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MU Extension & Missouri Partners Mental Health Awareness Month Promotional Toolkit

2 Contents Purpose ..................................................................................................................................... 3 Outreach Ideas 4 News Release ........................................................................................................................... 5 Interview Talking Points 6 Social Media Messaging.......................................................................................................... 7 Mental Health Awareness .................................................................................................. 7 Referral Resources............................................................................................................... 8 Recognizing Signs and Symptoms .................................................................................. 9 Managing Stress ...............................................................................................................10 Infographics ............................................................................................................................12 Video 12 Articles.....................................................................................................................................13 Print Handouts 14 USDA Webinars .....................................................................................................................15 MU Extension Programs 17 Suicide & Crisis Lifelines ....................................................................................................... 19 Acknowledgments.................................................................................................................22 For Questions About the Toolkit Contact 23 Endnotes .................................................................................................................................24 Bibliography 25

Purpose

Rural Missouri is historically strong and resilient while dealing with long work hours, weather, disease and insects, government regulations, machinery breakdowns, crop uncertainty, livestock problems, and commodity prices. Worry, isolation, loneliness, stress, and anxiety are challenges many face. This reminds us of the importance of evaluating personal health and wellbeing during Mental Health Awareness Month.

According to the February 2020 “Growing Stress on the Farm, The Expanding Economic and Mental Health Disparities in Rural Missouri” report, rural Missouri’s mental health crisis is more challenging than in urban areas. It may be especially severe in the agricultural community. Recent studies, media coverage and congressional action suggest that farmers and ranchers face a unique set of external challenges. These result in adverse mental health outcomes in agricultural communities. Pervasive stigma and geographic barriers to accessing mental health care sometimes prevent those seeking behavioral health services for stress, anxiety, and depression from receiving it in rural Missouri.

To address these issues, during the month of May, MU Extension, the Farm and Ranch Stress Alliance Center (FRSAC) and their partners join the national movement to raise awareness about mental health. Together, they work to fight stigma, provide support, educate the public, make referrals to telehealth counseling, and advocate for polices that support the millions of Missourians affected by stress, anxiety, and mental illness.

MU Extension and the FRSAC compiled a list of helpful resources to provide all Missourians in an online publication called the “Together We Can” Mental Health Awareness Month Promotional Toolkit The toolkit provides resources and tools to promote and support the mental health and wellbeing of rural individuals, farmers, ranchers, farmworkers, and their families in agricultural communities.

Outreach Ideas

Start the conservation in your community about mental health by:

• Sharing social media messages, infographics, articles, and resources on social media.

• Liking and sharing posts from the Show-Me Strong Farm Families Facebook page.

• Creating a watch party on Facebook or hosting a live screening of a video on mental health and wellbeing.

• Visiting the Missouri Department of Mental Health website and sharing rural mental health resources.

• Printing Show-Me Strong Farm Families Coping with Stress on the Farm resources to share with farmers, ranchers, farmworkers, and community members.

• Coordinating with MU Extension specialists to schedule/host a MU Extension program on rural mental health and well-being. See Pages

• Providing information and refer individuals to the Coping with Stress on the Farm telehealth counseling by a professional who understands agriculture.

• Referring farm families and agricultural communities to the Missouri Department of Agriculture AgriStress Helpline for Missourians.

• Distributing resources and messages from the Missouri 988 Toolkit and The Missouri Governor’s Challenge Team to Prevent Suicide.

*Thelastfew yearshavebeendifficultforfarmandranchfamilies.Manyareexperiencingfinancial andemotionalstress as aresult. Toassistfarmfamilies duringthesestressfultimes,the“Farmand RanchFamilyStressandDepression:AChecklistandGuidefor MakingReferrals”guidesheetcanbe helpful.

News Release

Partner representative name

Title

Phone number

[CITY WHERE PARTNER REPRESENTATIVE IS HEADQUARTERED IN ALL CAPS,] Mo. –

University of Missouri Extension field specialist [name] or [insert partner representative name here] says May is Mental Health Awareness Month.

“In 2022, Missouri farmers, ranchers and their families face tough challenges,” says (last name of specialist). “Economic uncertainties, changes in commodity prices and ongoing weather issues add to the daily stresses of farming and ranching.”

Rural Missourians also sometimes encounter barriers to receiving help in a timely manner because mental health services may not be available in all rural counties.

MU Extension covers the 114 counties in Missouri. “The toolkit provides resources and tools to promote and support the mental health and well-being of farmers, ranchers and their families,” says Karen Funkenbusch, MU Extension health and safety specialist.

Throughout May, MU Extension and its partners will join the national Mental Health Awareness campaign to provide resources designed to be useful to farming and rural communities where they live, work, and play.

“With increased pressures on today’s farmers, we want to let farmers know there are ways to fight stigma and provide a safe environment to address mental health concerns of farmers, ranchers, farmworkers, and their families” says [insert partner representative name here]. “Together We Can” help our rural communities develop and maintain a support system for our farmers.”

For more information, go to www.extension.missouri.edu/programs/agrability/show-mestrong-farm-families or contact [partner representative] at [partner representative email.]

Interview Talking Points

Suggested talking points for Mental Health Awareness Month.

• May is Mental Health Awareness Month.

• Many resources are available to rural Missourians to help with ongoing stresses, but sometimes it is difficult to find them. MU Extension and the Missouri Department of Agriculture work together to help farmers, their friends and families, and rural communities find resources.

• Health care resources are not available in rural areas. Factors such as transportation, cost and stigma create barriers to seeking rural mental health resources and/or treatment. Farmers, who are self-employed, may not have insurance coverage for mental health issues.

• Farmers face unique challenges because there are many things beyond their control such as the weather and markets. Planting time is one of the busiest and most stressful times of the year for farmers.

• Mental health issues are not unique. 1 in 5 people will experience mental illness during their lifetime. Between 2003 and 2017, the suicide rate among rural Missourians grew by 78%. Hospital emergency department visits for suicide attempts or ideation grew by 177%.1

• While the overall suicide rate declined in 2020, it rose slightly in those under 24 and preliminary data suggest that the suicide rate increased in Missouri during 2021.2

• In early May and September, Missouri typically experiences a peak in suicide behavior and deaths.2

• Telehealth has become more commonplace for mental health counseling. You can build coping skills with confidential, telehealth counseling from a trusted source.

• Telehealth might be new to you. Like many new things, telehealth counseling can be intimating at first. With a little preparation, you may find telehealth counseling is a valuable, and convenient tool to take care of your mental health from a trusted source.

* To find more Missouri facts and resources, see the Missouri Department of Mental Health “Suicide Infographic 2021” and the American Foundation of Suicide Prevention “Suicide Facts & Figures: Missouri 2023”.

Social Media Post

MentalHealth Awareness

• Suicide is growing at an alarming rate in rural Missouri. Between 2003 and 2017, the suicide rate among rural Missourians grew by 78%, and throughout the last decade hospital emergency department visits for suicide attempts or ideation increased 177%.1

• Farming is a stressful business that typically requires long hours in predominantly isolated working conditions. Farmers tend to live in communities where access to mental health care is limited by distance, stigma or cost due to insurance status 1

• Rural communities may have limited access to healthcare services, which can make it difficult for farm and ranch families to receive support when they experience a mental health crisis. Poor mental health can make it difficult to manage other common stressors 1

• Stigma may not directly affect you, but it may prevent 1 in 5 Americans with mental health conditions from seeking help. Rural, agricultural communities can be highly influenced by stigma. Take the StigmaFree quiz to see if you might be affected: https://www.nami.org/Get-Involved/Pledge-to-Be-StigmaFree 3

• Suicide prevention specialists and mental health care providers talk about the importance of suicide prevention among farmers and ranchers: https://youtube/rWDSKCnZWDA.3

• Everyone has stress and a moderate amount of stress is normal. Read more about the different types of stress and how they can affect you as an individual at: https://extension.missouri.edu/news/when-stress-is-not-normal-3454.

• According to the U.S. Department of Health and Human Services Office of Minority Health (HHSOMH), Black Americans are 20% more likely to experience serious mental illness than the general population.4

• Children’s Mental Health Week is a week in early May dedicated to children’s mental health. Find resources and locate a Children’s Mental Health Week Event at: https://dmh.mo.gov/children-services/children-mental-health-week

Referral Resources

• Telehealth continues to grow in popularity among rural individuals, farmers, ranchers, and their families. Individuals can build skills coping skills with confidential, telehealth counseling from a trusted source.

• Build coping skills with confidential, telehealth counseling from a trusted professional who understand agriculture. Any Missouri farmer, rancher, farmworker, and immediate family member is eligible. To request free telehealth counseling, follow the confidential link: http://muext.us/PSCFarmRanch/.

• Preventing suicide means being informed and knowing what to do when you or someone you know is having a difficult time. Call the 988 Suicide and Crisis Lifeline for free, confidential assistance 24/7.

• Suicide Safe is a free mobile app that helps providers integrate suicide prevention strategies into their practice and address suicide risk among their patients. Download app today from the app store, https://store.samhsa.gov/product/suicide-safe/.5

• Five steps to help someone at risk: ask, keep them safe, be there, help them connect, and follow up. Learn more about each of the 5 steps at: https://www.nimh.nih.gov/health/publications/5-action-steps-for-helpingsomeone-in-emotional-pain/index.shtml/.

• Comments about suicide should never be discounted. If you or someone you know is contemplating suicide, call the 988 Suicide and Crisis Lifeline/.

• “Missouri 2-1-1” is a free referral and informational helpline that connects people with a wide range of health and human services 24/7. Simply dial 2-1-1 from any phone.

• Youth.gov has many resources for youth and families facing mental health issues. Learn more and find resources for youth at: https://youth.gov/youth-topics/youthmental-health/.

• Mental Health conditions typically begin during childhood adolescence or young adulthood. Make things easier and explore information, tips, and resources for getting youth treatment, support, and accommodations they need at: https://nami.org/Your-Journey/Kids-Teens-and-Young-Adults/.

• Missouri Governor’s Challenge Prevention of Suicide Among Service Members, Veterans & Their Families (SMVF) brings together leaders in the community and state governments to prevent suicide among SMVF. Find resources at: https://mogovchallenge.com/

Recognizing SignsandSymptoms

• Individuals experiencing a mental health crisis may not even realize it. Identifiers of someone who may be at risk include change in routine, decline in the care of animals, increase in illnesses, increase in farm accidents, or decline in appearance of farm 6

• Sometimes you NEED help. Sometimes you ARE the help. Learn about signs and symptoms of stress on the farm or ranch. Addressing stress is important for prevention of anxiety and depression: https://www.youtube.com/watch?v=Jt9Tt3CcJuY&feature=youtu.be/.

• Farm life is a busy lifestyle. If you are caring for your mind, body, and soul but still feel like you are struggling, visit http://www.mhascreening.org to check your mental health symptoms. Screening is free and confidential.3

• Men cope with stress differently. Men are less likely to talk about stress. Men escape by trying to get away physically or by denying there is a problem. They may cover stress up with drugs or alcohol. Men may also get angry and aggressive in response to stress.

• Women cope with stress differently. Women are more likely to "tend and befriend." They reach out to friends and family to talk things through and gain support with their problems.

• Stress can surface in the form of physical, emotional, or behavioral changes depending on the person and the situation. Learn about Stress Management for Farmers and Ranchers.

• Do you have a loved one who may be experiencing stress? Chronic stress can lead to anxiety and depression. It is important to Check the Signs and Symptoms

• Be proactive and talk to your health care provider. Ask about potential signs of stress, anxiety, or depression 7

• You know better than anyone else how you are doing emotionally. Be sure to check in with yourself and prioritize your mental health.

Managing Stress

• Manage and alleviate your stress by taking time to take care of yourself. Set limits on how much time you spend reading or watching the news. You can stay up to date on the news, but make sure to take time away to focus on things in your life that you can control.

• Chronic and uncontrolled stress can be detrimental to your health and interpersonal relationships. Learn ways to manage stress in your life: https://ag-safety.extension.org/production-agriculture-and-stress/ 8

• Work and life create stress for all of us and we all manage and cope with stress differently. Here are resources to help you manage stress in your life. https://extension.missouri.edu/news/personal-resources-to-manage-stress-3456.

• Farming and ranching are stressful occupations. It is important to know how to manage stress levels and reduce the effects of unwanted stress: https://extension.umn.edu/farm-safety/managing-farm-family-stress

• Build fun and relaxation into your daily and long-term plans. Think of something you can do regularly, even if you can only take five minutes a day.

• Approaches that focus on relaxation can help a variety of health conditions. Learn about relaxation techniques and which technique is right for you: https://nccih.nih.gov/health/stress/relaxation.htm#hed2.

• Farmers and ranchers often work long hours and eat meals on the go. Healthy, regular eating is essential. Pack fruits and vegetables, whole grain snacks, and plenty of water for long days in the field.

• Take care of your physical health to help lower your stress. Take a break to focus on positive parts of your life, like connections with loved ones.

• Research shows the benefits of exercise go beyond just physical well-being. Physical activities, like walking, biking, and tai chi, can help reduce feelings of depression and stress, enhance mood and overall emotional well-being, increase energy levels, and improve sleep 9

Hashtags:

• #MentalHealthMonth

• #MentalHealthAwareness

Infographics

Common Warning Signs of Mental Illness

How to Deal with Stress and Anxiety

It’s Okay to Talk About Suicide

Getting the Right Start: Student Guide to Mental Health

Suicide Prevention Facts and Resources in Missouri

Taking Charge of Your Mental Health

Want to Know How to Help a Friend? A Student Guide to Mental Health

Videos

Agriculture Mental Health Motion Graphic from Ag Health and Safety Alliance

Loneliness from Brownfield Ag News

Farm Stress: You Are Not Alone from Douglas County Kansas

Farm Management Minute: Mental Health Resources for Farmers from MU Extension

Farmers who Run: Why Exercise Matters in Stress Management from Cause Matters Corp.

Managing Mental Health – Less Stressful Farm Transitions from Brownfield Ag News

Managing Mental Health – Trainings Can Help Save Lives from Brownfield Ag News

Importance of Telehealth in Rural Areas from AgriSafe Network

Suicide Prevention in Rural Communities from I-CASH Iowa Ag Safety

The Surprising Rate of Farmer Suicide | Listen to America from HuffPost

Understanding Key Stresses in Farming and Ranching from NDSU Extension

Articles

Chronic Stress Leads to Health Problems

Come Together to Manage Stress on the Farm

Have You had 15 Laughs Today?

How to Talk to a Man About His Mental Health

Mental Health Issues Facing the Black Community

New Research Identifies Behavioral Health Crisis in Agriculture

Personal Resources to Manage Stress

Suicide Prevention for Men

Supporting Farmers’ Mental Wellness

The Gift of Better Mental Health (page 18)

When Stress is Not Normal

Worries Within

Print Resources

Coping with Stress on the Farm: Telehealth Counseling: Fact or Fiction from MU Extension

Emergency Preparedness Guide for Farmers, Ranchers, & Families with Health Conditions from MU Extension

Farm and Ranch Family Stress and Depression: A Checklist and Guide for Making Referral from MU Extension

Growing Stress on the Farm, The Expanding Economic and Mental Health Disparities in Rural Missouri – February 2022 from Missouri Coalition for Community Behavioral Healthcare, Missouri Department of Mental Health, Missouri Farm Bureau, Missouri Hospital Association and MU Extension

How Stress Affects Your Health from American Psychological Association

I’m So Stressed Out from National Institute of Mental Health

Missouri Ask Listen Refer from Missouri Department of Mental Health

Signs and Symptoms of Stress from MU Extension, Missouri Department of Agriculture, and Upper Midwest Agricultural Safety and Health Center

Suicide Prevention & 988 Guide for Schools from Missouri Suicide Prevention Network

Suicide Prevention Facts and Resources in Missouri from Missouri Department of Mental Health

Stress Management and the Challenge of Balance from MU Extension

Suicide-Proofing Your Home from MU Extension

The Teen Brain: 7 Things to Know from National Institute of Mental Health

You are not alone from MU Extension and North Central Farm Ranch Stress Assistance Center

MU Extension Programs

Health Information for Men

“Health Information for Men” (HIM) program aims to help change life expectancy for American men. Through lessons that cover the latest finding on health-related topics ranging from hypertension to sleep, HIM provides the information needed to improve their health.

Heroes to Hives

“Heroes to Hives” supports the financial and personal wellness of veterans through a free, online nine-month beekeeping course and hands-on training. Participants receive between two to six hours of lecture content every month from March to November that is pre-recorded so they can learn at their own pace.

Mental Health First Aid Training

“Mental Health First Aid” is a course that teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders. The training gives you the skills you need to reach out and provide initial help and support to someone who may be developing a mental health or substance use problem or experiencing a crisis.

Missouri AgrAbility Project

The purpose of the Missouri AgrAbility Project is to help increase the likelihood that farmers, ranchers, farm workers, and farm family members who are limited by any type of disability or chronic health condition employed in production agriculture or agriculturerelated occupations become more successful.

Question, Persuade, Refer (QPR)

QPR a one-hour program. An MU Extension certified QPR Gatekeeper instructor will help participants recognize the warning signs for suicide and learn how to intervene using the three-step QPR method. Participants will become certified QPR Gatekeepers prepared to “Ask a question, save a life.”

Taking Care of You

“Taking Care of You” is a stress management program developed by an interdisciplinary MU Extension team. This research-based, multi-session program offers practical strategies and experiences to help you deal with stress in your life. Managing life’s challenges in a healthy way allows you to take better care of yourself and your overall health. Each session week you will explore topics through small group discussion, self-reflection, and activities.

Tai Chi for Arthritis and Falls Prevention

“Tai Chi for Arthritis and Falls Prevention” is designed to improve multiple aspects of health through slow, gentle movements that can be practiced almost anywhere. The degree of exertion can be easily adjusted, making this program suitable for adults of all levels and abilities. You will learn warmup exercises, six basic and six advanced moves and a cool down during 16 one-hour classes. Harmony of inner and outer self comes from integrating mind and body, which can be achieved through the ongoing practice of tai chi.

Weather the Storm in Agriculture: How to Cultivate a Productive Mindset

Weather the Storm in Agriculture focuses on helping farmers and their families understand the effects of stress on the mind and body and how to manage it effectively during difficult times.

Youth Mental Health First Aid Training

“Youth Mental Health First Aid” teaches you how to identify, understand, and respond to signs of mental illness and substance use disorders. This training gives adults who work with youth the skills they need to reach out and provide initial support to adolescents (ages 12-18) who may be developing a mental health or substance use problem and help connect them to the appropriate care.

Suicide & Crisis Lifelines

The 988 Suicide & Crisis Lifeline is a national network of local crisis centers that provides free and confidential emotion support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States. They are committed to improving crisis services and advancing suicide prevention by empowering individuals, advancing professional best practices, and building awareness. The lifeline is available for everyone to find resources specific to an individual visit 988lifeline.org/help-yourself/.

Access Crisis Intervention (ACI) Hotline

“ACI” provides access to services for individuals experiencing a behavioral health crisis. Callers will have access to behavioral health crisis services. The hotline provides free, confidential assistance 24/7. Visit the website to find the “ACI” hotline number for your county.

AgriStress Helpline for Missouri

Anyone involved in the Missouri agriculture industry who wants to talk is encouraged to contact the AgriStress Helpline for Missouri by calling or texting 883-897-2474. The helpline is available 24 hours a day, seven days a week.

Coping with Stress on the Farm

Build coping skills with confidential, telehealth counseling from a professional who understand agriculture. Any Missouri farmer, rancher, farmworker, or immediate family member is eligible. To request free telehealth counseling, follow the confidential link: http://muext.us/PSCFarmRanch

Iowa Concern

Iowa Concern provides stress counselors, an attorney for legal education, information, and referral services for a variety of services that Missourians can access through MU Extension and a North Central Region Farm and Ranch Alliance Network federal grant. The toll-free number, live chat, and website are available 24/7. 800-447-1985.

Missouri 2-1-1

“Missouri 2-1-1” is a free referral and informational helpline that connects people with a wide range of health and human services 24/7. Simply dial 2-1-1 from any phone.

Missouri 988 Toolkit

The Missouri Department of Mental Health has launched a statewide campaign to spread awareness and educate Missourians on this life saving service. Within this toolkit you will find graphics, videos, print materials, and more. These are available for you to share with friends, family, local organizations, and anyone else who may need it. Help spread the word about 988 and save lives.

Missouri Governor’s Challenge Team to

Prevent Suicide

The Missouri Governor’s Challenge Team to Prevent Suicide among Service Members, Veterans and their Families has a website to further the state’s efforts in reducing suicides. Website provides general information on the team’s projects and strategic priorities, the impact suicide is having on the military community, and resources for both members of the military community and for anyone wishing to support them.

Missouri Suicide Prevention Network (MSPN)

MSPN’s goal is to coordinate and develop implementation of the Missouri Suicide Prevention Plan, based on the National Strategy for Suicide Prevention.

More information on 988 in Missouri can be found here: https://missouri988.org/

If you need support, are thinking about suicide, are experiencing a mental health or substance use crisis, or worried about a friend or loved one, reach out for support by calling or texting 988 or chatting at 988: https://988lifeline.org/chat/.

North Central Farm and Ranch Stress Assistance Center

The North Central Farm and Ranch Assistance Center is a 12-state, 15-partner collaborative to create and expand stress management and mental health resources and services for agricultural producers and stakeholders in the North Central Region. We believe in “Working Together” to cultivate rural supports, mental health resources, and community to help farmers, ranchers, farmworkers, and other agricultural workers as they navigate increasing stress.

Acknowledgements

The preparation of this document was coordinated by Karen Funkenbusch, Project Director, Farm and Ranch Stress Program, University of Missouri Extension. Special thanks to the Farm and Ranch Stress team who provide support and educate Missourians affected by stress, anxiety, and mental illness.

Amber Allen