00:00:12:07 - 00:01:19:25

Hilary Sims: Hi there, I'm Hilary Sims. There's no shortage of stressors in farming - climate variability, drought, flooding, frost, input costs, market volatility, pest and disease outbreaks - the list goes on. And while crop destruction is often highly visible, the impact on growers mental health can be less apparent. And while awareness and access to rural mental health services is growing, it's agronomists that sometimes find themselves on the frontline witnessing or discussing issues with growers that go beyond the paddock. In this GRDC podcast, we focus on how agronomists can handle tough conversations with growers who could be experiencing mental ill health. Joining me is Associate Professor Kate Gunn. She's with the University of South Australia in their rural health department. She's also a clinical psychologist and grew up on her family's property, about 650kms west of Adelaide. She starts by sharing some of the warning signs of mental ill health. And just a note to listeners that this podcast contains references to suicide. Here's Kate.

00:01:20:08 - 00:03:49:00

Kate Gunn: So I guess the warning signs can be quite varied, but if I were to summarise it, I'd probably say that if you notice a change in someone's behaviour, that's probably the biggest giveaway that someone's not coping. So it might be a change in their sleep or a change in, you know, the way they interact with other people, or a change in the amount of alcohol they're drinking, or a change in their attendance at footy or cricket or whatever it might be. And then I guess there's more obvious things as well. Like, you know, if someone starts talking about hearing voices or having thoughts about hurting themselves or others, you know, they're all things that you'd obviously start to become concerned about as well, but usually you don't get into these conversations straight up. You might notice some changes in behaviour first. And I guess, you know, if you're an agronomist or another sort of consultant working with growers, you might notice things even as you drive up the driveway. So you might see, you know, harvest was finished a couple of months ago, but the head is not in the shed. And this person's previously been a pretty tidy person. And I've got a new piece of equipment sitting out in the weather, and that might seem sort of out of character, for example. Or if you're sitting across the table from someone and they're not able to focus on the conversation, and you're noticing that they're not able to make decisions and they're really confused, they can be giveaway signs as well. Other people might appear really closed or withdrawn and just give one word answers, or be a bit avoidant in the way that they answer. Over the years, we've worked with rural financial counsellors quite a lot who are experienced in dealing with farmers who are experiencing stress. And they've reported that, you know, they'll see farmers even in tears at times. They'll see farmers get quite angry, they can pick up on their body language. They might be sort of in a phase where they're blaming everyone else for their problems, or they might be in denial about the challenges they're facing. And based on the experiences of those rural financial counsellors, they're always good things to pick up on as well. And I guess the reason this is really important to take note of is because the rates of suicide in the farming population are high, you know, they're twice the rate of other employed people, which means we need to keep an eye out and help people where we can. And seeking the right sort of help at the right time really can make a big difference to people's lives. You can be a really great help.

00:03:49:03 - 00:03:58:16

Hilary Sims: So, Kate, for those agros that have spotted a few of these warning signs, how can they go about starting the conversation or what's an appropriate first step to take?

00:03:58:18 - 00:06:27:17

Kate Gunn: So I guess the first thing you need to do is try and put your fear aside and just talk and listen to them so you don't really have to do anything particularly clever. Apart from be kind and take an interest in what they're experiencing. So, you know, just asking questions that indicate that you care about them and expressing empathy. So saying things like, wow, that must be difficult for you are a really good place to start. Once you've got out of them how they're going. I think another really important strategy is to ask people what they're already doing to help themselves, because people don't like to be told to do something that they're already doing, and if they tell you that they're doing anything right, whether that be, you know, going for a walk or talking to their brother or their wife or listening to music or, you know, cutting back on alcohol, whatever it is that they tell you, as long as it is a positive strategy, you know, really praise them up for taking a step in the right direction. And once you've kind of got out what they're already doing to help themselves. That might be a point at which you could then come in with a suggestion around another service, or another strategy that might be useful. And if we're thinking about how do you tell someone about a service, you know, often people will fob off advice that you give them. So if you say, mate, I think you should go and see your GP, often they'll quite quickly dismiss it. But if you can say, mate, I think you should go and see your GP and I know of someone who went and saw their GP and found it a really positive experience. Or if you can tell them a good news story about someone who did access that service or take a step in the right direction, usually your advice will be more persuasive and they'll be more likely to make that first step. So there's quite a list of things to think about. But once you've made some suggestions around how people can help themselves, the final thing is to make sure that you follow up at a later date to see whether or not they have made that next step to help themselves, because often people will walk away from these conversations and feel a bit worried about whether or not they've disclosed too much, or whether they said something that you're going to judge them for, you know, whether it be a few hours later or maybe the next day, if you send them a message and say, hey, it was really good to talk, I'm thinking of you, or it was a really good to talk, I'm happy to help you with the next step, that will just provide that reassurance that they've done the right thing in speaking to you, and also enable them to pick up the conversation with you again, which is really important.

00:06:27:19 - 00:06:39:04

Hilary Sims: So what resources are out there for growers experiencing mental ill health, and for people, like agros, who might be trying to best support someone they know with mental health challenges?

00:06:39:07 - 00:12:47:21

Kate Gunn: What you would refer someone to really depends on the situation that that person is in. And I guess we need to differentiate between whether or not you're just a bit concerned about someone's ability to cope with their everyday life, or whether or not you're concerned about someone's safety and whether or not they might be thinking of taking their own life. If you might be worried that they're thinking about taking their own life. It's really important that you ask them directly if that's something that they're considering, and validate that that must be really hard for them, and tell them that you'd really like to help, and you're going to stay with them and help them through this dilemma, whatever might be contributing to it. So if someone says to you, yes, they are having thoughts about ending their life, my advice would be to help them contact a support person, whether that be a friend or partner or a neighbour or anyone else. And then you might actually need to link them in with one of the services that is available 24/7. So for example, lifeline, they're available in 13 11 14 or Beyond Blue are available 24/7 as well. The next thing you might do is ask them if they have a plan to end their life, and if they have a plan, you might need to take immediate action by taking them to their local GP or a hospital. Ringing one of those helplines that I just mentioned. Depending on the situation, you might need to find emergency services and do whatever you can to keep them safe in that moment before help arrives. So that's more the extreme case, but I think in that situation, it's really important that people remember not to leave the suicidal person alone and not to try and handle the situation on their own. Like, you really do need to reach out for professional help, whether that be from one of those helplines or taking them to the GP or the local hospital, or getting the emergency services involved. You can't do it on your own. And each state has state-based mental health services available as well, including in rural areas that you can ring. After you've had this interaction, don't just leave the person. Make sure that you continue to check in with them over the following days as well. So that's the extreme situation in a less severe situation where you might think that someone's not coping and might just need to be pointed in the direction of some resources. There's a range of things that can be helpful. There's telephone based services like Beyond Blue or Men's Line. There's a whole range of services that depending on the issue. So there's helplines for domestic violence or PANDA, for example, for perinatal anxiety and depression. There's far too many to list. But if you Google helplines for mental health challenges, there'll be lists that come up that are available. And then of course there's face to face services. So going to see your local GP can be challenging in rural areas. We know there are big wait lists, but if you ring up and you explain that it's a mental health situation that you're wanting some help with, often they will try and be accommodating if they can. There's also state based mental health teams, the Royal Flying Doctor Service provides clinics in some areas. There's Relationships Australia that provides support in some rural areas, and organisations like headspace for younger people as well. So face to face services certainly do exist. Sometimes they can have waitlists, but that is something that a lot of money is being poured into to try and reduce waitlists and improve access to these sorts of things, which is excellent. And then, of course, there's online services as well. And for rural people, this has been quite a game changer since Covid, because now we can access GP's via telehealth that previously haven't been available. You can access psychologists by telehealth as well, and there's a whole range of online programs that might be beneficial. The one that we've developed is called ifarmwell, and it's free resources that have been developed with farmers specifically for farmers to help them deal with the challenges that they face. And we found that a lot of agronomists and advisers and things find and relevant as well, because they share that farming culture and can relate to the material as well. So if you go to ifarmwell.com,au, you can work through the free resources there. On that website, there's also a list of farmer friendly mental health resources that are available nationally. So if you go to ifarmwell, then other initiatives and then farmer friendly mental health services, there's a whole list of resources that are freely available and available nationally. So lots of things to think about there. And when I speak to farmers, sometimes they say, oh, I'm worried about confidentiality or I don't want to bump into the GP in the supermarket or other farmers say look, I wouldn't know what to say to the GP. So I always say to people like, you need to remember that anything you say to a GP or a mental health professional, they have a professional duty to keep that confidential and if they were to gossip about your situation, they could actually lose their registration. So, you know, that's very unlikely to happen. Sometimes people don't like to waste the doctor's time either, but you really aren't wasting it. It's a really good investment of their time to prevent your mental health from deteriorating, or to help you through things if it has already deteriorated. And if you don't want to see your local GP, you know, jump online and see one using telehealth or go and see one in a neighbouring town. There are options these days, and if you don't know what to say to a doctor or a mental health professional, if you go to the ifarmwell website, we've actually got a script on there that you can print out, and it will guide you on what to say when seeking professional help. And there's a video on there showing another farmer having that kind of conversation with his GP, and he shows that, you know, it's actually not as hard as you think. And some really practical things and positive steps can come out of those conversations.

00:12:47:24 - 00:12:59:18

Hilary Sims: Thanks so much for talking us through those resources. Do you have any tips on how to interact with growers or anyone having a hard time? How to get the information across or influence them in a positive way.

00:12:59:20 - 00:15:08:10

Kate Gunn: I think the first thing is you just need to slow your information sharing down more than you normally would, and take the time to stop and listen to their story. And then when you're imparting information, just try and keep it a bit simpler. And another thing that can really help is if you can see someone's really overwhelmed, try and talk about something at the start of the conversation that puts them at ease, so puts them back in control and positions them as the expert. So, you know, you might have driven up the driveway and notice that they've got a new ute. So you might say, oh, notice you've got a new ute there, and get them to talk about something that they're excited about before you. Then bring up the really tough fact that they're going to have to spray the lentils all over again, or whatever it might be. So there's some practical things. Another thing that's really important in terms of making these conversations go positively when someone is a bit down, is to try and find a way to instil hope in people. And this doesn't mean you have to try and be a psychologist. It just means that you can gently highlight positives or things that they have done well, and also kind of steer them in the direction of focusing on what they can control and letting go of what they can't control. And using that language, you know, well, that's out of your control, isn't it? And this is something that you can do to empower them, to make them feel like they have some agency over their situations. And I guess another thing that you often have to do in these situations is be a little bit more flexible. So the conversations might take longer and you might need to explain things twice, maybe not just to dad, maybe to mum and the son as well, for example. But from the work we've done with rural financial counsellors, they say that when they're in these situations with distressed farmers and they push on and they don't listen to their story, and they impose deadlines and impose solutions too quickly, things can fall apart when you're dealing with someone who's under pressure. So taking that time, building the rapport, putting the person at ease and making them feel like that is something that they have control over can be really powerful.

00:15:08:15 - 00:15:20:23

Hilary Sims: Okay, Kate, we've covered some pretty serious topics. So on the back of that, do you have any recommendations or thoughts around self-care for agros outgrows after they've had difficult conversations like that?

00:15:20:25 - 00:15:52:28

Kate Gunn: The number one thing I'd say is to keep in mind the limits of what you can do yourself, and don't expect to or try to solve other people's problems all on your own. You're not doing yourself a favour if you do that, and you're not doing the other person a favour if you try and solve things, either. You really do need to bring in professionals who do this stuff every day, and if people don't have luck with one professional, help them problem solve and find another professional or another online resource, you know, there are plenty of options available now. Something else I'd say is when you're talking to someone who's distressed, if they're telling you about a challenge they're facing that you've also been personally affected by, try to be careful to only share with that person what's going to benefit the other person. So don't burden them with your situation as well. And I know it's a natural reaction that if we've experienced something similar, you sometimes do want to jump in and let that person know that they're not alone, which can be helpful, but you just do have to do that in a bit of a careful way, particularly if you've got a professional relationship with this person as well. You know, you're their agronomist and they're the client. You do want to be a little bit careful there. And I guess in a similar vein, it is helpful to be able to compartmentalise these sorts of situations or in other words, sort of leave the client's problems at the farm gate. And I know that that's easier said than done, and it's quite a skill to be able to learn to be involved enough so that you're authentic, but then not overinvolved so that that person starts to impact upon your personal life. So that's another important thing to do. And finally, I guess I'd say that, you know, dealing with distressed people in general, whether it be a farmer or anyone else, can be quite draining and challenging. So if you do have one of these situations, it's really helpful to have a confidential conversation with a colleague or even your partner or whoever it might be. And you know you don't need to and you shouldn't pass on personal information, but it's okay to debrief with people in an anonymised way. You know, usually they'll reassure you and say, yep, you've done a good job and you've done everything that you can to help this person. But there might be situations where, in the heat of the moment, you have forgotten to suggest that they call Lifeline and Beyond Blue, for example. Or you might have forgotten to refer them on to another service, so sharing with another person can be useful. I guess it's a bit of a balance, you know, surrounding yourself with people who also have these experiences of dealing with other distressed farmers as useful. But at the same time, you also want to balance that with not hanging out with them all the time. So maintaining other interests too, and going off fishing or going on a holiday somewhere, you know, might be helpful for your own self-care. You don't want to be overwhelmed with these situations all the time, which can happen if people are having a tough year in a small community, you can find yourself being surrounded with it quite a lot. You need to recognize the importance of your own health and well-being and prioritise that. Because you can't pour from an empty cup. You know, it's also really powerful to model to other people in your community that looking after their well-being is important, so you can show them how to do that.

00:18:42:11 - 00:18:50:11

Hilary Sims: And Kate, just to finish up, what do you want growers to take away from this podcast? And I hear you have a final story to tell.

00:18:50:16 - 00:20:08:10

Kate Gunn: I think the most important thing to take away from this podcast is that you don't have to be an expert to really make a difference in people's lives. There's a man called Don Ritchie who's now passed away, but he lived at the Gap at Watsons Bay in Sydney for about 50 years, and he's thought to have talked about 160 people out of suicide. And the way that he did it was when he was fit and young, he would physically restrain people while his wife called the police. But when he got too old to do that, he'd just go out there with his thermos and offer people who were contemplating taking their life a simple cup of tea and a chat. And as a result of this great work, he was named Australia's Local Hero in 2011. And he said, never be afraid to speak to those who you feel are in need. Always remember the power of a simple smile, a helping hand, a listening ear and a kind word. And I guess in my experience, people in farming communities are already pretty good at this. But there is always more that we can do both to look after ourselves and each other. So I just wanted to reassure you that you don't have to be an expert. You can be just like Mr. Richie, and offer someone a cup of tea, a bit of time and just show that you care and it really can go a long way.

00:20:15:01 - 00:20:45:11

Hilary Sims: That was University of South Australia Associate Professor Kate Gunn. If you or anyone you know needs help, you can contact lifeline on 13 11 14 or beyond blue on 1300 224 636. More information and resources on this topic can be found in the description box of this podcast or online at GRDC.com.au. I'm Hilary Sims and you've been listening to a GRDC podcast.