Briana N. M. Hagen

Farmers globally face significant occupational stressors and are reported to experience high levels of depression, anxiety, burnout, suicide ideation, and suicide. While the impacts of high stress and poor mental health have been well-studied in the general population, and to some extent, in specific occupations, the impacts on farmers are understudied. The objective here was to explore the lived experience of high stress and (or) poor mental health in Canadian farmers, including the perceived impacts. Using a phenomenological approach within a constructivist paradigm, we conducted 75 one-on-one research interviews with farmers and people who work closely with farmers, in Ontario, Canada, between July 2017 and May 2018. We analysed the data via thematic analyses and identified four major themes. Participants described myriad negative impacts of farmers’ high stress and (or) poor mental health: (1) personally, (2) interpersonally, and (3) cognitively, which ultimately negatively impacted them (4) professionally, including consequences for productivity, animals, and farm success. The data described far-reaching, interconnected impacts of high stress and poor mental health on participants, the people and animals in their lives, and most aspects of their farming operations, financial viability, and success. Farmer stress, mental health, and well-being are important considerations in promoting sustainable, successful agriculture.

Characterized by high unpredictability and little control, everyday factors make farming one of the most stressful occupations globally. Indeed, farmers around the world and in Canada score more severely on measures of perceived stress and negative mental health outcomes like anxiety and depression, and suicide ideation among farmers is disproportionately high. Research investigating effective ways of coping with everyday stress within the time and workload constraints of farming is scarce. This mixed-methods study explores the ways farmers in Ontario and Canada cope with daily farming stressors. Qualitative data from 75 in-depth interviews with farmers and industry professionals in Ontario, Canada, were analyzed to investigate farming-specific coping strategies within the farming context. Quantitative survey responses from 1167 farmers across Canada to the 14-item Ways of Coping measure developed for the Canadian Community Health Survey Cycle 1.2 were analyzed to determine which coping strategies Canadian farmers use most in relation to the representative national population. The ways of coping endorsed by farmers are presented in this paper, including adaptations of positive coping strategies in the farming context. The descriptions of positive and negative coping strategies used provide direction for effective avenues to reduce stress and boost farmers’ well-being.

Farming is widely regarded as a highly stressful occupation, and many farming stressors have been studied globally. Research on farming stressors in Canada is scarce, yet there is some indication that Canadian farmers have high perceived stress scores and score more severely across mental health outcomes compared to the general population. This study provides a comprehensive exploration of farming stressors in Canada with the aim to inform avenues to reduce stress and/or boost the well-being of farmers. An exploratory sequential mixed-methods design was used. First, qualitative data were collected from 75 in-depth interviews with farmers and industry professionals from Ontario, Canada from 2017 to 2018. These data were then used to inform items measuring self-reported stress across 12 farming stressors in a national cross-sectional survey of farmers’ mental health conducted February–May 2021. Results from both data sources provide an initial understanding of the episodic and chronic stressors faced by farmers in Canada, and the context within which these stressors are experienced. Implications and focus areas for stress reduction and well-being promotion are discussed in this paper.

Farmers in Canada faced higher levels of mental distress than the general public prior to the Coronavirus Disease 2019 (COVID-19) pandemic and are generally less likely than the public to seek help. However, the mental health impacts of COVID-19 on farmers in Canada remain unexplored. Our objective was to investigate mental health outcomes among farmers in Canada by gender and within the context of COVID-19. We conducted a national, online, cross-sectional survey of farmers in Canada (February–May 2021). The survey included validated scales of anxiety, depression, perceived stress, burnout (emotional exhaustion, cynicism, professional efficacy), alcohol use, resilience, and questions regarding participants’ perceived changes in these outcomes during the pandemic. Data were also collected on the impact of COVID-19 specific social and economic factors on mental health, help-seeking, and sense of community belonging through the pandemic. Descriptive statistics were summarized, and Chi-square analyses and t-tests were conducted to compare survey results between genders and to data collected in our similar 2016 survey and normative population data. A total of 1167 farmers participated in the survey. Participants scored more severely across scales than scale norms and the general Canadian population during COVID-19. Scale means were consistent between the 2016 and 2021 samples. Most participants with moderate to severe scores for any outcome reported worsening symptoms since the pandemic began. Women fared significantly worse than men across measures. Over twice as many women reported seeking mental health or substance use support during the pandemic than men. Participants rated the mental health impacts of all social and economic factors related to COVID-19 examined significantly (p < 0.05) differently than the Canadian public. The pandemic has negatively impacted the mental health of farmers in Canada and in ways that differ from the general population. National level and gender-specific mental health supports are needed to help improve the mental health of farmers in Canada.

Globally, farmers report high levels of occupational stress. The purpose of this study was to identify and explore factors associated with perceived stress among Canadian farmers. A sequential explanatory mixed-methods design was used. An online cross-sectional national survey of Canadian farmers (n = 1132) was conducted in 2015–2016 to collect data on mental health, demographic, lifestyle, and farming characteristics; stress was measured using the Perceived Stress Scale. A multivariable linear regression model was used to investigate the factors associated with perceived stress score. Qualitative interviews (n = 75) were conducted in 2017–2018 with farmers and agricultural sector workers in Ontario, Canada, to explore the lived experience of stress. The qualitative interview data were analyzed via thematic analysis and then used to explain and provide depth to the quantitative results. Financial stress (highest category—a lot: (B = 2.30; CI: 1.59, 3.00)), woman gender (B = 0.55; CI: 0.12, 0.99), pig farming (B = 1.07; CI: 0.45, 1.69), and perceived lack of support from family (B = 1.18; CI: 0.39, 1.98) and industry (B = 1.15; CI: 0.16–2.14) were positively associated with higher perceived stress scores, as were depression and anxiety (as part of an interaction). Resilience had a small negative association with perceived stress (B = −0.04; CI: −0.06, −0.03). Results from the qualitative analysis showed that the uncertainty around financial stress increased perceived stress. Women farmers described the unique demands and challenges they face that contributed to their overall stress. Results from this study can inform the development of mental health resources and research aimed at decreasing stress among Canadian farmers.

Working in agriculture has been associated with an increased prevalence of psychological distress and mental health concerns. Farmers are also less likely than non-farmers to seek-help for their mental health. Previous research examining help-seeking among farmers has focused predominantly on male farmers, and has not included many of the Canadian agricultural commodity groups or provinces. The goal of this study was to explore perceptions of farmer help-seeking for mental health amongst farmers and people who work with farmers. The study objectives were to characterize the motivations and barriers to help-seeking behaviours. Semi-structured interviews were conducted with 75 farmers and individuals who work with farmers in Ontario, Canada, between 2017 and 2018. Interviews were conducted in person, and by telephone when needed. Topics of discussion included farming stresses and their impacts; personal well-being; agricultural crises and mental health help-seeking; use of mental health supports; motivators and barriers to help-seeking; and perceived ideals for mental health supports. Thematic analysis was conducted collaboratively by three authors using inductive and deductive coding. Our analysis resulted in five themes around help-seeking motivations and barriers: 1) Accessibility of mental health supports and services; 2) Stigma around mental health in the agricultural community; 3) Anonymity and/or lack of anonymity in seeking support; 4) Farm credibility; and 5) Recommendations for implementing mental health services for the agricultural community. This study provides insights around how farming culture and the accessibility and delivery of services may influence help-seeking for mental health, and proposes strategies to break down barriers to help-seeking in this population.

A systematic review and meta-analysis were conducted to determine the overall prevalence of depression among farming populations globally, and explore any heterogeneity present. Eligible studies were primary research articles published in English, which involved the collection of data for the purpose of determining the prevalence of depression among a farming population. Four relevant databases were searched in January 2019. Potential for bias was assessed using a modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. From 7662 records, 72 articles were deemed relevant and had data extracted. Of these, 45 utilized the Center for Epidemiologic Studies—Depression Revised scale (CES-D/DR) to quantify depression, 42 of which were conducted in the United States (U.S.). As a result, meta-analyses were restricted to this geographic location. Substantial heterogeneity was seen in the initial whole-group analysis (I² = 97%), and while sub-group exploration suggested a significantly higher prevalence of depression among migrant farm workers (26%, 95% CI = 21–31%) than in studies examining a non-migrant farming population (12%, 95% CI = 8–17%), substantial heterogeneity remained (I² = 96%), indicating that the majority of between study variation was due to factors other than sampling error. Additionally, the majority of studies (81%) in migrant farm worker populations were published since 2010, while only 21% of studies in non-migrant farming populations were published in this timeframe. It is possible with recent efforts to de-stigmatize mental illness, participants in more recent studies may be more likely to self-report depressive symptoms. Hence, while it appears that migrant farmworker populations may have an elevated prevalence of depression, it is also apparent that little research in the U.S. has been done to evaluate depression among non-migrant farming populations in recent years. Perhaps a reporting bias may account for some of the difference between the two populations. A research gap also appears to exist in estimating the prevalence of depression among farming populations outside of the US. Assessment for bias at the study level revealed challenges in reporting of key study design elements, as well as potential for selection bias in the majority of studies.

This study evaluated the impact of “In the Know” mental health literacy training for Canadian agriculture. We hypothesized that “In the Know” would significantly increase participants’ knowledge around mental health, confidence in recognizing mental health struggles, confidence in speaking about mental health with others, and confidence in helping someone who may be struggling with mental health. “In the Know” was a 4-h, in-person program delivered by a mental health professional who also had experience in agriculture. Six sessions were offered in Ontario, Canada in 2018. Participants were farmers and/or worked primarily with farmers. A pre-training paper questionnaire was administered, followed by a post-training questionnaire at the end of the session and 3 and 6 month post-training questionnaires via email. Wilcoxon signed-rank tests were performed to compare participants’ self-reported knowledge and confidence across four timepoints. “In the Know” significantly improved participants’ self-reported mental health knowledge and confidence in recognizing mental health struggles, speaking to others, and helping others who are struggling immediately following training and often at 3 and 6 months post-training. This is the first study among farming populations to measure program impact with 3- and 6-month follow-ups. Given the reported associations between mental health literacy and increased help-seeking, disseminating “In the Know” more broadly across farming communities may help to increase mental health literacy and thus increase help-seeking among farmers.

While farmers in several countries worldwide are reported to be at higher risk for poor mental health outcomes like chronic stress, depression, and anxiety, there is a paucity of research on burnout in farmers. This cross-sectional study used an online survey administered between September 2015 and February 2016 to investigate burnout (as measured by the Maslach Burnout Inventory–General Survey (MBI–GS)) amongst farmers in Canada. The specific objectives were to measure the three components of burnout (exhaustion, cynicism, and professional efficacy), and to explore potential associated risk factors, as well as to determine the prevalence of the different burnout profiles (engaged, ineffective, overextended, disengaged, and burnout). MBI–GS results were obtained from 1075 farmers. Approximately 70% of the study sample identified as male and 30% as female, and participants were from a variety of farming commodities. Scores for exhaustion, cynicism, and professional efficacy were all higher than international norms. While 43% of participants were classified as engaged, 44% were classified in the ineffective, overextended, or disengaged profiles (i.e., intermediate profiles on the engagement – burnout continuum), and 12% were classified in the burnout profile. Risk factor results highlighted the positive effects of farmer support from spouse/romantic partner, friends, and industry. Overall, the results from this study demonstrate cause for concern with respect to farmer burnout, suggest potential avenues for intervention, and serve as a call to action to better support farmers in Canada.

Mental health issues among farmers are identified population health concerns. While one systematic review focused on suicide in farming populations in the United States, there have been no scoping studies examining mental health in farming communities worldwide. The objectives of this scoping review were to: provide a descriptive analysis of the literature pertaining to mental health outcomes in farming populations; describe the international scope of the research; and highlight published mental health services and interventions that have been evaluated. Following Arksey and O’Malley’s scoping review framework, five major health and science platforms were used to identify studies examining mental health outcomes in farming populations, worldwide. Studies that met a priori inclusion criteria that were published prior to December 31, 2017 were included in this review. Data synthesis and descriptive statistics were conducted using STATA 15® software; proportions were calculated by country. The initial literature search yielded 9,906 records. After title and abstract screening, 676 articles were reviewed in-full. Of these, 341 met a priori inclusion criteria. Studies included were conducted between 1979 and 2017; the majority (265; 77.7%) were published between 2002–2017. The most frequently measured outcomes were stress (41.9%), suicide (33.1%), and depression (32.6%). Over 70% of studies that examined stress described using quantitative research methods, most predominantly, cross-sectional designs (42.7%). Approximately 64% of studies that measured suicide reported using a quantitative approach; the largest proportion of included suicide studies (33.6%) described using cohort designs. Approximately 84% of studies that measured depression described using quantitative approaches; sixty percent of these studies reported using a cross-sectional study design. Twenty included studies described a mental health service or intervention (5.9%). This scoping review provides a critical overview of the literature examining mental health outcomes in farming populations worldwide. Given the importance of farming and agriculture, this review can be used to ensure future research complements existing work, avoids unnecessary overlap, and begins to tackle the less-studied mental health outcomes amongst farmers. These results can guide researchers to identified gaps in research and services, leading to a more informed approach to future work, and ultimately, a more comprehensive understanding of mental health among farmers worldwide.