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This report addresses mental health matters within the agricultural sector by analysing the sectoral realities, factors, needs, policies, and European initiatives. It has been produced in the context of FARMRes (Farmers Assistance Resources for Mental Health), an Erasmus+ Project, which aims to raise awareness and provide strategies for farmers to deal with mental health problems. This Introductory Report analyses the current situation in the sector. It identifies the factors affecting farmers’ mental health, highlights initiatives to support their mental health and reviews the current state of European policies on this particular aspect of health and wellbeing. This Report also aims to identify preliminary training and awareness-raising needs which is a specific goal that is a core outcome of the FARMRes Project. The Report is based on desk research and interviews with policy makers, farmers, stakeholders, and experts in the field.
Good mental health is a vital condition for people to thrive. According to the report “Health at a Glance: Europe 2020: State of Health in the EU Cycle” (OECD/European Union, 2020), in 2018, one in nine adults.
The COVID Pandemic has marked a significant turning point in mental health, awareness e.g. notable an increase in pathologies associated with stress, anxiety, anger, depression, addictions. This heightened awareness of mental health problems has taken on a new dimension and importance in both the public and private sectors. It is an issue that is frequently discussed in the media, and for which multiple initiatives are being developed.
Rural areas have not been as impacted by the effects of the pandemic, due to the lesser restriction of movement and the sense of community in many towns and villages. This community spirit reduced the impact of the isolation experienced in urban areas during the necessary restriction on free movement at the height of the Pandemic. However, despite this, there has been a marked increase in anxiety, stress and depression resulting from a heightened sense of insecurity and vulnerability, which affects not only the personal but also the professional sphere.
Within rural areas, farmers are the group that, in addition to the social circumstances as a consequence of the pandemic, are suffering circumstances that are having a greater impact on their economic security, generating situations of uncertainty than ever before. Circumstances linked to the market, the escalation of input prices, problems arising from climate change, unfair competition from third countries, reductions in CAP aid, regular negative media press about famers and climate change are the key factors that are seriously impacting the sustainability of farms and are putting many farmers “on the ropes”, as they are becoming more overwhelmed by these new circumstances.
When it comes to the agricultural sector, there is a lack of comprehensive studies and statistics on the incidence of mental health issues in the farming sector in the EU. There are mainly country related statistics and studies, proving the existence of the problematic in many EU countries.
FARMRes has to conducted an EU-wide survey in 2021. Most respondents (75%) declared to have encountered farmers with mental health issues over the previous three years (237 respondents from 11 EU countries, mainly farmers).
Within the farming community, it is women, young people, people with lower levels of less education, as well as small farms holders who are currently most impacted by these emerging circumstances. In order to address these changes, it is necessary to support this group to acquire new skills and competencies that will allow them to manage these situations of uncertainty and most importantly to ensure that they maintain good mental health.
There are multiple needs around farmers’ mental health. Given it is a stigmatised subject and difficult to talk about with the group the focus of FARMRes, it is essential that a sensitive and methodological approaches are adapted to meet their needs is necessary.
Training in this area, the development of self-knowledge, self-assessment, and the use of tools to manage emotional aspects are essential to ensure good mental health in the sector.
The “Agriculture, forestry and fishery statistics” (European Commission, 2018) outlines the major trends in the European farming sector, based on the latest collection of data under the Farm Structure Survey of 2016. The main trends are:
Agriculture has advanced socially compared to the society of 50 years ago, the rural world and the agricultural sector have improved considerably. However, more progress is needed in the areas of, health and wellbeing education and culture.
In recent years, the figure of the farmer has been revalued through awareness of organic, more traditional, natural, and healthy food. The appreciation of agricultural entrepreneurs is increased with the discussion on security of supply. But in general, the farmer’s work is not sufficiently valued anyway, the consumer wants above all cheap but healthy products, while over-concentrated distribution maximises its margins at the expense of farmers’ incomes.
“Is appreciation measured in what is spoken? In speeches, the appreciation has risen. But does the appreciation show in the prices? The store takes the excess away from the producer through the competition.”
European society seems to value agriculture, but there is a current of opinion that perceives agriculture as being to blame for many current factors such as climate change, scarcity of water resources, soil pollution, high sales prices, etc. This view and the debate around these aspects affects society’s view of agriculture.
“When they think about what is holding back the climate, what immediately comes to mind is that agriculture must be done away with.”
“Climate issues are externalised, and they end up blaming agriculture because it is far away from its own environment”.
Farmers have understood the importance of coming together e.g., in associations and cooperatives, to defend their rights and to generate meaningful communication and dialogue with the institutions, as well as to face investments.
Despite everything, their social position is still very low, they are seen as the last step in the chain, and their work is not valued or desired. It is a physically labour-intensive activity and is subject to many uncontrolled factors such as floods, atmospheric catastrophes, pests, diseases, droughts, etc.
Farmers are still stigmatised as unskilled people, employed or self – employed in an unattractive activity and representing a weak link in the value chain. Although this view has been evolving, it is still a professional category that is not sufficiently valued and recognized in our society.
Young people increasingly see farmers as professionals with fewer economic resources compared to other sectors and a lower quality of life, which has an impact on the future and continuity of the activity, and young people want to work in other activities that they consider more profitable.
There are still prejudices about the educational and economic levels of farmers, which have an impact on the vision of agricultural and livestock farming activity. The truth is that it is an activity that does not require specific training, which facilitates access to all kinds of people, who sometimes do not have the necessary skills, knowledge, and abilities to manage the uncertainties that may arise in the activity.
The educational level of agricultural entrepreneurs has increased, but for now the educational level is lower than the average of the population (Luke 2022). The expansion of compulsory school attendance policies is having a positive impact on higher levels of educational achievement and entrepreneurship with the agriculture sector. Consequently, the number of farms run by farmers with higher education, has increased since 2005. In this sense, it is worth noting that young European farmers are more educated than older ones.
New technologies will become increasingly affordable and easier to use. However, for these innovations to make an impact, it will be necessary to increasingly ensure that there are qualified people, with advanced technical skills, who can implement and manage such innovative production systems. This will support and enhance the transformations that are linked to technological advances.
To this end, the farmer of the future will have to be a multidisciplinary professional, who knows how to operate machinery, with knowledge of business, computers, robotics, meteorology, chemistry, and biology.
The idealisation of the rural environment overlooks the existence not only of situations of social exclusion, but also of a number of rural barriers that contribute experience of social and geographical isolation and exclusion, such as restricted and a limited supply of services to the rural population, the lack of social meeting places and social life, the deterioration and scarcity of the of housing stock, the spatial-temporal limitations of accessible public transport.
However, not all rural areas are exposed to such restrictions or these problems in the same way, they have better capacities or resources to overcome such negative consequences. Nonetheless in the rural environment, whatever it may be, there are deficiencies and problems that lead to social isolation and exclusion, in such a way that their impact is greater and gives rise to more serious and complex situations than in areas with more resources as in the case within urban areas.
The deterioration of the labour and consumer markets in rural areas has led to an increase in poverty rates, as well as a reduction in job opportunities. The few jobs that were available were characterised by their marked precariousness due to their link to low-value sectors (such as agriculture and/or livestock, construction, transport, tourism, the small size of enterprises (often family-based), and difficulties in accessing information and additional supports and resources
This situation has led to the migration of skilled human resources towards urban labour markets, with more opportunities, increased pay. A serious consequence of this is the loss of population in rural areas and a significant deterioration in their attractiveness for the development of both new productive investments and services and infrastructures of all kinds.
Regarding farmers, low prices and poor profitability within the farming sector are contributing to the risk of social isolation and exclusion for family farms including small and medium-sized farmers. They are the first group at risk of social exclusion, a situation that stems from high costs, increased competition from third countries that are generating lower sales prices, the continuous reduction of CAP budgets, are factors that result in lower margins and lower economic profitability. In the event of an exit from their farming activity, these professionals with few resources and little training are groups at greater risk of social exclusion. This will probably make them more dependent on subsidised basic incomes and a greater demand for social services.
Exclusion develops slowly, at the beginning, the farmer experiences exhaustion, or financial difficulties, for which he or she does not dare to ask for help. Many farmers work alone, which increases the risk of social exclusion. Farmers without a family and those without close interpersonal relationships easily go unnoticed. With Covid -19, it seems that more and more farmers are isolating themselves on their own farms. Social services do not reach agricultural entrepreneurs, so access to services that meet needs, especially in rural areas, is perceived as a major challenge and requires attention and future development.
The market, costs, low prices, third markets, tariffs, climate change, indebtedness, drought, water shortages. It generates uncertainty, economic and financial insecurity, which can induce situations of depression, anxiety, addictions, violence, self-harm and suicides.
In order to be able to assess them, indicators are divided into two well-being variables: the dependent variable – which includes issues such as personal characteristics, farm, or economic situation – and independent variable – based on different proxies such as suicide or depression rates.
This section considers the dependent variables affecting the mental health of farmers in Europe. That is to say, the factors that have a direct impact on mental health. They are grouped in three categories: Economic-sectoral risk factors, personal-family risk factors and social-labour risk factors.
Price fluctuations of agricultural products and costs for investment are on the rise, further adding to financial insecurity and high degrees of indebtedness. As price-takers, farmers have low bargaining power. The rise of extreme weather events, climate change and of diseases/pest calamities affects the financial stability of farmers and impacts their ability to plan. This significantly adds to uncertainty and stress.
The relationship between the agricultural entrepreneur and the Financial Provider is seen as a mental health factor in economic terms. Such a person can be feared and seen as a threat, as he can decide what happens to the farm. This approach is seen as a burdening factor and an obstacle to seeking other forms of finance. Some agricultural entrepreneurs perceive the financier as an important partner, in which case trust is increased on both sides.
Regulation and administration are increasingly complex and rapidly changing. This is a source of frustration and anxiety for farmers. Laws and regulations should respond to citizens’ problems, not generate more harm than they solve. Continuous regulatory changes, an increasingly restrictive regulatory system, the complexity of regulations, and the ideologization of regulations are restricting the sector.
European farmers are highly dependent on CAP subsidies to maintain the sustainability of their farms and to make the improvements they require. Cuts in European budgets, and their potential disappearance, are straining the continuity of many European farms..
The continued opening of European markets to third country products and the closure of other markets to European products leave the agri-food sector in a complicated situation from the point of view of competitiveness in a globalised sector..
Farmers are at the centre of climate change and are regularly viewed as an accelerating agent. They must defend their role as managers and protectors of their environment and seek a balance between economic and environmental sustainability.
While the profitability of agriculture is at an all-time low, abusive, and unfair commercial practices continue to take place. The weak position of the farmer in relation to the bargaining power of intermediaries and distribution encourages these abusive practices and speculative models.
Working in a sector characterized by a difficult access to agricultural land, farmers compete over land. When a farmer is confronted to moments of fragility, neighboring farmers might take advantage of the situation, to access to his lands and properties. Therefore, this competitive attitude block discussions over personal problems and mental health issues.
In many cases, farmers most at need of help are the ones that have an attitude of distrust towards institutions (State, European Union, public institutes). This prevents them from taking action and asking for help to overcome mental health issues (interview with Jeroen Adam).
Many farmers have a strong outspoken professional attitude of endurance and survival. At difficulty and challenging occasions many don’t speak openly about their problems to family members or access aid, which they perceive as a waste of time or as a sign of fragility (interview with Jeroen Adam). Many studies point at similar issues regarding the stigma and supposedly ‘strong attitudes about being self-reliant and independent’ among rural communities raising barriers to mental health care (Magnus A.M. and Advincula P, 2020: 40).
A question of gender subjectivity comes to the table. The common stereotype of traditional masculinity, quite spread among the male farming community, contributes to exacerbate the taboo over mental health issues.
Work in the countryside has very specific characteristics and involves working conditions that are different from other sectors, being exposed to extreme environmental conditions. In addition, there is little family reconciliation, and agricultural activity is very demanding in terms of time and dedication for farmers.
Family burdens, children, and dependents. There is a correlation between training and emotional management tools, which allow them to relativise and manage the multiple areas of professional, personal, and family responsibility.
Employees with temporary contracts that do not guarantee sustainability for their families’ economy and which in many cases oblige them to move to different locations throughout the year, looking for seasonal harvests of different crops. This can be difficult to manage on a personal level and, in many cases, forces them to live in living and hygienic conditions that are not always optimal and far from their families.
In rural areas we are also finding many undiagnosed psychological disorders, many have spent little time in the education system which has not allowed for assessment and treatment in the early stages of their lives. Some decide to go into farming, and these shortcomings impact on their activity as well as on their social and family relationships. They are more prone to family problems, and more likely to have addiction problems, emotional management problems and greater mental health problems.
Farmers must realize they are a key player in the future of society, but they are not valued as such. The debate on the role of farmers in climate change, on their responsibility for food inflation and on their involvement in environmental management are not adequate to improve this social view.
The lack of training requirements of the activity allows access to young people without sufficient experience and knowledge from a technical point of view, as well as management and planning, these situations increase situations of uncertainty and insecurity, which can lead to situations that affect their peace of mind and emotional management.
Increasing loneliness is seen as a risk factor for mental health. It is believed that the challenges associated with long distances can be helped by digital tools. However, they are not believed to completely replace the needs of social situations.
Farming is a sector of low prestige. The hard work of farmers, those producing the food and protecting the environment, is often not valued by society. In some cases, the societal pressure to step up to environmental standards degenerates to extreme episodes of violence.
The societal stigma associated to problems of mental health creates a taboo in for those suffering, including farmers.
Mental health support services are often very rare and located in isolated areas. In addition to this, there is a lack of specialist mental care services.
Farming is a profession unique in nature: farmers work in isolated rural environments, with very aggressive climatic conditions, often only with family members and with little possibility of social contacts with externals. It’s characterized by a poor work-life balance, high workload, and a low possibility of replacement or time-off . Under these conditions, speaking about mental health problematics can be badly perceived and is a taboo topic. This can exacerbate situations of fragility, leading to stress and anxiety.
the inappropriate use of plant protection products and fertilisers can have an impact on the physical and mental wellbeing of farmers in the medium and long term, and the detrimental effect of many of these products on the health of farmers, if used incorrectly, has been demonstrated.
The primary sector has a high occupational accident rate, and agriculture ranks 4th in the number of accidents per 100,000 workers. Around 13% of occupational accidents occur in agriculture, a rather worrying figure.
The concept of competence is broad. It includes production and financial know-how, change know-how and forecasting and risk management know-how. Planning is seen as important. The constant need to react is considered a way of working that puts a strain on mental health. Planning and risk management help get out of the cycle of constant reacting.
Working with low-skilled, sometimes inexperienced people, or people from diverse cultural backgrounds can be a difficult situation for many farmers to manage, as they must be more aware of these worker profiles, which can lead to loss of productivity and increased costs.
It is an individual, routine, often solitary job, involving long hours, which makes it difficult to reconcile personal and professional life. Many men are beginning to recognise the incompatibility of being able to start families, enter relationships or share time with their families. Loneliness and lack of support generate reluctance, demotivation and sometimes frustration due to the impossibility of delegating.
Good mental health is vital for people’s ability to live healthy and productive lives. Living with a mental health issue can have a significant impact on people’s lives, contributing to worse educational outcomes, higher rates of unemployment, and poorer physical health.
The pandemic exacerbated many risk factors associated with poor mental health and weakened many protective factors, leading to an unprecedented worsening of mental health in the first two years. Early in the pandemic, the prevalence of anxiety and depression doubled in some European countries (OECD, 2021). Mental health was typically worst around pandemic peaks, with depression symptoms generally highest around the time of strict confinement measures.
Available data in some countries suggest that in the first half of 2022, depression symptoms were lower than during the peaks of 2020 and 2021 but remained higher than before the pandemic. In France, depression symptoms among adults peaked at over 20% during the lockdowns and were down to 15% in May 2022, a rate still higher than before the pandemic (13.5%). Similarly, in Belgium, while less than 10% of adults had depression symptoms in 2018, this proportion reached 20% and over during the pandemic peaks of 2020 and 2021 and decreased to 16% in March 2022.
In the first half of 2022, the mental health and well-being of many adults in EU countries remained affected by the ongoing impact and uncertainty around the pandemic, to which new issues such as rising cost-of-living and Russia’s war against Ukraine have been added. Data from Eurofound’s e-survey indicate that in the spring 2022, more than one in two people (55%) could be considered at risk of depression on average across EU countries (Figure 3.13). The share of people at risk of depression ranged from about 40% in Slovenia, Denmark, and the Netherlands to about 65% in Poland, Greece, and Cyprus. In nearly all countries, the share in the spring 2022 remained higher than in the spring 2020.
The risk of depression throughout the pandemic was higher among women, unemployed people, people with financial difficulties and younger people. The rate was nearly 60% among women, compared with 50% among men; nearly 70% among unemployed people, compared with slightly over 50% among those employed; 75% among those reporting financial difficulties compared with about 45% among those who did not report difficulties. Young adults reported poorer mental health than any other age group during the pandemic, a tendency that runs counter to pre-pandemic trends.
The pandemic has challenged already stretched mental health care services, with reports that waiting times increased in a number of European countries. In Belgium and Switzerland, care providers reported increased waiting times for mental health care during the pandemic (Belgian Federal Public Service Health Food Chain Safety and Environment, 2021; Werling et al., 2022). A March 2021 review in the Netherlands similarly reported an increase in both waiting times and waiting lists, with waiting times in some inspected institutions reported to have doubled (Dutch Health and Youth Care Inspectorate, 2021). More recent data from Finland indicate that these challenges persisted in 2022: in September 2022, 40% of people had to wait more than 90 days for specialised mental health care, up from 13% in August 2019.
European countries have taken action to mitigate the impacts of the pandemic but given the magnitude of the impacts and extraordinarily high levels of unmet need, further action is needed to ensure the pandemic does not leave permanent scars on a generation of young people.
As with so much else, the COVID-19 pandemic has taken a heavy toll on the mental health of Europeans and the rest of the world. The effects of the first months, with home confinement and uncertainty, were ambivalent. There was an increase in the percentage of the population experiencing feelings of being down or depressed, having trouble sleeping and little interest or joy in doing things. But, at the same time, the percentage who reported feeling tired, feeling bad about themselves, or having trouble concentrating decreased.
The changes in these mental health indicators, which the European Health Survey collected until July 2020, are more pronounced in women than in men, and they too start from higher pre-pandemic values.
Articles published in the Journal of Psychiatry and Mental Health and in Depression & Anxiety, with data from more than 9,000 health workers in 18 health centres across Spain, showed that half of the people surveyed were screened positive for a mental disorder, and that almost 15 per cent suffered from a disabling mental disorder, i.e., with negative repercussions on their professional and social life. The main symptoms observed indicated a high likelihood of depression, anxiety, panic attacks, post-traumatic stress disorder and, to a lesser extent, substance abuse.
Another paper, published in June 2021 in the Journal of Affective Disorders and conducted through a survey of the adult population during the 2020 confinement, concluded that lack of social contact increased anxiety and depressive symptoms, and found that social relationships, but not so much individual mode and type of living, influenced this increase in potential mental health problems. Detachment was strongly associated with both affective disorders and social support had a statistically significant moderating effect on this association; people with a low level of social support and a high level of detachment were at greater risk of depression and generalised anxiety disorders.
Particularly relevant is the increase in suicide and self-harm rates, especially among adolescents. This group suffers from a lack of emotional management tools. At the level of healthcare workers, they have suffered a high degree of physical and mental fatigue. Even young children born in the COVID have problems with social relations, because confinement has hindered their evolutionary development at such early stages.
The COVID has highlighted the needs of mental health, which was a little-disseminated issue that society was not focusing on. Since the pandemic, mental health has gained a new dimension, making it possible to launch new programmes and initiatives in the public and private spheres.
COVID has allowed people to stop and reflect, for many it has allowed them to make a vital evaluation, and to know their degree of satisfaction with the goals they have achieved in relation to their personal expectations. Many have realised how vulnerable we are, not only from a health point of view, but also how these crises easily impact on our work and personal lives. These situations of dissatisfaction and insecurity have amplified the previous emotional situations that society already had, enhancing new situations of anxiety, depressions, addictions, suicides, etc.
Country
Anxiety
Depression
Portugal
Netherlands
Ireland
Cyprus
Germany
Malta
France
Austria
Greece
Italy
Monaco
Luxembourg
Belgium
Spain
Denmark
Mental disorders have increased in rural areas, but rural areas have been different from cities. In rural areas there is a social cohesion factor compared to cities where there is more anonymity and risk levels were higher.
In rural areas, although there have been fewer restrictions on mobility and interactions, due to lower incidence and less risk due to isolation compared to urban areas, there has been an increased sense of uncertainty, which has had important effects in terms of anxiety and depression.
The COVID has been a before and after in relation to mental health at a European level, many people have suffered post-traumatic stress with a significant increase in insomnia, stress, anxiety, depression, fear, sadness, and guilt. This has generated a spectacular growth in the demand for psychological services, most of them linked to these situations of dissatisfaction and uncertainty in the professional and personal sphere.
In rural areas there are fewer doctors and health and social care resources per 100k inhabitants than in urban areas. Resources are more geographically distant, so if there are difficulties in travelling, it is difficult to access health care services, as well as those related to mental health. There are many villages that are widely dispersed, with few services and few mobility facilities.
Differences are also related to management mechanisms, in urban areas there are more mental health support agencies and associations, and primary care physicians refer with some agility to mental health services. This is more complicated in rural areas where resources are more difficult and less efficiently managed.
In rural areas we can also find many undiagnosed psychological disorders, many have spent little time in the education system which has not allowed for assessment and treatment in the early stages of their lives. Some decide to go into farming, and these shortcomings impact on their activity as well as on their social and family relationships. They are more prone to family problems, and more likely to have addiction problems, emotional management problems and increased mental health problems.
In rural areas, many stress management disorders are emerging, which have increased the fundamental disorders are anxiety disorders, panic disorders and depression.
Rural areas are characterised by a significant increase in the levels of alcohol and drug use, which is a consequence of lower levels of education, culture and the low level of entertainment and leisure facilities. Rural councils have very limited resources, and no enriching leisure options are available, in addition to the geographical isolation mentioned above. It is a widespread problem among young people, but in the family environment it is often the relatives who alert about the problem and demand support for the affected family members.
The significant increase in suicide attempts is notable, which is alerting about the need to create new strategies for prevention and monitoring of groups at greater risk and with previous attempts.
Public mental health resources are scarce and saturated, with long waiting lists and long consultations, and in rural areas there are few private mental health options compared to what can be found in urban settings. This affects the access and level of services that rural areas enjoy compared to urban areas. Meanwhile mental health professionals are overburdened, with schedules that are difficult to manage, which also impacts on the quality of service provided.
Although things are changing, with greater willingness on the part of institutions, and greater interest on the part of society, the fact is that rural areas will presumably be the last to enjoy the benefits of this change in trend.
In surveys conducted in the agricultural sector in some countries, post-pandemic job satisfaction scores have been particularly low, with only 40% of respondents being satisfied with their jobs (2020: 47%). The most satisfied with their jobs were young entrepreneurs, farmers with larger farms and crop farmers (Mela, Work Well-Being Barometer 2022).
The job satisfaction of agricultural entrepreneurs is generally lower than that of other occupational groups, which is explained by physically demanding and accident-prone work. It should also be noted that, according to the 2022 results, especially the satisfaction of the younger age groups (under 40 and under 54) had weakened.
Among the psychological symptoms, the most common was weakness and tiredness, which was experienced by about half of the respondents. Fatigue was more frequent on dairy farms. Compared to previous years, depression (2018: 23 %, 2020: 22 %, 2022: 28 %) and irritability (2018 and 2020: 33 %, 2022: 39 %) had increased in particular. Two thirds of the respondents experienced stress. In animal farms, larger farms, and entrepreneurs under 40 years of age, stress and psychological symptoms were more common. Perceived symptoms of mental stress were irritability, sleep problems and anxiety (Hämäläinen 2022).
A survey conducted in 2021 by MTK-Satakunta targeting agricultural entrepreneurs found that almost half of the agricultural entrepreneurs were worried about the change in the attitudinal climate (49%), 45% were worried about their liquidity and 37% were worried about their own ability to cope. More than half (52%) of the respondents wanted more information on mental well-being.
On the other hand, the Royal Agricultural Benevolent Institution (RABI), in its report “The Big Farming Survey” highlighted that almost half of the farming community is experiencing anxiety and that young farmers are more likely to feel lonely.
Without effective support, mental health problems can increase the risk of dying from suicide. Many studies in EU member states show that suicide rates among farmers are higher than in the general population. For example, the Mutualité Sociale Agricole (MSA) in France consulted its statistics to get a broader picture of the phenomenon: compared to the 40 million people covered by the social security system in 2015 (for 4,991 suicides recorded that same year), members of the agricultural scheme have “a 12.6% higher risk”. And this propensity is even “more pronounced among agricultural workers” (18.4%).
The farmer can work as a farm entrepreneur even if he/she has mental health problems. However, a positive attitude towards services that support mental health is a prerequisite for success at work. The challenge is the limited availability of mental health services in rural areas and the stressful nature and workload of agricultural work. Mental health plays an important role in how the farmer manages to take care of the farm. When, for example, it is difficult to cope with the work and the mood starts to become depressed, the options are reduced.
Agricultural entrepreneurs have the same symptoms of mental disorders as all people. There can be large variations in the symptom picture. Mental health problems can manifest themselves in many ways:
Attitudes towards people with mental health problems have become more positive in recent years. However, there is still a stigma around mental health. 11% of respondents are afraid of meeting people who have experienced mental health problems. The assumption that you cannot live a full life with mental health problems is also still strong (41%). (FCA for Mental Health 2021.)
Stigma related to mental health are seen to have decreased among agricultural entrepreneurs as well. Rural areas are seen to be somewhat behind cities in reducing stigma. Talking about mental health at the level of society, including among agricultural entrepreneurs, has increased. The threshold for asking for help has lowered over the past ten years.
However, there are still stigma about mental health, especially in rural areas. Shame and fear of dealing with mental health problems are obstacles to seeking treatment. Mental health is not yet seen as that we all have a vulnerable mind and for others, the threshold for seeking help is high. Seeking help for mental health problems is also prevented if there is a person who belittles the symptoms experienced by others.
In addition, the concealment causes mental health problems to become entrenched and grow, entering a circle from which it is difficult to escape without help.
Not knowing how to support people with mental health problems generally leads to rejection and isolation, resulting in prejudice and stigmatisation of people with mental health problems. In rural areas, where there is a sense of community, it makes it difficult to recognise a mental disorder, to avoid social isolation.
The reality of people with mental disorders is that they live daily with the effects of stigma and prejudice in different areas of their daily lives. It is true that steps have been taken and actions have been carried out to limit and raise awareness, however, there is still a lot of work to be done. In some cases, the fight against stigma must be more focused on awareness-raising and training, to break down the wall that separates society from the reality of people with mental illness. In others, the effort will be aimed at political advocacy, lobbying different bodies to ensure that the rights of people with mental disorders are respected.
The sustainability of services that support the mental health of agricultural entrepreneurs is important. In addition to the need for permanent services, more preventive services must be developed to promote mental health. At the same time, the availability of the service network in rural areas needs constant attention. Threats to mental health in the future have been described as largely, the same type of issues that agricultural entrepreneurs face now. The concern is that the impact of existing mental health risk factors will increase.
| Future threats to the agricultural entrepreneur's mental health | |
|---|---|
|
Economic uncertainty |
The economy is a big factor of uncertainty. Agricultural entrepreneurs are perceived to have only few opportunities to influence their income generation. It is very difficult to predict costs. The economic effects caused by the change in the period of the Common Agricultural Policy (CAP) will only be seen close to the implementation date. |
|
Network fragmentation |
The number of agricultural entrepreneurs is decreasing, so there may not be neighborly help and conversation partners anymore. Loneliness increases. The network of both mental health and other health services is fragmented and concentrated in urban areas. Fewer than before understand the work of an agricultural entrepreneur and the factors affecting it. |
|
Changes that cannot be influenced |
The volatility of the agricultural sector. Uncertainty is seen to be increasing all the time. Agriculture is undergoing drastic changes. The uncertainty related to changes in CAP -period is also seen as a threat to mental health. |
|
Laying blame |
Blame for climate change, animal rights and poor condition of nature shifted and escalated towards farmers even more than currently. Blame is also seen as a threat to professional identity and professional pride. |
|
Lack of elements supporting work ability |
The development of working life and mental health is considered in Finland for the needs of wage earners. Innovations that develop services do not support the needs of entrepreneurs. |
|
World situation |
Pandemics, wars and other crises affecting society are also a threat to agricultural entrepreneurs and food production. |
Threats to mental health were easy to spot, but opportunities were hard to spot. It is not easy to find ways to eliminate threats to the mental health of agricultural entrepreneurs, because agriculture is currently affected by such a large number of mental health threats. The increase in mental health support and the mental health know-how of agricultural entrepreneurs, increase in appreciation, a fair price from the market, the increase of influence opportunities, and digitalization were seen to create opportunities to support the mental health of agricultural entrepreneurs.
| The future possibilities of the agricultural entrepreneur's mental health | |
|---|---|
|
Development of support |
The skills of the network to bring up a topic and networking is strengthening. Asking for and receiving help becomes easy. The educational level of agricultural entrepreneurs increases, and the knowledge and skills related to mental health develop. |
|
Appreciation |
Self-sufficiency, domestic food and primary production are valued. People are interested in the origin of food. The price that can be obtained from the market is such that the financial survival and development of farm is possible. Finnish food becomes a brand known for its purity and high quality. |
|
Changes that the agricultural entrepreneur can influence |
Working life is becoming more diverse. The growth of farm businesses increases professional farm management. On the other hand, sideline agricultural entrepreneurship is seen to be increasing. It is significant that the things that farmer can influence are observed on the farms. |
|
Digitalization |
Digital tools enable collegial support, even if other agricultural entrepreneurs are not physically nearby. Digitalization increases the availability of health services over long distances. Farm automation reduces the amount of physical work that can reduce the large workload of an agricultural entrepreneur. |
Certain programmes aimed at the most sensitive groups (women, adolescents, unemployed people, etc.) are emerging on a public level from the town councils and on a private level through associations, although these initiatives need to be increased, as for example, now it is not common to find programmes aimed at groups such as farmers.
Covid has made progress, but much remains to be done. There are few resources and initiatives. At the municipal level, courses are being run that focus on the individual, with training in emotional management, emotional skills, etc. European funds through social services and town councils, for greater self-knowledge and the improvement of tools to improve mental health. Rural associations are doing a lot in addiction prevention for adolescents, with individual and group therapy.
In rural areas it is necessary to have a mental health assistant who is a person close to the community, who could act as an intermediary and bring together the services offered to solve problems affecting mental wellbeing.
From agricultural point of view, as long as there have been regulations on the prevention of occupational hazards, there have been obligations to prevent psychosocial factors. However, employers are not aware of this and do not offer solutions in this area for themselves or their workers.
At the level of agricultural organisations, organisations of specific groups such as women’s groups, which carry out initiatives, programmes, and conferences in which they give visibility to these problems at a professional, family, emotional, etc. level. These initiatives are brief and lack continuity, focused on increasing knowledge and raising awareness, but do not allow time to develop emotional and mental management skills and abilities.
Many companies in prevention already have psychologists and coaches who try to facilitate the adaptation process. This is not as widespread in the agricultural sector, although there are online portals that provide these services, although they are not as well known. Incentives should be provided to empower workers through coaching sessions, which would result in higher levels of productivity and satisfaction in the work environment.
Therefore, in terms of work-related training, associated with the workplace, there are options, but they are not being used adequately and even less so in the agricultural sector, so there is still a great deal to be done.
In the last years, many European countries have started to draw up national strategies and to strengthen their policies to support mental health. According to the report “Mental health in all policies: scoping review of national developments (2017 – 2019)” (Mental Health Europe, 2019), 20 countries have recently taken important steps to improve or update their national legislation or policies in relation to mental health.
As Elena Schubert (Policy Officer and Deputy Equality Coordinator for DG AGRI) mentioned in the final conference of the Rural Mental Health project, we are at an exceptional moment where mental health occupies a privileged place in the public debate and, of course, also in the European Union. Despite the lack of a defined strategy, this issue is becoming a cross-cutting one in all its new policies.
Looking at the initiatives from the European Commission, the European Commission has launched the Healthier together – EU Non-Communicable Diseases Initiative (EU NCD Initiative) to support EU countries in identifying and implementing effective policies and actions to reduce the burden of major non-communicable diseases (NCDs) and improve citizens’ health and well-being. Some of the priorities in mental health are the support to favorable conditions for mental health and increasing resilience; implementing mental health in all policies; or the
protection of rights, enhancing social inclusion, and tackling stigma associated with mental health problems. Always in the European Commission, DG SANTE has set up a dedicated network space on its Health Policy Platform for health and social stakeholder organisations to exchange specific mental health practice and knowledge related to COVID-19.
On the other hand, the European Parliament focuses more on advocacy than on the development of mental health policies.
In 2012, some members of the European Parliament established the Coalition for Mental Health and Wellbeing. It is a platform of like-minded MEPs amplifying the voices of people with mental health problems and advocating for a coordinated response to address the most pressing determinants of mental health.
Similarly, there is the MEP Alliance for Mental Health (established in 2009 as the European Parliament’s Interest Group on Mental Health, Well-being, and Brain Disorders), which aims to bring together MEPs and relevant stakeholders to advocate for the development of strong EU policies that contribute to the prevention of mental ill-health and ensure appropriate, high-quality services and person-centered care, empowering those affected.
The socialists in the European Parliament have supported this initiative. Among them, Estrella Durá Ferrandis, member of the European Parliament from the Spanish Socialist delegation and of the Committee of Employment and Social Affairs, called for an EU strategy on mental health.
In addition to her, other MEPs such as Maria Walsh, as part of this alliance, are lobbying hard to establish 2023 as the European Year of Mental Health.
Recently there has been a noticeable increase in the calls for an integrated approach to mental health, taking into account health, social, welfare and youth policies. They have flourished in Europe and at member state level. For example, the OECD Council Recommendation on Integrated Mental Health, Skills, and Work Policy (OECD, 2018) called on governments to promote the provision of early and fully integrated services in order to improve social and labour market outcomes for people suffering from psychological distress symptoms.
Social innovation is key to find solutions to mental health problems and open up the public debate on the topic. It is important to identify strategies for the farming community to normalise conversations around mental health in order to help reduce stigma as a barrier to help-seeking behaviour (University of Reading, 2022). Examples of existing strategies are:
| Educational and peer-to-peer learning strategies for farmers | Train farm gatekeepers to detect and face problems of mental health among farmers | Increasing mental health literacy among farmers (e.g., young ones) |
|---|---|---|
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Open discusión circles |
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Open days and tours to experience a farmer’s daily work and life. E.g.: Hungary |
DJP Foundation Mental Health Support - Farmwell |
Development of course material about mental health literacy for agriculture higher education institutions. E.g.: Belgium |
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Learning networks to develop peer-to-peer learning. E.g.: Belgium |
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Other strategies worth to be explored are:
| Artistic methods to destigmatize mental health problems among farmers | Appoint local champions: charismatic farmers to open communication on the topic. |
|---|---|
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Theatre of the Oppressed, invented by Augusto Boal |
Locally embedded skilled intermediaries offer an incredible resource that can be utilised to reach farmers. |
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Content |
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Below, a prospectus of existing initiatives to tackle mental health issues in agriculture:
| Initiative | Level | Description | Key take-aways | Main sources |
|---|---|---|---|---|
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Farmwell |
European Union |
European Thematic Network project funded by Horizon 2020. The project aims to improve farmers’ mental, physical, and social wellbeing through social innovations. |
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Rural Mental Health |
European Union |
Erasmus+ project that aims to redress the inequality and imbalance between mental health provision in rural areas compared to urban ones. The main purpose of this project is to improve awareness and prevention of serious mental health issue occurrences. |
e-Training, case studies and event about mental health |
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|
ENRD Contact
Point |
European Union |
Supports the operation of the European Network for Rural Development (ENRD) |
It coordinates thematic and analytic work, facilitates networking and exchange, and communicates the work and voices of the network. ENRD developed projects related to mental health. |
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Agrokompas (Compass for Farmers) |
National: Belgium |
Online reference scheme through which farmers have an overview of all relevant (aid) organizations or channels, linked to the wide array of social challenges farmers are being confronted with |
Connect farmers with the right (aid) organizations & channels |
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Mental Health Literacy for Farm Gatekeepers |
National: Belgium |
Providing training to farm gatekeepers in order to detect certain problems in an early stage |
Tackling mental and economic & business problems in an early stage |
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Make the Moove – Farmers Matter |
National: Ireland |
Workshop developed in a community-based response to positive health and well-being for farming men in their rural communities in a new joint initiative. |
Challenging farmers to think about how they approach their work, their own well-being, and their personal lives. |
| Zoom-in: Make the Moove – Farmers Matter | |
|---|---|
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Created by Macra na Feirne, Make the Moove is a farmer-driven, farmer-led program promoting positive mental health among farmers and rural people with the ultimate goal of a nationwide network/service. We interviewed John Keane, President of Macra na Ferine and creator of the initiative. The main reason that led them to create this programme was the high suicide rate in their community in the Midlands (Ireland): in summer 2018, it reached high levels to the point of being the number one problem in their community at the time. |
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In this sense, they started a public consultation with people in their area to gather ideas; they did this through two questions: |
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1. What are the main issues that are affecting you in your life today? |
2. What solutions would you like to see implemented to help you address those issues? |
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From spring 2019, they began to open up the debate and encourage conversation about mental health, managing to speak to over 400 farmers. As a result of their success, they sought to take the programme beyond their region, conducting the same consultation in other counties in Ireland during November 2021, the results of which reinforced the first research. |
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It is necessary to train in the field of emotional management from an early age, if we are not trained in the emotional field, we will have problems to manage them all our lives.
When a person detects that they have a problem due to anxiety, irritability, negative thoughts, saturation, anxiety, or depression. If you are taught to identify the warning signs, you will know when it is necessary to ask for help, where to ask for help where a multidisciplinary assessment (psychotherapy, medication, etc.) is carried out.
Qualified personnel should be involved in this training, facilitating the presence of psychologists and psychiatrists.
Training is needed to provide resources and tools for different situations:
As mental health is a stigmatised topic, to make it more accessible and interesting and to avoid rejection by farmers, it should be oriented towards and clearly associated with wellbeing management, growth management, business management, personal life management skills.. The lexicon and or mental health literacy is important in talking and discussing this sensitive topic with a focus to , generating healthy lifestyles, professional improvement, healthy leisure, in short, focusing on potential improvements, rather than avoiding controversial topics or masking mental health issues.
With the male population, if working groups are created which are concerned with their point of view, in which the problems are focussed in relation to their specific problems (dissatisfaction, working conditions, working relationship), then they will find meaning and practical solutions that can be given to specific problems. However, for particularly sensitive issues, it is possible to work on an individual level i.e., on a one-to-one basis.
With women, to empower themselves they look for the group and need to communicate more and express their emotions. However, for psychological and family situations, individualised psychological care works better.
The family is a whole, if we help one member and the problem remains at home, we will not find a solution. For this reason, it is necessary to work on an individual and family level, in which everyone develops an integral work.
At a methodological level, it must be active and participative, reaching their problems, direct and practical treatment is the best way for them to look for solutions in their lives. In terms of resources and materials, written resources favour knowledge, but farmers do not tend to use texts. It is better to use audio-visual materials, practical workshops, and sharing experiences.
Peer-to-peer sessions can enrich their experience as they share the same language and the same problems, experiences, and solutions. This generates support groups that allow them to accompany each other outside the sessions and share free time with people with whom they have an affinity.
Coaching, mentoring, personal development programmes and training in time management, time organisation, project construction and project evaluation could be very useful for inexperienced young people to feel accompanied and mentored.
Training is needed through courses focused on areas of mental health and wellbeing that can have a greater impact on their personal lives and work, such as: Emotional Intelligence applied to work, Stress and/or frustration/anger management, Resilience, Conflict management. Even business or administrative management programmes for your farms which can generate confidence and security when making decisions or have a greater sense of control over your product. Programmes such as disaster assistance, where families whose crops have been lost or affected can access these resources. Training for diversification and development of initiatives to boost their business. Addiction programmes. Interpersonal skills competencies. Time management, key signs, and symptoms in the main disorders.
Other areas to develop would be:
For addictions:
In the analysis of factors that impact on farmers’ mental health, we have seen how farm business management and planning as well as decision-making are important factors in preventing situations of economic insecurity that can lead to situations that can affect farmers’ mental health.
Therefore, in addition to specific training for the prevention, identification and resolution of problems related to emotional health, training in professional farm management can be considered as a protective factor for mental health. Integrated farm management is considered to consist of three different areas: Self-management, work management and network management.
Good self-management enables the farmer to respect his and his family’s daily schedule. Good labour management and labour leadership ensure that work is done in terms of quantity and quality. Good network management allows and ensures good access to market information as well as market entry.
Furthermore, and this is very important to mention, the result of good management and leadership are possibilities and time slots for family and social activities. Looking at both sides of the coin medal, the downward spiral is exactly the reverse of the upward spiral in the interaction of the farmer and his family business: family and business.
Every day, the farmer, as manager of the family business, faces the challenge of having to make good decisions as a leader. A good decision, of course, requires foresight in the literal sense: those who can best assess how the future will develop have a distinct advantage.
Strategic planning on paper and in theory seems easy. In practice, in everyday life and at work, it is very difficult to distinguish between important and unimportant issues. However, farmers with the right support can use existing concepts and tools both to steer and to make decisions.
It can be concluded that without entrepreneurship and a sense of the market situation, as well as a sense of basic agricultural production, it is very difficult to always make good decisions. However, by providing business management and personal management tools, so that farm leaders can professionalise their management and facilitate their decision making, can be very important factors from the point of view of promoting positive mental health and preventing the impact and consequences of farmers and other members of the agricultural sector experiencing mental health challenges.
This report highlighted the following key messages, ideally targeting policy makers committed to the cause:
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Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them.
