed mood was in turn highly associated with adolescent depression (r = 0.83), social anxiety (r = 0.54), and generalized anxiety (r = 0.69). Conclusions: The results show a strong association between parent and adolescent mental health and parental depressed mood and debt. There is not a clear association between economic stress and mental health in this sample, but further work is needed to be done at a population level. Preliminary results are promising for application of the full Family Stress Model as we continue to accrue farm families into the study cohort.

From believers to skeptics: Latent class analysis of COVID-19 protective practices and perceptions among agricultural community members.

PURPOSE: This cross-sectional study aimed to identify homogenous groups of agricultural producers and stakeholders based on their perceptions of effectiveness and use of COVID-19 protective behaviors. METHODS: We conducted an online survey of agricultural producers and stakeholders through Qualtrics. Participants responded to 7 statements about COVID-19 protective behavior effectiveness and 7 statements about participation in COVID-19 protective behaviors in the previous 2 weeks. These statements included handwashing, disinfecting, refraining from touching one's face, covering one's face when coughing/sneezing, staying at home, social distancing, and wearing a face mask. Additional survey sections included demographics and health history. We performed separate latent class analysis (LCA) to identify clusters of agricultural producers' and stakeholders' perceptions and participation in COVID-19-related protective behaviors based on their pattern of responses. FINDINGS: Based on LCA, participants were distributed as universal believers (33%), social believers (16%), personal believers (26%), moderate believers (17%), and social skeptics (85%) of effectiveness and as low (15%), moderate (40%), and high (45%) adherents of COVID-19 protective behaviors. Those who were female, older, or had underlying health conditions were more likely to be universal believers and highly adherent. High adherence was also more likely among those who lived in urban areas or were not self-employed. CONCLUSIONS: Results suggest that groups of agricultural producers and stakeholders based on perception of effectiveness and participation in COVID-19 protective behaviors are associated with demographic and health characteristics. Public health campaigns that increase or maintain motivation to comply with protective behaviors should be developed and implemented specific for agricultural populations.

Agricultural Producers' and Stakeholders' Perceived Effectiveness and Participation in COVID-19 Protective Behaviors.

This study was designed to identify the perceived effectiveness of COVID-19 protective behaviors and participation in COVID-19 protective behaviors among agricultural producers and stakeholders in the Midwest, United States. A questionnaire was disseminated online to agricultural producers and stakeholders in April-July 2020. Respondents (N = 1,876) shared their perceptions of the effectiveness of COVID-19 protective behaviors and participation in those behaviors. Respondents were primarily agricultural producers (85.5%), aged 64 or younger (66.4%), male (81.2%), white (98.3%), and rural residents (88.7%). About three-quarters of respondents thought washing hands with soap and water and covering a cough or sneeze is very effective at preventing the spread of COVID-19, however, only 30% thought wearing a face mask when in contact with others or in public is very effective. Similarly, over 80% reported washing hands with soap regularly every day and covering their cough or sneeze every day in the past two weeks. In contrast, less than 40% reported staying home as much as possible and wearing a face mask when in public every day in the past two weeks. Rural residents were less likely than urban or suburban residents to report wearing a face mask when in public or with people outside their household. Agricultural producers and stakeholders were found to be at risk of getting COVID-19 due to the perceptions and practices, especially those related to protective social measures. Understanding engagement in protective behaviors and perceptions of their effectiveness is critical to developing effective public health interventions for agricultural communities.

Swine industry stakeholders' perception on the use of water-based foam as an emergency mass depopulation method.

The U.S. pork supply chain is vulnerable to various internal and external threats and in need of prompt, comprehensive response plans. Under urgent circumstances, for example in the case of foreign disease incursions, swine farms will have to perform on-farm animal depopulation to prevent disease spread. Several animal depopulation methods including water-based foam (WBF) have been proposed and are under evaluation for feasibility in the field. However, the psychological/emotional impacts of applying depopulation methods for personnel managing and carrying on the tasks are not currently well understood. Thus, this study aimed to investigate WBF as an alternative for depopulation compared to existing methods approved by the American Veterinary Medical Association. Swine industry stakeholders were invited to voluntarily observe a WBF depopulation trial and to provide their self-reported perspectives before and after the observation. A survey was designed to explore key areas on expected and perceived method effectiveness, efficiency, and animal welfare considerations, as well as to evaluate short-term post-observation psychological impacts. Among 42 recruited stakeholders, 31.0% (13/42) were educators/researchers followed by animal health officials (26.2%, 11/42) and veterinarians (23.8%, 10/42), with an average of 11.7 ± 12.6 (n = 39) years of work experience. After the trial, respondents' positive perception of WBF depopulation increased specifically regarding the animal loading process being less stressful than restrained in-barn depopulation options (P = 0.003) and by the observation of fewer swine escape attempts and vocalizations than expected (P < 0.001). Respondents' positive perception of WBF also increased regarding to the time required to fill the trailer with foam, to stop hearing animal vocalization, and stop hearing animal movement, as the observed trial times were faster than their pre-observation estimates (P < 0.001). Additionally, 79.5% (31/39) of respondents agreed that the rapid destruction of animal populations had priority over animal welfare under urgent scenarios. Minor post-traumatic stress disorder-like (PTSD-like) symptoms from the observed trials were reported (26.7%, 4/15 respondents) one month after the observation. This study showed that the WBF depopulation process was perceived positively by swine stakeholders and may have limited short-term psychological impacts on personnel involved in animal depopulation.

Farmers' Mental Health: Perceptions from a Farm Show.

Introduction: Current economic and environmental conditions have increased awareness of farmers' mental health. Agribusiness professionals may be important key informants to assist agricultural safety and health professionals in understanding the mental health experience of farmers and inform their potential role in mental health promotion. The objectives of this study were to explore agribusiness personnel's perceptions of their farmer clients' mental health and their perceived role in mental health promotion.Methods: Fifteen brief interviews of agribusiness personnel were conducted across 3 days in July 2018 at Farm Technology Days in Wood County, Wisconsin.Results & Discussion: Many interviewees commented on the mental health status of farmers in Wisconsin, stating farmers are "stressed" and "depressed". However, agribusiness personnel were hesitant about their organization's role in mental health promotion. Several respondents cited lack of training and confidence as barriers to addressing mental health with their clients. Others were optimistic about their organization's role in mental health promotion; however, participation would be mostly passive, stating mental health is a difficult topic to broach with some individuals.Conclusion: To engage agribusiness in mental health promotion, efforts to reduce the stigma of mental health disorders and increase agribusiness representatives' confidence and skills in talking about mental health will be necessary.

Who and How: Exploring the Preferred Senders and Channels of Mental Health Information for Wisconsin Farmers.

Unfavorable economic and environmental conditions have fueled the development of mental health resources and services for farmers. However, it is unclear who farmers want mental health information from (senders) and how they want mental health information delivered (channels). A self-administered questionnaire was used to determine the preferred senders of mental health information and the preferred channels of mental health information. Farmers were most receptive to receiving mental health information from medical providers, spouses/family members, and friends. Among the channels of information, respondents were interested in receiving mental health information from farm newspapers/magazines and one-on-one in person. Our findings have pragmatic implications for agricultural safety and health and public health organizations working to disseminate mental health information to farmers. Receptiveness to specific senders and channels of information among farmers should inform resource dispersion and future intervention.

Social and Individual Influences on Tractor Operating Practices of Young Adult Agricultural Workers.

PURPOSE: Tractor-related incidents are the leading cause of agricultural-related fatalities in the United States. Injuries from rollovers can be prevented by equipping tractors with rollover protective structures (ROPS, an engineering approach) and by using seatbelts (a behavior-based approach). While adult farmers report low seatbelt use and frequent use of tractors without ROPS, it is unknown whether the young adult population has adopted similar tractor driving practices. This study was designed to identify tractor operating practices among young adult agricultural workers and the influence of supervisors, peers, and parents on their safety behaviors. METHODS: An online survey was conducted among college students enrolled in agricultural science classes in four Midwestern colleges and universities. Participants answered questions about their tractor operating practices, the influence of supervisors, peers, parents, and individual risk taking tendencies on their workplace practices. A tractor operation safety score was estimated from participants' responses. Linear regression was used to examine the association of these influences and the tractor operation safety score. RESULTS: Of the 193 respondents, most (78.8%) reported that they never or rarely wear a seatbelt when operating a tractor with a ROPS. Supervisory influences, such as being negatively evaluated by a supervisor, were found to be more strongly associated with tractor operating behaviors than peer or parent influence. CONCLUSIONS: Young adult agricultural workers frequently reported unsafe tractor operating behaviors. Supervisors were found to have the most influence over reported behaviors of young adult agricultural workers.

Increasing the number of trained health and safety professionals in agricultural medicine: evaluation of the "building capacity" program, 2007-2013.

ABSTRACT The University of Iowa began training health care professionals to care for farmers' occupational health needs since 1974. In order to geographically expand this training to practicing health and safety professionals, the "Building Capacity: A National Resource of Agricultural Medicine Professionals" program was developed and launched in 2006. The model began in 1987 as a program of Iowa's Center for Agricultural Safety and Health. In 2006, with funding from the National Institute for Occupational Safety and Health (NIOSH), Great Plains Center for Agricultural Health (GPCAH), the program was expanded beyond the Iowa borders. The principal component of the program, the 40-hour course, Agricultural Medicine: Occupational and Environmental Health for Rural Health Professionals-the Core Course (AMCC) is now being offered to health and safety professionals in nine states in the United States, in Australia, and a modified version presented in Turkey. An initial paper evaluated the first phase of the program, years 2007-2010. This paper compares the first phase (2007-2010) with the second phase (2011-2013), which has involved over 500 health and safety professionals. This paper also describes evaluation of the course and changes resulting from the evaluation. Finally, this paper describes best practices for operating this program and makes recommendations for future courses, as well as other trainings within the field.

Toward a national core course in agricultural medicine and curriculum in agricultural safety and health: the "building capacity" consensus process.

ABSTRACT The agricultural industry poses specific hazards and risks to its workers. Since the 1970s, the University of Iowa has been establishing programs to educate rural health care and safety professionals who in turn provide education and occupational health and safety services to farm families and farm workers. This program has been well established in the state of Iowa as a program of Iowa's Center for Agricultural Safety and Health (I-CASH). However, the National 1989 Agriculture at Risk Report indicated there was a great need for agricultural medicine training beyond Iowa's borders. In order to help meet this need, Building Capacity: A National Resource of Agricultural Medicine Professionals was initiated as a project of the National Institute for Occupational Safety and Health (NIOSH)-funded Great Plains Center for Agricultural Health in 2006. Before the first phase of this project, a consensus process was conducted with a group of safety and health professionals to determine topics and learning objectives for the course. Over 300 students attended and matriculated the agricultural medicine course during first phase of the project (2007-2010). Beginning the second phase of the project (2012-2016), an expanded advisory committee (38 internationally recognized health and safety professionals) was convened to review the progress of the first phase, make recommendations for revisions to the required topics and competencies, and discuss updates to the second edition of the course textbook (Agricultural Medicine: Occupational and Environmental Health for the Health Professions). A formal consensus process was held and included an online survey and also a face-to-face meeting. The group was charged with the responsibility of developing the next version of this course by establishing best practices and setting an agenda with the long-term goal of developing a national course in agricultural medicine.