Farmers and mental health

In this Mental Health Awareness Week, which also coincides with this year’s Balmoral Show, this article examines an issue which has received comparatively little attention and on which, so far, not much research has been carried out: mental health within the farming community. What are the causes of poor mental health among farmers and their families, and how much do we know about the personal and social effects of this?

Farming today in Northern Ireland

Northern Ireland has approximately 30,000 farmers and a total farm workforce – incorporating farmers, families and others – of approximately 49,000. There are approximately 25,000 individual farms with an average farm size of 41 hectares; this is the smallest in the UK. A key characteristic of farming in Northern Ireland is that 70% of agricultural area here is defined as ‘less favoured’; this brings challenges in terms of successful farming. The most common forms of agriculture practised are the grazing of livestock for either milk, meat or wool production. Farm incomes here are highly reliant on subvention in the form of the European Union Common Agricultural Policy (CAP) – farm business income across all farm types was calculated as being £6,745 per farm minus direct payments in 2017/18. Farm Business Incomes minus direct payments for cattle and sheep farms were actually negative for the 2017/18 period, meaning that the viability of these enterprises without direct payments in 2017/18 would be questionable.

How extensive are mental health issues within the farming community in Northern Ireland?

This is a difficult question to answer as there are no definitive quantitative statistics that relate specifically to local farmers. The challenge of answering this question is also compounded by the fact that mental health issues can range along a continuum from stress, through anxiety and depression to, at an extreme end, suicide, and as such it is hard to capture an accurate and comprehensive view.

In a more general sense though, Northern Ireland’s population as a whole does appear to have significant mental health issues when compared to the rest of the UK as revealed by the following key statistics:

• Northern Ireland has a 25% higher overall prevalence of mental illness than England – 1 in 5 adults here have a mental health condition at any one time;
• Northern Ireland had the highest suicide rate in the UK in 2014 – 16.4 per 100,000 population compared to 10.3 in Scotland, 9.2 in Wales and 14.5 in Scotland (see also a recent blog article on the issue of suicide statistics and policy);
• Prescription costs per head of population for depression in Northern Ireland are £1.71 compared to £0.41 in Scotland and £0.26 in Wales.

Interestingly, rural/urban analysis of key mental health indicator statistics collected by the Department of Health highlight that, whilst not as high as urban areas, rural Northern Ireland, of which farmers and farm families are an integral part, has issues with suicide, hospital admissions due to self-harm and prescribing rates for mood and anxiety drugs.

With specific regards to local farmers the then Department for Agriculture and Rural Development (DARD) in 2002 commissioned a Social Survey of Farmers and Farm Families. Amongst other things the survey collated data on the health of farmers and agricultural works and found that 5% of workers who worked 10 hours per week or more on the family farm were suffering from stress, depression or anxiety. Of those who were experiencing stress, depression or anxiety, 3% said work was the cause, 1% said work had made the condition worse and 2% said it had both caused and made the condition worse.

More recent work completed on behalf of the local charity Rural Support in July 2016 looked at health and social impacts of the agricultural downturn in Northern Ireland.  Drawing together both responses to a survey (199 responses) and qualitative interviews, the final report included an assessment of the mental health of survey respondents utilising a series of self-assessment questions that generated a value on a scale from -1 to 23 (where the higher the number the worse the mental health condition). Analysis of this data revealed a mean score of 9.8 but also revealed significant numbers of participants with scores that would be either concerning (11-15) or very concerning (>=16).

Is this a recognised issue in other jurisdictions as well?

There is ample evidence to suggest that poor mental health among the farming community is also an issue in other jurisdictions, including:

• More than one farmer a week in the UK dies by suicide;
• Within Great Britain, research completed by the Farm Safety Foundation revealed that 80% of young farmers (under 40) believe that mental health is the biggest hidden problem facing farmers today, with 92% also stating that promoting good mental health is crucial if lives are to be saved;
• Also within GB, a 1998 study of 84 English and Welsh farmers who died by suicide revealed that the most common single causal factor was the presence of mental health problems;
• A 2012 UK study of psychological morbidity of farmers and their partners/spouses based on 784 face to face interviews at agricultural shows found a higher risk of psychiatric disorder amongst farmers and their spouses as compared to non-farmers;
• In 2013/14, dairy farmer interviews in New Zealand as part of a wellness and wellbeing programme found a prevalence of depression amongst dairy farmers lower than the general population, but anxiety disorder prevalence was higher;
• In 2015, a national survey of the mental health of Canadian farmers revealed that 45% were classified as having high levels of perceived stress, whilst 35% met the criteria for depression classification.

What are the causes of mental health issues amongst farmers in Northern Ireland and beyond?

There appears to be no single common cause for mental health issues amongst farmers, but there a number of factors related to the actual business of farming and the nature of the farming community that could be contributing factors, including the following:

• Social isolation and the solitary nature of the work;
• Long and unsocial hours;
• Lack of time off work – particularly as home is often the workplace;
• Time pressures;
• Record keeping and meeting regulatory requirements;
• Weather;
• Working with multi-generational family members;
• Moving from running a family farm to running a business;
• Lack of access to health and support services – time and remoteness;
• Financial worries – income volatility, reliance on direct payments and debt – what, if anything, replaces the direct payments of the CAP post ‘Brexit’?
• Hazardous working conditions – eg machinery, livestock, chemicals; and
• Stigma around mental illness – preventing people admitting they have an issue or seeking help.

It is probably worth noting that many of these factors are also outside the control of a farmer and as such the reality of being a ‘hostage to fortune’ in these instances may also bring added pressures and stresses.

 What are some of the potential consequences of mental health issues for farmers and farm families?

At the most extreme end of the mental health continuum, the impacts of suicide on farm families and wider rural families have been well established and have tended to dominate many of the headlines around farmer mental health. Whilst the loss of a life is both tragic and can have a catastrophic impact on a farm family and farm business alike, there do, however, appear to be more nuanced but nonetheless significant impacts.

At a basic level poor mental health is well established in literature on the topic as having a potential negative impact on physical health. The loss of earnings from an absence at work due to a mental health issue can also be significant for any self-employed businesses such as farming.

There is also some evidence that suggests that poor mental health can increase the risk of injury through accidents, which is a particular concern given the dangerous nature of farming as a profession.

What needs to happen next in relation to this issue?

A key challenge remains the need for more extensive data on both the scale of the mental health issues amongst the local farming community and a greater understanding of the causes and effects of poor mental health. This would undoubtedly assist with the identification and development of approaches to deal with the issue. But it should be noted that there probably also needs to be a conversation around who should be responsible for both co-ordinating and delivering support/interventions.