How to recognize mental distress

Though the signs of mental distress are generally well known these days, the rate of suicide among farmers is still higher than the average population.

And despite the fact that there are now several farm-specific mental health resources across the country, many farmers find it difficult to ask for help, lack close social support or aren’t aware of what resources are available to them.

To add to the challenges, there are several reasons why people are still generally uncomfortable bringing up the topic of suicide with someone they see struggling:

Old social taboos around the types of subjects one shouldn’t discuss with others.

Cultural models that tell us how we “should” act, e.g., men shouldn’t talk about feelings; farmers are tough and will just figure out how to get through it.

The myth that “If I mention the word suicide, it will give them the idea.”

The person who wants to help just doesn’t know how they can.

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What triggers suicidal thoughts?

People considering suicide often talk about feeling trapped in a box. Quebec’s Sentinel Suicide Prevention Program training guide indicates that they feel desperate, isolated and powerless; they feel stuck and that things will never change. They also feel that their suffering is intolerable.

The guide also notes that people considering suicide will often feel ambivalent: part of them wants to die to stop the suffering, but part of them wants to live. This is the part that can help us help them stay safe.

There are many triggers that make a person consider suicide. The Sentinel program uses the term “critical moments” to denote these triggering events. They include a significant loss (job, money, relationship); failure affecting reasons for living (shame; trauma [sexual assault, rape, etc.]); and problems with the law or authority.

For farmers, the Sentinel guide notes that significant herd, crop or income losses, actual or potential loss of the farm, and/or transitions, such as breakups or retirement, could become critical moments.

Shame alone can be a major trigger.

Merle Massie, executive director of The Do More Agriculture Foundation, a national organization supporting mental health in farm communities across Canada, notes that you might hear things in your community that signal whether someone feels embarrassed or ashamed.

“Is their farm okay or do you know that they’ve been refinancing/stretched/in trouble? Has there been a recent relationship breakup (siblings or family splitting farms acrimoniously, marriage breakup, etc.)? Is this a single or newly single farmer, perhaps lonely or otherwise socially distant? Have they had something happen that’s really embarrassing or shaming that people are talking about?”

The Sentinel guide notes that certain people are more vulnerable to suicide:

People with mental health disorders (e.g., mood disorders, schizophrenia, personality disorders).

People with addiction problems (alcohol, drugs, gambling).

People who have attempted suicide in the past (especially in the past year).

Men in situations of vulnerability (especially if they embrace traditional masculine roles).

Watch for these signs

Mental distress doesn’t look the same in every person. In a community such as agriculture, that has traditionally emphasized head down, hard work, pride and resilience, mental distress can show up in unassuming ways.

“Farming asks a lot of people — long hours, financial pressure, weather worries, isolation and responsibility that never really shuts off,” says Jennifer Wherry, a counsellor with the Manitoba Farmer Wellness Program (MFWP).

“Most farmers are used to pushing through hard seasons. But sometimes stress turns into something heavier, and it can be hard to see, especially when the person struggling is known for being strong and dependable. Knowing the signs of mental distress, and knowing how to check in, can make a real difference.”

Massie says that signs of mental distress can include anything that feels “off”. For example, she says their clothing may be rumpled when they usually appear put together; maybe they’ve forgotten about meetings; the typically organized farmyard looks unkempt; or they’re less chatty than usual and look haggard from lack of sleep.

“Maybe they’re talking about giving things away or getting things ‘sorted and settled’,” says Massie. “Of course, some of us just like to clean out the shop, but if something twigs you, that could be a sign.”

Wherry agrees. “One sign alone doesn’t mean something is wrong, but several changes over time are worth paying attention to.”

The infographic on the right explains some of the signs that could indicate someone might be struggling. Clip it out and keep it in your truck or office.

Beware of misleading signs, too. The Sentinel guide notes that “a sudden improvement in mood does not necessarily indicate the person is doing better. It may mean they have decided to die by suicide and now feel ‘at peace’ with their decision.”

How to check in

If someone talks about feeling trapped, hopeless or like they’re a burden — or mentions not wanting to be around anymore — Wherry says we must take it seriously. There is only one way to know whether a person is considering suicide: ask the question directly.

“Ask them, ‘Are you thinking about hurting yourself?’” says Wherry. “This does not put the idea in their head. It opens the door to honesty.” (See the myths section on the next page.) She says that if you’re worried about their safety, stay with them and help them connect with professional support. If there’s immediate danger, contact emergency services or a local crisis line. (See Resources box on the next page.)

Massie says they teach people in Do More Ag’s ‘Talk Ask Listen’ workshop that asking the question directly is hugely valuable.

“Being brave enough to ask shows that you care. A good practice is to start with ‘I notice.’ For example, ‘I’ve noticed that your hay bales are out in the field.’ Or ‘I know that your best friend died last spring.’ Saying something that you notice opens the conversation.”

She says you can follow with a question such as “Can you tell me how you’re really doing?” and then wait.

“It’s a hard space. People are trained to feel uncomfortable and ‘private’ and ‘I’m not an expert’. We are socially programmed to withdraw and not ask,” says Massie. “Yet we know that it’s when a friend or colleague or neighbour opens the door and says, ‘I’m here to listen, tell me more’, that people feel welcome to share their struggles.

“We never worry about this if someone says they have cancer or heart disease. We only have this fear when it comes to mental health and that’s too bad, because it’s the biggest thing that stops people from saying anything, thinking ‘I don’t know what to say, I don’t want to make it worse.’”

Wherry agrees. “You don’t need the perfect words. What matters is showing up and listening.” See box for ways MFWP suggests you can check in, without feeling awkward.

The dos and don’ts

When establishing connection with someone you think might be in mental distress, keep these dos and don’ts in mind.Don’t simply ask “how are you?” if you feel that something is not right. This polite social convention is something we do automatically; however, people who are considering suicide typically don’t want to be a burden and will reply with the socially correct response of “I’m fine, thanks.” There are other things we might say that can help someone feel comfortable to share their feelings, for example, “You seem sad/angry/far away today. How about we take a minute to chat?”

Don’t use expressions like “successful suicide” or “failed suicide” because they qualify the act in a positive or negative way. Instead, use terms such as “suicide attempt” or just “suicide.”

Don’t try to be their saviour or keep their secret, especially if you feel that they are in imminent danger.

Don’t offer your own “recipe” for happiness. Everyone reacts differently to different types of stress.

Do choose an appropriate time/place to dig in to how they’re feeling. Don’t ask them to talk about their difficulties or concerns when employees or other family members are around, or when you’re in a public place, such as the coffee shop.

Do stay calm and create an atmosphere of trust.

Do “stay within the listen.” Massie says, “Your warm attention, your willingness to listen, that’s the gift that you bring. Suicide simply means that their life, as it is, is in some way intolerable. It’s not about fixing or solving. It’s about listening.”

Three classic mistakes to watch for when you’re listening:

Moving straight to the solve. “In agriculture we are all about solving problems,” says Massie. “We move from problem to problem solving. Stop. Remind yourself that your job isn’t to problem solve or give advice or tell them what to do — even if they ask. It’s about staying within the listen.”

Being a cheerleader. Massie says many of us want to offer positivity, offering platitudes such as “You’ve got this!” or “Tomorrow will be a better day!” But she says, “If someone is in a deep dark place, cheerleading tells them that their hard feelings aren’t welcome or valid, or that it’s just an attitude problem.” Cheerleading sounds like a good idea but those who have experience in the deep, dark pit say, no, it’s not helpful.

Taking over the story. Massie says another way we think we’re helping is by saying, “That sounds tough. That sounds kind of like what happened to me” and make the story about ourselves. “We do this to try and build connections through shared storytelling. Resist this, if you can. Stay within the listen and get them to talk more. Ask active listening questions such as ‘Tell me more’ or ‘How did that make you feel?’ These are ways to be present in the conversation and keep the focus on them.”

Do recognize that people in distress may have biases and negative attitudes towards professional help. Try to understand the reasons behind their resistance and reassure them that professional support is the best option.

Myths about suicide

The biggest myth about suicide is that talking about it or asking someone about suicidal thoughts will put the idea in their head.

“No, it will not,” Massie says. “Asking about, talking about suicide, showing that you’re not scared of the conversation, is so important. When you focus on the person, on listening to what’s really bothering them, staying within the listen, that’s the key. Help them find the parameters of how they’re feeling. That’s the gift that we can give.”

Another challenge comes from people’s misunderstanding between “mental health” and “mental illness.”

“We all need to look after our mental health, and things like eating, sleeping, moving our bodies, resting, these are all important tools,” says Massie. “If someone has a diagnosable mental illness that is erupting — and in your lifetime 25 per cent of Canadians will — then you will do better if you get help. You can’t mental wellness your way through schizophrenia, post-partum, post-traumatic stress disorder or obsessive-compulsive disorder (OCD). These are real illnesses that, if treated early, are entirely manageable, just like diabetes and heart disease.”

See box for myths and truths about mental health.

What to do if you’re not comfortable discussing suicide

What if you feel like something might be wrong with a neighbour or friend, but you just can’t seem to bring it up? Massie suggests AgTalk.

“It’s online, anonymous, completely confidential and people can access it 24/7,” she says. “It’s designed for people in agriculture to talk to one another because some of this stuff is really hard.

“The Do More Agriculture Foundation can send AgTalk cards to any company … to leave with (fellow farmers). We also have stickers with a QR code that links to a wealth of resources right across Canada.

“Sometimes, someone needs a listening ear. Sometimes, they need professional help from a call line. Sometimes they could benefit from professional therapy. As people start to access help, they start to find what works for them.”

Following up

“Support isn’t a one-time conversation,” says Wherry.

“If you’ve encouraged your (neighbour or friend) to open up to you and/or you’ve helped them receive the support they need, she suggests that the next time you visit them, you could say something like, “I was thinking about our talk. How have things been?” She says to stay connected you could invite them for a coffee, a drive or offer to help with chores.

Massie adds that if you’ve had a tough conversation with someone and you’ve managed to connect them with a crisis counsellor, or you left an AgTalk card or a crisis sticker, remember that you also deserve support.

“Please ensure that you call a help line, such as the National Farmer Crisis Line (1-866-327-6701), or 988, the suicide hotline. They have techniques and training to help you debrief. If you’re meeting with that farmer again, you can open by first saying, ‘The last time we chatted, we got into some deep stuff.’ Then, ask ‘I’d like to check in: how are you doing now?’”

Wherry says to remember to share resources, such as local counselors or helplines, privately and respectfully. “And keep showing up for them — even if they don’t open up right away.”