Attendees of the “Standing in the Gap” rural mental health summit Aug. 22, 2023, in Dodge City listen to NAMI Kansas executive director Sherrie Vaughn speak. Officials with NAMI Kansas and other mental health care providers heard concerns about the increase in mental health issues and lack of access to care in western Kansas. (AJ Dome for Kansas Reflector)
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DODGE CITY — Kansas mental health care workers acknowledge a gap in mental health services and data for farmers and ranchers in the western portion of the state.
Officials with the Kansas chapter of the National Alliance on Mental Illness held an inaugural summit Aug. 22 in Dodge City, called “Standing in the Gap,” to highlight the difficulties of accessing mental health care services in rural Kansas and offer potential solutions to frontier mental health issues.
NAMI Kansas executive director Sherrie Vaughn said her Topeka-based organization is concerned about the lack of mental health care in some rural areas.
“We continue to see an increase in suicides in our frontier and rural communities,” Vaughn said, “farmers and ranchers specifically, and just access to care overall. It continues to be an ongoing problem.”
According to data from the Centers for Disease Control and Prevention, agricultural producers have a higher suicide rate than other professions. The CDC report, published in 2020 with data sourced in 2016, found that men who worked in the agriculture industry were at greater risk, with a ratio of 43 deaths by suicide per 100,000 people. Statewide, the suicide rate for men is 19 per 100,000 people.
Maria Perez, a clinical pharmacist and NAMI summit presenter, said men who work in the agricultural sector in Kansas are three to four times more likely than women to die by suicide. Of the suicide deaths recorded in Kansas in the past several years, Perez said, 50% involved firearms. Additionally, 90% of people nationwide who died by suicide had an undiagnosed mental illness.
Suicide is “the 10th-leading cause of death in the U.S.,” Perez said. “There’s an average of 129 suicide deaths per day in the U.S.”
The CDC report indicated the suicide rate among the working-age population in the U.S., people ages 16-64, increased by 40% in less than 20 years. In 2017, about 38,000 people died by suicide in America. That figure peaked at 48,344 in 2018. The most recent data comes from 2021, when 47,646 suicides were tallied in the U.S.
Stigmas and ‘doing better’
Farmers and ranchers are more prone to suicidal thoughts and attempts for multiple reasons, Perez said.
Stress over finances, crop conditions, insurance and other physical health matters can compound over time, and without proper counseling or access to services, rural residents’ mental health can suffer.
Hodgeman County rancher Brian Hastings was one of five panelists who participated in a group discussion at the summit. He told the group of about 50 attendees that he thinks the long distances ag producers cover in Kansas contributes to overall feelings of isolation, as well as a lack of accessible care.
“We’ve got some very good services out in southwest Kansas, but in my own opinion, they’ve got way too much to do,” Hastings said. “You talk about burnout among farmers and ranchers, but I think medical providers are having issues, too.”
Hastings is a licensed marriage and family therapist in addition to owning a cow and calf operation in western Kansas. He said the mentality of most ag producers in the state is one of rugged individualism, a “do it yourself” attitude, which can conceal a lot of mental health concerns.
“When you’ve got a rancher that’s been ranching for 60 years, nobody tells him what to do,” Hastings said. “That’s why he’s still out there, he’s independent. But he doesn’t know why his buddy is starting to drink so much beer, you know. It used to be, you drank beer after 6 o’clock. Well, now they’re drinking beer at 8 or 9 o’clock (in the morning), filling up the cooler and going out to the field, and it’s a problem. It’s depression, and these folks just don’t understand the connection.”
Hastings said it’s important for groups like NAMI Kansas and other mental health care providers to continue having conversations about mental health needs of rural residents, to both combat the stigma surrounding mental health and find workable solutions.
Sim Wimbush, a social worker and disability policy engagement director for Healthy Blue of Kansas, was another panelist. She said she’s concerned by the tactic some insurance companies are taking following the end of the public health emergency spawned from the COVID-19 pandemic.
“Some of the current insurers are denying claims for assessments, like behavioral health assessments, being done virtually,” Wimbush said. “They’re saying, ‘Well, the pandemic is over, so you should be doing this in person now.’ In a rural area where it can take you maybe an hour-plus, two hours-plus, to get to an appointment, if you can find someone to begin with … to me that’s a big concern.”
Wimbush said having consistent telehealth and behavioral health options — as well as reliable broadband internet access — in western Kansas is key to ensuring people can access care when they need it. Fellow panelist Itzel Moya, who helped found the southwest Kansas chapter of NAMI in 2021, said another challenge for mental health care providers comes from a language barrier. As the Spanish-speaking population grows in southwest Kansas, so too does the need for health care materials to be printed in Spanish, as well as the need for bilingual care providers.
“In western Kansas, we do have more providers that speak Spanish now, and we have more resources that are in Spanish now, in comparison to how it was when I was growing up,” Moya said, “but it could still be better.”
Eric Van Allen, vice president of business development for national nonprofit health insurance plan CareSource, said everyone from mental health advocates to local religious leaders and other farmers and ranchers can “do better” to collectively normalize talking about rural mental health needs.
“I think we have to get much better at that,” Van Allen said. “We have to do better at funding it, we have to do better at providing it, we have to do better at engaging community members to do it, so that it just becomes part of the conversation.”
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