Teaching mental health professionals to think like a farmer

Kaila Anderson stands in front of some photos in the farmhouse where she grew up, near the tiny town of Sabetha, in the northeast corner of Kansas. Outside, frozen February fields of wheat, hay and corn stubble repeat across the rolling hills. This agrarian landscape inspired a breakthrough she made four years ago that now promises to help farmers struggling with their mental health. 

A licensed social worker, Anderson knows firsthand that farmers have a propensity for depression and one of the highest rates of suicide of any occupation, often attributed to the demanding and precarious nature of the job. Yet she has found that crisis-line staffers, doctors and therapists in farm country often don’t have the cultural training to recognize the signs of emotional stress unique to farmers.

She wanted to explore an emerging idea in psychology that farmer stress is deeply intertwined with the land. But, as a therapist, she needed a tool that could make this connection clear to farmers themselves. And then she saw it, right here on the wall of her childhood home: an aerial photograph of her own family’s farm — the house, the old barn, the windbreak of redcedar trees, and these same fields in summer green. Almost every farmhouse in America has a photo like this hanging on its walls — just another member of the family, as it were.

“I walked by these images, and they’ve been there in various forms for my whole childhood, it was like, whoa,” said Anderson, 40. 

Farmers don’t typically talk about their emotional lives, but these photos, or a hand-drawn map of their operation, can become an unthreatening tool that therapists or family doctors use to start a discussion that eventually reveals a farmer’s underlying emotional struggle. A cattle feedlot, for instance, might be the locus of intense stress when there isn’t enough money to feed the cattle. Or a reliable field of alfalfa could be a solace.

She used this idea to create the LandLogic Model, a new way to train healthcare providers that uses farmers’ relationship to their land to identify and treat depression, anxiety, and other emotional issues within a notoriously hard-to-reach population. Operating in areas that typically don’t have enough mental health professionals, she’s trying to get family doctors, crisis hotline staffers, county health workers, pharmacists and others to recognize what it can mean when a farmer says, “I can’t afford to feed my cows,” or, “The sorghum crop just failed” — statements that are often about much more than financial stress. 

Over the last three years, Anderson has kicked off most of her LandLogic training sessions and presentations across Kansas, Colorado and elsewhere in the Western US with these aerial photos, and watched farmers’ eyes light up as if to say, somebody understands me.

“The common denominator,” she said of farmers, whether they grow corn or soy or run a dairy operation, “is the land.”

Anderson has an intimate understanding of this relationship to the land, and of the potential emotional consequences when it starts to break down. As we stand in front of the photos in the family farmhouse, her mother, Linda Ackerman, points at one and said to Kaila’s father, Galen, “Weren’t you out in the silo shed when you thought about doing yourself some self-harm?”

“Yeah,” Galen said, pointing. “See that little white building there?”

Forty years ago, Galen had been struggling with depression. In that little white shed, a spinning auger pulled stored cattle feed out of the silo. “I thought about sticking my hand in the auger,” he said. “That’s just completely illogical. But also I thought, ‘Well, we have insurance.’ It was probably a $50,000 policy or something, but I thought, ‘Oh, Linda would be so much better off if I was gone and she had that money.’”

It was the height of the farm crisis of the 1980s, when agriculture collapsed nationwide. Crop prices plummeted and interest rates on operating loans — which farmers take in the spring to pay for inputs like seed and fertilizer, then pay back after harvest — were over 20 percent. By the end of the decade, an estimated 250,000 American farms would be sold or lost to foreclosure and more than 1,000 farmers had died by suicide.

Galen and Linda had been under tremendous stress since they took over the 160-acre family farm. They had initially arranged to split responsibilities with Galen’s high-school-aged brother, but the plan fell apart only months later when he was killed in a tractor accident. And like other farmers, their incomes dropped in the mid-80s — while he and Linda had two kids, and Kaila on the way.

Galen became obsessed with the thought that he would lose the family farm. He thought he would rather die than lose that legacy. He stopped sleeping, then stopped eating, saying he was “gloomy.” Finally, Linda called the pastor of their church for help. She didn’t call a mental health professional, she said, because that was for “crazy” people.

The pastor gave Galen Bible verses to memorize: “Do not be anxious about anything,” the “peace of God … will guard your hearts and your minds.” He recited them out loud whenever the bad feelings arose — in the silo shed, in the feedlot, hammering nails on the new house he was trying to build. 

He got through the winter and started to improve. 

The fear and uncertainty that made the farm crisis of the 1980s so deadly, however, still plagues rural America today, as farm stress is rising to another crisis point. Agricultural producers have endured several years of very low commodity prices, inflation on things like fertilizer and pesticides, rising consolidation in the marketplace, avian flu, and the mounting effects of climate change. If that weren’t enough, now the Trump administration is imposing tariffs (which did serious damage to farms during his first term), cancelling food-aid programs and energy project payouts, targeting migrant farmworkers, and firing federal employees who deliver critical services, from pest research to weather information. The situation is prime for another rash of mental health emergencies in rural America.

Anderson’s work is built on that of Dr. Michael Rosmann, a psychologist and Iowa farmer. Considered one of the creators of an emerging field of medicine and wellness called agrarian behavioral health, he launched outreach programs, hotlines and rural treatment centers during the farm crisis in the 1980s. He later helped federal lawmakers draft the Farm and Ranch Stress Assistance Network, a national suicide prevention network; developed a set of best practices for farmer suicide prevention and counseled hundreds of rural people.

At the core of agrarian behavioral health is understanding why farmers farm, and why they despair when they cannot. Studies starting in the early 1980s found that while most people ranked personal events, such as divorce or the death of a family member, as leading causes of stress, for farmers, it was the loss of their farm. Rosmann’s own surveys found that farmers considered the loss of the ability to farm, or even the threat of such a loss, equal to the loss of a child.

Rosmann believes this connection goes beyond the fact that the land is how farmers make their living. In 2010, he came up with a theoretical explanation that he calls the agrarian imperative:  humans are genetically inclined to protect and nurture a piece of land that produces food, wood, or needed products for life. Writing in the Journal of Agromedicine, he suggests that this genetic tendency is in everyone, and that it is activated by contact with the land, animals or the environment. Farmers, foresters and commercial fishers are good at their jobs because they get deeply attached, but are at risk when that role is threatened.

For farmers and Ranchers, Anderson notes, it can be a source of relief to know that genetic drives partly shape our behavior. Through LandLogic, she’s advancing the agrarian imperative by doing what Rosmann says he himself did not: use the land in treatment.

LandLogic draws heavily on cognitive behavioral therapy. Developed in the 1960s, CBT attempts to identify the relationship between a person’s thoughts and behaviors, and redirect negative thought patterns to something more positive. Today, it’s one of the most common, and best-studied forms of psychotherapy. In training sessions, Anderson describes LandLogic as “a cultural adaptation of cognitive behavioral therapy designed for the agricultural community.”

Kirsten Wulfsberg, a licensed counselor in Chaffee County in central Colorado who has taken the LandLogic training, shows how a therapist can create interventions using the farm itself as a tool. In her job with the Colorado AgrAbility Project, part of a nationwide network helping farmers overcome physical and mental issues, she had one client who repeatedly told her that he was stuck in a rut.

“So I told him to go sit in a rut,” Wulfsberg said. She told him to find a ravine on his farm and sit there. As he sat there, he watched birds and other animals go in and out of it. Some of them climbed straight up the sides of the ravine, and others found routes that were less steep. He eventually recognized that he tended to take the harder routes in his life. This intervention showed him that he actually had options — that maybe he wasn’t so stuck.

“Ranchers and farmers don’t spend a whole lot of time talking about their emotions,” Wulfsberg said. “[This approach] gives them a language that’s non-threatening, a form of communication that they didn’t have before.”

Chad Reznicek, a clinical therapist who is co-developing LandLogic with Anderson, says the key to LandLogic’s acceptance among the farming community is its “ecological validity,” meaning it fits the world of the agricultural producers it’s meant to treat.

“How can we move the work in therapy from an abstract exercise in an office that’s detached from someone’s experience and instead do something that gets them to reconnect in a different way with their day-to-day experience on their land and in their operation?” said Reznicek, also a behavioral health specialist with the Colorado AgrAbility Project.

Farmers are problem-solvers, both Wulfsberg and Reznicek point out. Give them an opportunity to change their behavior, in a way that they can do themselves, and they have a path forward.

This emphasis on the practical is also the key to getting farmers and ranchers in the door with a therapist in the first place. “You don’t have to be a producer,” Anderson said. “You just have to think like one.”

For Maddie Caldwell, who grew up on her family farm in Elmwood, Illinois, this approach is critical. If she had had this kind of help earlier in life, she says, she might not have attempted suicide. As a freshman in high school, she started a business with her father selling show cattle, prize animals that win awards at stock shows. She started seeing therapists in college, when she realized that stress had taken over her life. Since then, she’s seen about 15 different counselors, and even though she’s sure the providers want to help her, they just didn’t relate to her farm experience. 

“The first therapist that I went to, he’s like, ‘So, do you have two hours every day to go sit by a lake or a pond and just reflect on things?’” Caldwell said, chuckling. “I barely have 10 minutes to eat food on the farm. I cannot imagine if I told my dad, like, ‘Hey, I know we need to tour cows today, but I need to take hours to just look at the sky.’ My dad would have a high-speed come-apart.”

By the time she was a senior in college, she had attempted suicide twice and nearly died. The second time, she was sitting at one of her favorite spots on the farm, a trough for livestock feed that she used to visit with her grandfather. She says the urge to go there was just “instinctual.” 

Caldwell says she likes LandLogic because it encourages crisis counselors and doctors to ask questions about places like that feed trough. 

“One of the main things that I talked to Kaila about was, I don’t think it’s much about the knowledge that [care providers] have about ag,” she said. “It’s obvious that for someone from the middle of nowhere in Illinois, I can’t find a therapist that specializes in ag. It’s more so just being willing to learn through their experience.”

Some of LandLogic’s training is simply about recognizing bad times for farming — like the current moment. A large new body of research, begun during the farm crisis of the 1980s, has shown that anxiety, depression, substance abuse and suicide go up and down as weather, farm prices, and government actions get better or worse.

But other aspects are more specific. Therapists, for instance, will learn to identify 10 so-called cognitive distortions, or negative patterns of thinking, that are common to agricultural people – what Anderson calls “barbed-wire thinking.” These include catastrophizing, and what’s known as the “heaven’s reward fallacy,” in which one expects self-sacrifice to always pay off just because that would be fair. Another is “toxic grit,” in which a producer refuses to acknowledge that they’re struggling and keeps toiling away at a task — showing “grit” — even if it won’t work or will cause pain. (LandLogic offers different training tailored to medical doctors, hotline staffers and other professionals.)

In early 2023, Jared Auten had just become the director of a 988 Suicide and Crisis Lifeline for Kansas, when a friend told him about the LandLogic training. Auten had about 30 staffers and 60 volunteers at an office in Lawrence, a bustling college town not far from Kansas City. But crisis calls and texts come from all over, including the agricultural counties of western Kansas.

“LandLogic jumped out to me,” said Auten, who grew up in rural Osawatomie and recognized the urgent need to reach out to farm folks. “Someone’s thought of how to connect with this population in a creative way.” He got in touch with Anderson and had the whole staff trained.

The behavioral health and suicide risks facing farm communities, he says, are many. The isolation is real, particularly in western Kansas where farmers work thousands of acres, with miles and miles between houses. They also have ready access to lethal means in the form of firearms and toxic farm chemicals. And there are very few therapists or even doctors working in farm counties. One of the community mental health centers that Auten’s group worked with covers 19 rural counties. “These communities feel like they’re forgotten about,” Auten said.

In 2022 and 2023, Kansas ranked near the bottom in annual state-by-state rankings of mental health resources. With few places to turn to, those in crisis are even more likely to end up dialing 988 — if they call at all. 

Auten and others point out that, despite progress, the stigma around discussing behavioral health issues is still significant in farm country, especially for men. “In 40 years, I can count on one hand the number of farmers who have come in and said to me, ‘I’m about to lose my ground and I’m depressed about that,’” said Max Meschberger, director of Compass Behavioral Health’s regional office in Scott City, Kansas, a rural town in the far west of the state.

Sarah Gideon, executive director of Healthcare Innovations Network of Kansas, a collaboration of 15 hospitals, says this is exactly why she had the medical staff trained in LandLogic. A few years back, she lost a cattle ranching friend to suicide, and wondered if there could be a better safety net when there aren’t enough behavioral health professionals in the area.

“We thought that if we could take a tool like LandLogic and bring it to our primary care providers, that they may be the ones that could have better knowledge of their patients,” she said.

Anderson and Reznicek put the LandLogic Model online in 2024 and virtual training sessions in English are now available anywhere. They hope the model will be adopted even more broadly — by individuals, governments, agricultural organizations and medical groups — and to refine it with scientific study. The two have been gathering data, and have started a collaboration with researchers at Colorado State University to determine how farmers can have the best long-term outcomes.

They are aware that Black, Latino or Asian producers, among others, are underrepresented in the materials, just as they are in farm publications or agricultural medicine in general. But as understanding of the agrarian imperative spreads and deepens, this connection to the land is already capturing the imagination of diverse users.

Dr. Nancy Lucero, a member of the Mississippi Choctaw tribe, owns a 75-acre farm in southeast Colorado, where she grows feed crops like alfalfa, sorghum, oats and corn. A couple of years ago, her community in the Lower Arkansas Valley was rocked when six people who were farmers or ranchers died by suicide in just one month. In the last five years, there have been 102 suicides in agriculture-related professions across the state, and they have so affected the town where Lucero lives, the remote town of Rocky Ford, that a local healthcare provider now runs a bi-weekly meetup program for producers.

Lucero, who’s also a therapist and social work research professor at the University of Denver, decided to take the LandLogic training because she was curious about how a deep connection to the land could also become a risk factor.

Too often, she says, farm-stress training focuses on the economics of farming. But people in farm country have feelings about the land, even if they don’t own it. “As Native people, we understand the land wants to give to us, and then we have not a transactional relationship with the land — it’s a relationship of gratitude and reciprocity,” she said.

Anderson has been thinking about this too. She and her sisters don’t intend to take over the family farm, and she has cried some tears over this. It hurts that the legacy ends with her, but not for economic reasons. “I don’t really want to farm, but I’m emotionally connected to the land,” she said.

That emotional connection, she says, is what drove her to develop LandLogic. “My story is not a stepchild to agriculture. I am still part of this group.”