Why some people avoid seeking behavioral health treatment is not well understood. This circumstance is particularly relevant to agricultural producers currently, because many are struggling with serious stress that is increasing their vulnerability to anxiety, depression, substance abuse – and, occasionally but infrequently, even the risk of suicide.

Fortunately, Congress and the media (including radio, television, print) are paying attention to the uncertain farm economy and its effects on the well-being of farmers, their families and communities. For instance, there is much concern about how proposed tariffs will affect the export sales of such agricultural commodities as soybeans, pork and sorghum.

Behavioral health care services and other forms of assistance, such as agronomic and business advice, are available in most places of the United States where people farm or furnish other agricultural products such as fish or lumber. Despite the increasing economic pressures that threaten many ag producers’ livelihoods, some of the people in most need of emotional support avoid professional assistance that is available.

The factors that contribute to people avoiding mental health care when it is needed, and how to overcome these barriers, are not fully known. This is the first of two columns about what is known why some people avoid behavioral health services, and what to do about this circumstance.

A 2014 publication of the Assoc. for Psychological Science indicated that in any recent given year about 60 million Americans experienced some type of mental illness, but only about 60 percent of people with a diagnosed illness seek the treatment they need.

From a public standpoint, the authors said: “Stereotypes depicting people with mental illness as being dangerous, unpredictable, responsible for their illness or generally incompetent can lead to active discrimination, such as excluding people with these conditions from employment and social or educational opportunities. These displays of discrimination” can lead to internal and social stigma.

Lately, ownership of guns has been connected to incomplete understanding of mental illness by some media. Seeking mental health treatment has little to do with dangerousness associated with gun ownership. It’s a form of stigma.

What does the term “stigma” mean? To answer this question I drew on experts in psychology and related behavior sciences.

Stigma, according to a 2013 article by Graham Davey, usually entails discriminating behaviors directed toward people with such psychiatric labels as schizophrenic or bipolar. However, the term can be applied to anyone who acts strangely or defies norms.

Verbalizations, like “she (or he) is mental,” illustrate such stigmatizing behaviors. This is commonly referred to as social stigma. It helps to explain why Sen. Thomas Eagleton was removed as the vice presidential running mate for Sen. George McGovern in his presidential campaign in 1972, after it was publicized that Eagleton had been treated for depression.

Perceived stigma, also called self-stigma, describes the feelings of shame that many people who experience behavioral health disorders feel. For both social and self-stigma, other people and the symptom-bearers may feel that mental health and substance abuse conditions are signs of weakness, are self-inflicted and could be overcome with sufficient willpower.

A 2009 study of 5,555 students in 13 U.S. universities reported in Medical Care Research and Review indicated three main findings regarding stigma about seeking mental health care:

•Social stigma was higher than self-stigma

•Self-stigma was higher among students who were male, younger, Asian, from a foreign country, more religious or from a poor family

•The higher their self-stigma score, the greater they avoided seeking care in the form of psychotropic medication, counseling and reaching out to other sources of assistance, such as dormitory monitors and pastors

Farmers especially don’t seek treatment, Alleah Heise said in the most recent issue of The Ag Progress Dispatch. “Shh. We don’t talk about that … mental health in agriculture,” she noted.

According to research studies during the past two decades in Australia and Great Britain, farmers take pride in being self-reliant; they work excessively hard to overcome adversity on their own, trust their own judgment and have low ability to acknowledge or express mental health problems and seek help.

These behavioral styles contribute to farmers becoming successful, but work against them during stressful times, when they would benefit by reaching out for assistance.

Research my colleagues and I undertook over the past two decades indicates that negative stigma about seeking behavioral health care may be diminishing during recent years, and especially among younger and well-educated farmers. Many farmers and their families are beginning to consider mental health care much like they consider medical care for such problems as diabetes and back pain.

If medical care improves their capacity to work effectively and productively, behavioral health care can also help them farm optimally.

Next week we will look more at how behavioral health services can be improved to meet the needs of distressed farmers and their families.

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