Health

The lonely life of the farmer too often leads to suicide

Too proud to ask for help, patriarchs in agricultural areas across America's heartland lack mental health support

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Jim Short was ready when the sun came up each morning over his fields. He was a farmer who listened to his crops and knew precisely how to produce a good yield. He took pride in what he did for a living. He was the type who was the first in the fields in the morning and the last out at the end of the day.

In Craigmont, Idaho, a town of just 500 people where the state's panhandle starts to widen, Jim was a respected man. He owned his home outright. He had been married 30 years and raised three children, who all graduated from college. He loved to drive his Ford pickup around town. He often hosted friends for supper and loved showing out-of-towners the ways of farm life.

At the end of a long day, he liked to kick back a glass of water and rye — and sometimes he'd have one too many. With a little drink in him, sometimes he would tell his family that nothing made his heart swell like his children. Sometimes he would cry. Sometimes he would tell them that in every other part of his life, he had failed.

His daughter Jamie said that though her father was a deeply conflicted man, she remembers him as a man who personified the spirit of their town. He was always there to help those in need.

He was the first to arrive at the home of friends whose son had died by suicide. Jim felt so much pity for the family, he cleaned up the scene so they wouldn't have to.

Two weeks before his 50th birthday, just after 4 a.m. on July 19, 2005, Jim's wife found him sitting in the field behind their house, gasping for his last breaths after putting a pistol to his head.

Stunned, his family grasped for an answer.

Jim's story is one heard too often in the Gem State. Idaho consistently ranks as one of the states with the highest suicide rates from year to year. In 2010, it ranked sixth, with 18.5 suicides per 100,000 people (PDF), and in 2011, 285 people died by suicide there. Suicide is estimated to cost the state $36 million annually.

Every year, Idaho, New Mexico, Wyoming, Alaska, Montana and Nevada, among others, seem to leapfrog one another in the top 10 as the most suicidal. They're giant states — ones with more fields and long stretches of freeway than urban centers, places with populations of cows that rival those of people. Idaho is where Ernest Hemingway made his home and where he died by suicide in 1961.

And in a place like Idaho, one that relies heavily on rural people and a thriving agribusiness to contribute to its economy, the suicide rate of farmers remains a concern. In a report on suicide prevention in Idaho (PDF) from the state's Department of Health and Welfare, researchers said a lack of social and mental-health support — in addition to the unique stresses of farming — and access to lethal means puts people like farmers at a high risk for suicide.

Nowhere to turn

Rugged individualism is something you'll hear a lot about in Idaho. It's a phrase popularized by President Herbert Hoover and one Idahoans use like a creed to describe their self-reliance. But it's a mentality that doesn't lend itself to seeking help if someone is depressed or suicidal. (So strong is the stigma of depression, admission of vulnerabiliy and suicide, that Jim's daughter asked that his and her name be changed in this story to protect their identities).

Shortly before Jim's death, a hailstorm ripped through his fields and destroyed an entire crop of peas and lentils.

"Farmers have the hardest life where we come from," Jamie said. "The weather makes or breaks the crop, and there are very limited things a farmer can control."

The storm caused Jim to suffer an $80,000 loss.

"I think this sort of broke him a bit," Jamie said. "He worked so hard, and to have it gone in one storm, it was too much."

No matter how hard he worked, Jim wouldn't be able to make up that loss. And he was a humble man who would never ask for help.

Fearlessness is what's required. It's not the same thing, by the way, as bravery or courage.

Efforts by the state to keep its citizens from dying by suicide are unstable at best. The state's suicide hotline was shuttered because of a lack of funding in 2006, reopening just last November. And though the hotline has expanded its hours since then, it has secured only enough funding to keep the lines open for the next two years.

Even worse, Idaho's medical support system is bleak. Idaho has one of the lowest concentrations of doctors in the country (PDF). Plus its medical professionals are aging. NPR reports that 41.5 percent of the physicians in the state are 55 or older. And Idaho fares even worse for medical residents, with only 3.9 residents per 100,000 Idahoans.

That's all bad news, especially considering that Mental Health America has reported that nearly three quarters of those who die by suicide visited a doctor in the four months before their death. This revelation prompted legislation in neighboring Washington state to require all clinicians to undergo mandatory suicide-prevention training on the chance that they could spot warning signs in a potentially suicidal person.

But in a state with not enough doctors, how can people be helped?

Search for solutions

The mentality of rural America has to be understood first, said Dr. Thomas Joiner, the author of "Why People Die by Suicide" and a Florida State University professor of psychology. Farmers are acquainted with a hard life and regularly see death and pain in their work, he said.

"The lifestyle in a lot of rural settings is more rugged," he said. "People are more involved in things involving physicality. All of that kind of pushes people to be generally less afraid of physical, strenuous and harmful things."

That can be lethal when combined with the desire to die and with the more readily available means than most other people have.

"Fearlessness is what's required. It's not the same thing, by the way, as bravery or courage," Joiner says, "It's more that you've gotten used to bodily harm, injury, pain and the prospect of death."

Joiner said restricting the means of suicide has proved effective in preventing it. A barrier on a bridge, for instance, is effective in stopping people from jumping. But what barriers can be erected for farmers living fairly isolated lives?

Judy Gabert, a resource specialist with Suicide Prevention Action Network (SPAN) of Idaho, pointed to guns, which account for 60 percent of the suicides there. She said any talk of restrictions on guns doesn't go over well in Idaho, an extremely pro-gun state, so instead, her organization encourages gun safety and gun locks.

Gabert said that, given the prevalence of religion in Idaho — it's the 15th most religious state in the country and the only northwestern state to break the top 30 — SPAN has begun training clergy members in suicide-prevention strategies.

But Paul Quinnett, the founder of the QPR Institute, which offers a three-step question-persuade-and-refer suicide-prevention curriculum, said the issue needs to be attacked at the root. All states need to take measures to remove the taboos — stigmas that weighed down people like Jim Short — that are often associated with suicide, Quinnett said. He pointed to HIV and AIDS, saying that it wasn't until the "ick" factor was removed that the country recognized the threat of epidemic that the disease posed.

"Some of us in the suicide-prevention field think suicide has the same repulsion to it," he says.

He said opening mental-health clinics in rural areas won't solve the problem. Jamie Short agrees, saying that if there had been help in Craigmont, her dad wouldn't have sought it out.

"He would have never asked for help with anything," she said. "If help was available, sadly, I don't think it would have helped my dad. As much as I wish it would have."

But that's where Quinnett says technology can be an asset. Web-based therapy can be accessed in someone's home — or even from a smartphone — and could be extremely effective in rural communities. People can admit they're experiencing depression or suicidal thoughts and get the help they need, and no one else has to know. He says ManTherapy.org is a site that's good for men to start acknowledging potential issues. With males dominating agriculture and more men dying by suicide in Idaho, he said it's important to understand that mental-health solutions need to speak to that population.

Smaller communities also need to band together to look out for their own — almost like a barn raising, just with mental health, he added.

"You have a better chance, in some ways, of changing the culture in a smaller community than you do in a big city," he said. "You say, 'Our citizens don't die by suicide. We don't let anyone die alone.'"

After Jim's death, the Shorts were faced with harvesting their 3,000 acres of crops.

Craigmont came together and helped, as they knew Jim would have for anyone else.

"Every person reached out and helped in some way," Jamie said.

Trailers parked across their property. Farmers pitched tents in the fields. Soon the Shorts' property was buzzing with 30 combines and 80 grain trucks. Their entire property was harvested in just three days.  

"Ironically, even with the $80,000 loss from the crop lost in the hailstorm, it was my dad's best year in about 20," Jamie said.

"There were over 600 people at the funeral in the city park. The town only had 513 people in it at the time. It was amazing. It was horrible in so many ways but beautiful in others."

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