Farming is a job that brings with it an exceptional set of challenges that are hard to predict or to control. Our farmers feed nations. But isolation, climate variabilities and adverse weather conditions impacting a season's yield can lead to economic hardship. These issues have, for a number of years, been taking their toll. Adding COVID-19 to the mix means that farmers are experiencing even more mental distress and the debilitating issues are not going to disappear. Concerns are increasing locally, nationally and globally over farmers' mental health.
Due to their work conditions, agricultural workers are more likely than those in other industries to suffer illness overall. Their risk of physical illness, particularly lung disease and musculoskeletal disorders, is higher than for other workers. This can also add to stress and anxiety, which can in turn affect feelings towards others, complicate decision making, and undermine coping mechanisms and concentration (Gifford, 2019).
As farming is very often a way of life, ensuring a good work-life balance may be difficult to achieve. Often a farmer's business is also their home, so getting away from the workload may be difficult. Farmers may be perceived as strong, resilient and stoical but, like everybody else, farmers also experience a range of emotional issues that include bereavement, relationship breakdown, anxiety, stress and depression, and they are not immune to the ravages of COVID-19 or the ongoing uncertainty that Brexit is bringing. This is exacerbated by a range of other factors, including lone working, working long hours, isolation from the wider community, experiencing work conditions that cannot be controlled and dealing with life and death all of the time in their daily life (Men's Health Forum, 2018).
The ancestral burden of farming can also result in a great deal of stress for some farmers (House of Commons/Chambre des Communes, 2019); they may feel they have failed their ancestors, partners and descendants. Connecting with others can help to reduce isolation and feelings of being marginalised and this can help to improve a person's overall health.
Nurses have a collective responsibility to do something about the issue of poor mental health, as well as the risk of suicide, among farmers and those who work in the agricultural industries. Every one of us, regardless of the care area in which we practice, has a role to play in making every contact count. Nurses need to appreciate that, for some people, behaviours such as smoking, unhealthy eating or harmful use of alcohol are how they cope with the stress of their living conditions or of managing symptoms or conditions such as anxiety or depression. Preventing mental health problems will also benefit physical health outcomes (Public Health England et al, 2016).
We need to work together to maximise support for population behaviour change and help people significantly reduce their risk of experiencing poor mental health. An increased understanding of and engaging in discussions around mental health will, in time, reduce discrimination and stigma.
Creating a culture in care and support settings that promotes positive mental health can help people to better manage mental health problems. Ensuring everyone can talk about mental health is key but nurses also need to know how to provide support, by recognising warning signs and signposting patients to the support available.
The mental health issues that some farmers are facing come about as a result of complex relationships between social, environmental and economic factors. Although farming can be lonely, farmers do not have to be alone.