Federated Farmers: Don't be alone when fighting the demons

Sir John Kirwan, who suffered from depression, says there is always hope.

'Tis the season to be jolly, families come together and celebrate the festive season, looking ahead to the new year with anticipation, but for some farmers and rural communities, this period can be a time of great sadness and reflection for other reasons.

The weight of keeping the family farm productive against economical and environmental pressures notwithstanding adverse weather events can lead to a downward spiral where one's mental health can slide into the abyss.

Depression is recognised by health agencies in New Zealand as a common reason for people being absent from work, and it's estimated around 47 per cent of New Zealanders are likely to experience some form of mental illness during their lives. One in six may suffer serious depression.

Above all, depression is widely acknowledged as an associated factor for suicidal behaviour with the Health Promotion Agency reporting it increases the risk of suicide by 20 times. Those most at risk are aged between 45 and 64.

No one factor is attributed to why suicide is more prevalent in rural communities and the link between isolation and rural stress has been a largely under-researched area.

That said, farmers throughout the world are generally considered to be exposed to higher levels of psychological distress than others in society. Farm stress, if not recognised and addressed, can have a detrimental effect on the running of the farm, transpiring to often unforeseen tragic consequences.

Federated Farmers has been campaigning to raise awareness and launched "When Life's a Bitch" campaign in 2013.

The federation also recently requested data specific to farmer-related occupation suicides from Coronial Services.

It shows that from 2007 to June this year, 169 farmers had taken their own lives, eclipsing the 112 people who died in agricultural occupational deaths during that period.

Rural Health Alliance Aotearoa New Zealand (RHANZ), meanwhile, has identified mental health and wellbeing outcomes as one of the major disparities between people in rural and urban communities.

"Rural people, particularly those associated with the business of farming, are being pulled in different directions, which is creating big stressors," says RHANZ chairperson Dr Jo Scott-Jones.

Thirty per cent of his patients had psychosocial issues, mostly mild to moderate depression and anxiety-related disorders.

Marlborough sheep and beef farmer Doug Avery knows all about those 'stressors' and is a strong advocate for understanding and addressing what he prefers to call one's "emotional wellbeing" and he should know, he's been to hell and back.

"To be fair, I don't like it when I hear talk about mental illness or wellbeing. There's that stigma associated with the word mental, and people are immediately put off. They imagine straitjackets, padded walls and that movie One Flew over the Cuckoo's Nest.

"Yep, the black dog is an incredibly serious place to be. I was a helluva happy fella and doing well when the droughts -- the worst ever known -- took hold. After too long, without reward, I lost all enthusiasm for the farm and life itself," he recalled.

Mr Avery, the 2013 Landcorp Agricultural Communicator of the Year, said he was patently aware of the environmental and economical consequences that were surfacing as a result, but ironically, not the social degradation he was exhibiting.

"I was always tired at the end of the day and yet, I had nothing to show for it. I didn't realise the extent of it until I was in recovery mode and my wife Wendy suggested I answer an online questionnaire and I answered yes to virtually all 20 questions."

He had all the classic symptoms: "I would storm out of meetings, get angry and yell at people. I also laid off staff -- I was a huge contributor to my own unhappiness," he said.

Instead of confiding in people more, he pushed them way. That changed when he met Dr Derrick Moot at a Field Days event promoting Lucerne utilisation in dryland farming. The exchange they had that day was life-changing.

"I embarked on a journey of change after talking with him. It lifted me out of a terrible place. I learned about the importance of being in the present and concentrating on what is happening around me at that time. I learned there was "hope".

Mr Avery said it was one thing identifying depression but accepting that you were depressed was the only way to get better. One had to be prepared to "surrender themselves" and to realise that you can no longer manage your problems internally.

Those affected farmers might rationalise that the drought will be over soon or the flooding will recede or there's not a chance of anymore earthquakes, but that won't guarantee your future happiness if you are unable to "manage with the now and have the mechanics in place to adjust your mindset".

From joining a local farmers' committee, set up to acknowledge rural mental health issues, Mr Avery learned first hand the terrible toll the problem is having on rural communities.

"It knocks the stuffing out of communities. Most of rural New Zealand has experienced it and they have all been scarred by it.

"I got tied in with it all doing a video with Sir John Kirwan. I've had hundreds of phone calls from farmers who are just broken -- these will be your stereotypical hard-nosed guys who prop the local club's scrum. I'm happy to listen and help if I can, but it's just as important they talk to their wife or friends."

More often than not, farmers don't. Mr Avery was one of them.

"I still wonder how Wendy stayed with me through it all. She is pretty special, my wife. You know, I'm ashamed of that part of my life but I can tell you, for the remainder of my life, I intend to make it up."

It was okay to express your feelings; it did not make you any less of a man. Staying stoic in the circumstances was misguided.

"When my troubles started, my attitude hardened along with the arteries. I have since learned to soften my outlook and I'm sure my arteries are grateful too," he said.

Being the strong, silent type is not attractive to ladies, said Mr Avery.

"Just ask them - I know for sure. Some have lost their husbands forever and they are left with deep feelings of loss and regret."

Federated Farmers board member Katie Milne sums up the complexity of the issue: "You can generally see where a leg is broken, but not what's going on with a broken mind."
Ms Milne said farmers should confide in family members.

"It's no good being a bastard when you come home and driving your family away. Letting a wife or partner know what's wrong can help as they know you best and can intervene, if, after seeking professional help, your emotional state worsens. It will also explain your frustratingly bad behaviour."

Getting professional help and an early diagnosis to determine the stage of depression was vital. Those who had reached an advanced state of depression could be at "tipping point".

The Health Promotion Agency advises that a depression becomes "serious" when it goes beyond 14 days.

Depression is also highly likely to happen again if it isn't properly treated.

"If you have been feeling extreme sadness, the brain no longer functions as it should and this can be a process to get through. The only way to fix that is professional help and medication," Mr Avery said.

Mr Scott-Jones also urges farmers and their families to act promptly to prevent a potential crisis encompassing a farm, but therein lies the problem as to whether sufficient resources exist.

While there were around 611,000 people living in rural communities (2013 provisional census), health and history records were incompatible with their urban counterparts and information was generally collated from regional variations.

"According to the New Zealand Rural General Practice Network, nearly a quarter of all rural general practices currently have a vacancy for a GP, with some having more than one," said Mr Scott-Jones.

This significant turnover of rural GPs was a worrying trend, which was only exacerbating the situation.

"Without that mutual trust which is developed over time between patients and doctor, it's always going to be difficult," Ms Milne said.

A review of the Ministry of Health's voluntary bonding scheme, to see if it remains fit for purpose in attracting and retaining medical professionals, to rural areas, would be helpful.

RHANZ would like to see rural communities better equipped to deal with the problem. They recommend the same level of focus, funding and resources dedicated to the issue as is available to rural occupational health and safety.

Chief executive Michelle Thompson believes an emphasis on improved internet connectivity is a start.

Improvements in rural broadband would make rural life more "liveable and minimise isolation",

It would also be possible for GPs to work remotely and consult online.

"It's about training, building resilience and having appropriate access to high quality health services, ensuring people have the right skills to see the signs and to know when to seek help," Mr Scott-Jones said.

That void in essential services is further highlighted by the subsequent fall-out, from an on-farm depression, with the sudden collapse of the day-to-day running of the family business.

It's not regarded as a "workplace issue" so there is no ACC cover and limited immediate support available, said Ms Milne.

Because farms are viewed as self-supporting businesses, there aren't sickness benefits available, as the case with other occupations.

"For those who are suffering, there is no information on what you are entitled to and how you can go about it. In terms of running a farm, the breakdown can be profound and have longer lasting repercussions," said Ms Milne.

For example, if you are owner/operator, you might have animal welfare obligations, while a drop-in milk or meat production can impact greatly on your ability to make wages and pay the mortgage.

Otherwise, a loss of employees due to depression could be equally distressing for the farm owner, with unresolved contractual issues arising and the need to find a suitable replacement.

"It's that double-whammy effect," said Ms Milne. The key to averting an on-farm crisis is getting people to realise that "depression is an illness and not a weakness, and asking for help is not an admission of failure in any shape or form.

"If you don't take the steps to get help, a relatively short-term problem could manifest itself into something permanent and that might be clinical depression or even suicide. Imagine the devastating situation that would be for your family," Ms Milne said.

Mr Avery took the steps and is better for it. He is looking forward to the upcoming festive season and 2015 with renewed vigour.

"I'm so excited again about life, and what it offers. Look, there is always hope and as people, and a nation, this is a massive opportunity to help what is broken in our communities.

"I really believe this problem is fixable. I know farmers who changed their outlook and it transformed their lives. Many that I have helped didn't know that I was suffering too.
That's the key, open up and reach out. As farmers and families, we all have vested interest in our emotional wellbeing.