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Views and opinions: AgrAbility improves behavioral health of farmers with disability
 

 

An article in the February 2018 issue of Medical Research Archives by Robert Fetsch of Colorado State University and Christina Collins of Purdue University indicated significant improvements in the behavioral health of 273 farmers and ranchers from 14 states who participated in AgrAbility services.

These states were awarded contracts on a competitive grant basis to provide such services. AgrAbility clients were compared to a matched control group of 100 injured farmers from 17 states who did not have AgrAbility services. The study examined pre-test to post-test changes in both groups.

AgrAbility teams visited individuals and families in the treatment group to provide education and information about modifying their workplaces to accommodate their disabilities, to operate machinery and carry out chores safely, as well as to live and manage their homes and agricultural operations. The control group didn’t have AgrAbility assistance.

Injuries to farmers that are debilitating are among the greatest stressors that agricultural producers and their families may experience. Mishaps can contribute to increased worry about their farming operations and finances and can heighten the stress levels of all their family members and loved ones.

Research has documented that the risks for anxiety, depression and suicide increase following a disability.

The 28-year old, mostly federally-funded National AgrAbility Program connects injured agriculture producers with Vocational Rehabilitation and other resources such as Goodwill Industries, Easter Seals and the Arthritis Foundation, to acquire the assistive devices (e.g., prostheses, scooters) needed to continue farming. Clients also can opt to attend state and national educational and peer support conferences.

The researchers asked the treatment group of AgrAbility clients and the control group of injured farmers and ranchers residing in state that did not offer AgrAbility services to complete two surveys: a self-assessment of independent living and working levels, and the McGill Quality of Life Scale (MQLS).

Both groups completed the surveys twice. The treatment group averaged 16 months between pre- and post-test surveys, and the control group averaged 14 months.

The AgrAbility group reported statistically significant pre- to post-test gains on the MQLS overall and on subscales measuring their physical symptoms, physical well-being, psychological well-being, experiential well-being and availability of support. Their independent living and working levels also improved.

The comparison group who didn’t receive AgrAbility assistance reported decreases in their overall MQLS scores and the same subscales. Their reported independent living and working levels improved, but their gains were significantly less than for the AgrAbility group.

What helped? AgrAbility services focus on equipment modification and physical adaptations; it wasn’t expected that the behavioral health of the treatment group would improve significantly. The AgrAbility consultants were only informally trained to counsel and assist their clients.

Fetsch and Collins suggested that trained AgrAbility consultants provided the behavior health supports their clients needed. The clients perceived empathic assistance and guidance – they didn’t feel alone. Clients’ mindsets, the researchers said, changed from feeling overwhelmed to hopeful.

The clients often connected emotionally with their consultants (usually people with experience in agriculture and sometimes with previous injuries themselves) and with other recovering farmers at state and national conferences, if they attended these events.

What are the implications of these findings? The research results indicate that distressed farmers in this study who obtained AgrAbility supports improved their stress management and emotional well-being.

Importantly, the assistance must be suited to the farm families’ needs, provided by people who have credibility because they understand farming, and who gain the confidence of the people they assist. The providers of counseling don’t necessarily have to have professional degrees in a mental health field, but they must have common sense, ability to relate to other people, ability to maintain confidentiality and be available when needed.

There are too few controlled studies that compare the emotional well-being and suicide rates of distressed people engaged in agriculture and who obtain behavioral health care and other forms of personal and emotional support, with those who are similarly distressed and who do not obtain any behavioral health assistance.

The Sowing the Seeds of Hope (SSOH) project that I directed and which operated from 1999-2014 in seven upper Midwest states showed that many thousands of farm families benefited from the services. People engaged in agriculture and their family members could call statewide hotlines and obtain free follow-up counseling, if needed, from professionals who also were familiar with agriculture; they also could attend community education events.

However, SSOH funds did not allow for a controlled study with a comparison group, although we tried unsuccessfully several times to obtain research funds. That’s why the study by Fetsch and Collins, which demonstrates the benefits of emotional and physical supports, is important.

Helping agricultural producers with their behavioral coping is particularly needed during this protracted agricultural economic recession.

(Disclosure: I am a member of the Advisory Board for the National AgrAbility Project, for which I receive no salary and in which I have no financial interest.)

 

The views and opinions expressed in this column are those of the author and not necessarily those of Farm World. Dr. Mike Rosmann is a psychologist and farmer in western Iowa. Readers may contact him at mike@agbehavioralhealth.com

3/15/2018