In 2023 there were three confirmed suicides of agriculture workers in the state of North Carolina. While this may not seem like a lot, the sad reality is that the real number is likely much higher; in order to protect their families, agriculture workers often make suicides look like accidents. 

“There is very limited data on agriculture suicides, especially in recent years (2022, 2023), and that is a problem,” Robin Tutor Marcom, EdD, MPH, Director of the North Carolina Agromedicine Institute, told the Carolina Journal. “The fact that there were three known suicides in 2023 and that level of illness requiring hospitalization, for us to have that many in a year is very concerning. Farming and stress are synonymous.”

According to a policy brief by the National Rural Health Association the suicide rate among farmers is 3.5 times higher than that of the general population. Male agriculture workers have a significantly higher rate of suicide deaths, at 43.2 per hundred thousand, when compared to the average of 27.4 per hundred thousand across all other populations, according to the brief.

Major contributing factors to mental health struggles include financial struggles, social pressure, and reduced access. Many farmers are reluctant to seek out mental health care as it can be difficult to keep personal affairs private in the small rural communities in which they live. Fear of stigma and discrimination is also a contributing factor.

N.C. Agriculture Commissioner Steve Troxler in 2019 (CJ file photo)

“It’s just a matter of making sure that people do get the help that they need and once again not being ashamed to ask for and seek that help.

Steve Troxler NC Commissioner of Agriculture told the Carolina Journal.

Even for those who want to seek help, mental health services are often limited, if available at all, in rural communities.

“…those resources are out there in North Carolina, and I know the North Carolina Agromedicine Institute at East Carolina University has worked on this issue,” said North Carolina Commissioner of Agriculture Steve Troxler. “What I can tell you is that one farmer suicide is too many. We need to make sure that people get the help that they need and make sure that they’re not ashamed of it. Farming is a stressful, stressful, stressful business. There is so much money involved in it and the risks are so high that you know that’s the big problem. We saw the massive increase in inputs and agriculture over the past several years and what that means is you’ve got much more invested in a crop and if you do have a disaster, you’ve lost much more money.”

“We don’t do any farm session without talking about mental health,” said Marcom. “We are not going to interface with any farmer or farm family member without having this conversation. It really is about starting the conversation and reducing the stigma so that people aren’t suffering in silence. It’s okay to have those conversations and understand that conversation is not weakness.”

The work being done by the Institute and the systems put in place are working.

“We have this happen all the time where someone has recognized an individual in need of help and called themselves or helped that person connect, so we can save lives with the work we do,” said Marcom.

As with other industries, financial stressors are one of the biggest contributing factors to the state of mental health among agricultural workers. As Commissioner Troxler explained, farmers are investing more money along with a growing list of uncontrollable factors such as: weather, inflation, and the pandemic disruptions. While farmers are investing more money, profits have been squeezed in recent years.

“Some, like dairy farmers, are getting paid less than they ever did before for their milk, so there’s so many different factors and it is a hard job because they don’t get vacation days or sick days. It’s like a 24/7 type job,” said Troxler. “They’re providing food and other things for people you know in the state and across the country, it is hard absolutely…There’s a difference in what a farmer does and working, you know, a job somewhere else.”

The North Carolina Agromedicine Institute is working hard to remove the stigma and make mental health services available to agriculture workers and their families. The Institute is the flagship in North Carolina for work related to farm stress.

The Institute encourages education and awareness to start the conversation and make people aware of the signs and symptoms of depression and anxiety. They offer certified training in mental health first aid, QPR (Question, Persuade, Refer) and CALM (Counseling on Access to Lethal Means). All training is free and available across all 100 North Carolina counties.

“We also have NC Farm Helpline available 24/7, anyone can call, and we can get them linked to services,” said Marcom. “This helpline is not restricted to mental health issues but is available for any farm related issue including production, legal issues etc.”

The Institute also offers mental health services at no cost to farmers, families, workers and anyone working or living in the farming environment.

“Individuals can call the farm helpline or me (Robin Marcom) directly and they will be connected to a mental health professional that understands mental health and the farming culture,” said Marcom.

The Institute’s program funding comes from several sources, including North Carolina Tobacco Trust Fund Commission; Farm Credits Of North Carolina; the North Carolina Farm Bureau; the Corn Growers Association of NC; and, the NC Department of Agriculture (via USDA).

“Our goal is that if an individual in the community is in need of help, if they are experiencing any kind of mental health issue, that someone in their daily circle would recognize the issue and know where to reach out for help for them,” said Marcom.

In August, Rep. Yadira Caraveo, D-CO 8th, introduced a bill, known as the National Agricultural Crisis Hotline Act, which would establish through the US Department of Agriculture (USDA) a hotline to provide mental health support for agriculture works and their families. This bill would amend the Food, Conservation and Energy Act of 2008.

“I think the most important thing is that people need to understand that the mind and the spirit is not separate from the body,” said Marcom. “When we talk about mental health it can affect a person’s overall wellness, our spirit, and our mental health. We aren’t Ichabod Crane, our head and our body are not separate beings, they go together.”

Find contact information for the NC Farm Helpline, the National Suicide Prevention Lifeline, the Farmer Crisis Hotline, and other helpful resources available here.