Colorado State University emphasizes suicide prevention work in agricultural communities

Candace Krebs
Special to Ag Journal
Lorann Stallones, Director, Graduate Degree program in Public Health, Colorado State University, October 2, 2013

The Colorado AgrAbility Project, which helps farmers and ranchers find workarounds for physical limitations, is extending its reach with a new emphasis on mental health and suicide prevention.

It’s an evolution dictated by the unusual circumstances of the past year.

“When we met last year and discussed the AgrAbility project, we didn’t have any idea how critical this issue was,” said Blake Naughton, Colorado State University’s vice president of engagement and extension, during a project update. “As we’re talking to faculty around the state, we’re recognizing more and more how producers and business owners are stressed by the economic and social conditions of this time. It’s affecting agriculture communities in ways that we need to know about so we can help address those needs.”

Bob Fetsch, a CSU extension health and human sciences specialist and now co-director of Colorado AgrAbility, is already well known for his work on suicide prevention.

“The national suicide rate is 14.2 for every 100,000 people,” he said during the online meeting. “But for males working in agriculture it’s 2 ½ times that, at 36.1 per 100,000, so we’ve got a problem here in Colorado and across the nation.”

Increasing attention is also being paid to subsets of the rural population that are uniquely vulnerable, such as veterinarians and farmers or farm workers tasked with euthanizing large numbers of animals, he said.

As the extent of the problem becomes more widely recognized, new resources are becoming available.

A new law passed in November will set up a national suicide hotline with a three-digit number, 988, a derivative of the 911 emergency number that everyone memorizes.

“I think that will be very, very helpful,” Fetsch said.

The federal Substance Abuse and Mental Health Services Administration is also providing more than $400 million in emergency grants to state and tribal organizations during the COVID-19 pandemic, much of which is being used to provide low-cost and no-cost counseling in both English and Spanish.

Colorado State University's Psychological Services Center is currently offering free services for adults across Colorado. (Call 970-491-5212 to schedule an appointment. The Psychological Services Center is not a crisis center. If you or someone you know is in crisis, call Colorado Crisis Services at 844-493-8255 or text TALK to 38255.)

The Colorado agriculture department has also used a “train the trainer” approach to educate general practitioners on the unique character, language and circumstances of agricultural clients.

The recent AgrAbility webinar looked at some of the distinct suicide risk factors unique to rural areas. For that purpose, Fetsch brought in guest speaker Lorann Stallones, an epidemiologist and director of the graduate program at the Colorado School of Public Health.

Stallones also works with the Alliance for Suicide Prevention in Larimer County.

She emphasized the importance of understanding the unique biological and environmental factors that can increase suicide prevalence in rural settings.

“Families need to know it isn’t necessarily something that they did,” she said. “I think we have to have those conversations, even though they are difficult. I think it’s important that we understand that there are some external causes for some of the behaviors we worry about.”

Three research areas Stallones covered in her talk included pesticide exposure, poor diets and sleep disturbance. She also mentioned another factor that compounds the risk: access to firearms.

“Farmers are lot more likely to use a gun as a means of killing themselves. But I don’t think we are going to take the guns away from farmers,” she said.

Still, it can be extremely helpful to recognize when someone is in distress and take steps to make it harder for them to access firearms, either by locking them away or possibly taking them to a gun shop for storage over a period of time until the person begins to feel more stable.

The list of severe stressors unique to rural populations include loss of a farm, business or relationship, social isolation, unpredictable trade policies, weather and markets, long work hours and lack of workers to help with necessary tasks, she said.

“COVID has really exacerbated some of these,” she added.

Stress can eventually lead to depression, shame, loneliness and substance abuse. As internal and external stresses or traumas interact with genetics and brain chemistry, they set off a cascade of effects that can lead to suicidal tendencies.

Despite numerous studies on suicide prevention, only two strategies have proven to be reliably effective, Stallones said. One of those is restriction of access to lethal means. The other is educating primary care physicians and encouraging them to ask more questions related to mental health and substance abuse during office visits.

“Despite trying to increase treatment options, those were the only two that really were seen to have an impact,” she said. “I think it’s important to continue to monitor the suicide prevention strategies being used so that we target the things that are actually efficacious.”

Rural towns often lack sufficient health professionals and psychiatric services, creating additional barriers to care.

“Normal thinking about safety nets and prevention of suicide tends to include only mental health professionals and physicians, but in rural communities we need to broaden our thinking about what the safety net needs to be,” Stallones said.

Rural pastors, in particular, are one potential resource, she said.

“An overall safety network needs to be in place and readily available, and we need better teaching of coping and problem solving skills,” she summarized. “We need new ideas about how to deliver those programs, and COVID has given us some lessons on more virtual training and access.”