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Behavioral health supports in new farm bill won't be fully implemented this fiscal year

The Agriculture Improvement Act of 2018, which is the title of the new farm bill that was approved by Congress and President Donald Trump, includes $10 million for each of the next five years for behavioral health supports for distressed farmers. Matt Perdue of National Farmers Union reported that "the recently passed appropriations bill includes $2 million for a pilot Farmer Stress Assistance Network."

Congress originally approved a Farmer and Rancher Stress Assistance Network (FRSAN) as part of the 2008 Farm Bill, but funds were not appropriated. The recent government shutdown and subsequent delay in congressional approval of 2019 budget funds likely hampered implementation of the current FRSAN.

Perdue said the $2 million effort will serve as an on-ramp to full implementation of the FRSAN. The National Institute of Food and Agriculture is required to get that money out the door by Sept. 30, 2019.

Perdue added that the U.S. Department of Agriculture is moving forward on implementation of the farm bill's many provisions. USDA is currently in the midst of listening sessions on implementation of changes to programs of Farm Services Agency, Risk Management Agency and Natural Resources Conservation Service. The FRSAN is a "mid-tier" priority for implementation.

It has been unclear which USDA agency will house the FRSAN, but probably it will be administered by National Institute of Food and Agriculture. The Federal Office of Rural Health Policy recently hosted a convening of stakeholder groups and federal agencies including National Institute of Food and Agriculture, the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration to discuss the issue of mental health in agriculture. Perdue said the meeting was a positive step forward in their collective efforts and recommends similar discussions throughout the country.

Delayed implementation of the FRSAN worsens conditions for many distressed farmers, ranchers and workers who need assistance currently while agriculture is going through some of the worst strains since the 1980s. Farmers have the highest rate of suicide of any occupation. Economically marginalized farmers are in greatest need of behavioral health services but usually can't afford care.

The Office of Rural Health Policy funded much of the research and services that became the model for the proposed FRSAN services that are part of the recent farm bill. Funds were made available in 1998 by the Office of Rural Health Policy to the Wisconsin Office of Rural Health and the Wisconsin Primary Health Care Association to help a seven-state agricultural region (Iowa, Kansas, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin) deal with ongoing farm stress problems in a project called the Sowing the Seeds of Hope.

When it became clear that the Wisconsin entities could not administer the regional SSOH project beyond their state, representatives of the seven states met to discuss how to continue the project.

Many of the representatives who gathered at the organizational meetings had experienced the farm crisis of the 1980s; they indicated what worked to support farmers during that difficult era and what didn't work in their states. They chose AgriWellness Inc., a non-profit corporation with which I was affiliated, to administer the continuing seven-state program.

With the help of the state partners, we wrote many grant applications to federal agencies and private foundations and sought contributions to implement services that the leaders determined as having promise to assist distressed agricultural producers. State project coordinators within the seven-state consortium helped to secure funding for their states, such as state legislative appropriations and donations to supplement the resources obtained by AgriWellness.

The project leaders selected the key services for agricultural people: farm crisis hotlines and helplines, the provision of counseling to anyone in the agricultural population who needed assistance, the training of licensed counselors and other persons such as clergy and volunteers to work with farmers. The key services also included weekend educational retreats for farm families and community workshops.

The state project partners also opted to evaluate the effectiveness of support group meetings for distressed farmers and families, outreach efforts, coalition-building, social marketing of services, information clearinghouses and advocacy efforts.

The project services underwent multiple independent evaluations and scrutiny by national organizations. As data accumulated and the evaluation studies were published, the AgriWellness-administered project was declared a "best practice" in the federal publication, "Rural Healthy People 2010: A Companion Document to Healthy People 2010," and a compendium of best practices published by the National Rural Health Association entitled "Hope in the Face of Challenge."

Thus far, it looks like mostly federal agencies are implementing the FRSAN. National Institute of Food and Agriculture and Office of Rural Health Policy would do well to connect with key organizations involved in farming and outside federal government that undertook foundational research about farmers' behavioral health.

Federal officials should also consult with experts, including AgriWellness, around the country to develop the FRSAN program. Experienced researchers and service providers in farmers' behavioral health issues reside in New York, Colorado, California, Washington, North Carolina, Kentucky and other agricultural states.

Mike Rosmann is a Harlan, Iowa, psychologist and farmer. To contact Rosmann go online to: www.agbehavioralhealth.com.

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