Breaking stigma: Mental health solutions in farming and rural communities

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Emily Davenport: 0:01

Welcome to Cultivating Curiosity, where we get down and dirty with the experts on all the ways science and agriculture touch our lives, from what we eat to how we live. I'm Emily Davenport.

Jordan Powers: 0:12

And I'm Jordan Powers. And we're from the University of Georgia's College of Agricultural and Environmental Sciences.

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Emily Davenport: 0:21

Before we get started, a quick trigger warning. This episode discusses mental health and suicide. If you need help, or know someone who does, call the Suicide and Crisis Lifeline at 988. Help is available 24/7 toll free and staffed by licensed mental health professionals. Language assistance is available. We'll add a link to their website in the show notes as well.

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Jordan Powers: 0:45

We are here today with Anna Scheyett, former Dean of the UGA School of Social Work and professor in the CAES Department of Agricultural Leadership, Education and Communication. Anna, thank you so much for joining us today.

Anna Scheyett: 0:57

Thanks for inviting me.

Jordan Powers: 0:59

To kick us off, can you tell us a little bit about your background? How did you first get started with social work? And what brought you to UGA?

Anna Scheyett: 1:06

Sure, I actually came to social work from the health field. And so much what I saw in women's health had to do with the issues that weren't really health. They were all the social determinants and all of the psychosocial aspects. And that really got me into social work. And then from there, you know, like a lot of academics, over time, I sort of drifted into administration, and became the associate dean at Chapel Hill School of Social Work, and then the dean in South Carolina. And then I came to Georgia because this job opened up and it was really exciting to be at the University of Georgia.

Emily Davenport: 1:42

As a social worker, what do you bring to UGA Cooperative Extension with your work?

Anna Scheyett: 1:47

That's a really good question. And I've been sort of stunned at how syntonic social work and extension are. We're both very community-based, partnering with communities, pragmatic professions that want to do, not simply do the research. But I think the things that I bring that are a little different is, my background is as a psychiatric social worker. So I have that behavioral health background and the knowledge base and the knowledge of the mental health systems that Extension folk might not necessarily have. Social work also comes from a really strong advocacy base, and I think that's a piece that I bring also, to think about how you work with the community to advocate together for the changes that need to happen. The other pieces that I can think of that are really helpful, in social work, we come from a very strong systems perspective. So we always think about social ecological theory, which is used a lot in public health and in extension, but also about networks and systems and complexity. And I think when you're thinking about the entire state, and the big problems, that Extension helps communities tackle, being able to think from a systems perspective is really helpful. And then the last thing that selfishly was probably more helpful for me than it was to Extension was, in social work, we have really strong training in cultural responsiveness and cultural humility. So when I started doing rural work, because I'm a suburban kid, I did not grow up in a rural area, I came at it intentionally very humble. And I kept my mouth shut a lot. And I listened a lot, and was really fortunate in that wonderful people like Laura Perry Johnson, and Mark McCann and Andrea Scarrow, kind of took me under their wing. And so I refer to them as my cultural guides. They're the people who gave me credibility so that I could walk into a community, a group, Extension agents' gathering, and be known as somebody who could be trusted. And I think that really comes from coming in, not at all from an expert perspective, but from a listener and a learner perspective. And that's something that you learn a lot about in social work.

Emily Davenport: 4:01

That's fascinating and so important, as we know, with so many of the communities, especially the rural communities in Georgia, there can be that contention there of coming in, maybe as someone who has a lot of knowledge, but not somebody who can be trusted. So it's really wonderful to hear you speak on how you bridge that gap.

Anna Scheyett: 4:16

Yeah, the joke is sort of never say, Hi, I'm from Athens, and I'm here to help.

Everyone: 4:20

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Jordan Powers: 4:22

You touched on outreach and community throughout what you were just sharing, but can you tell us or elaborate a little bit more on how this work ties into UGA's outreach mission?

Anna Scheyett: 4:32

UGA's outreach mission in extension, what's the phrase? That Extension translates the science of everyday life to benefit the health and prosperity of Georgia or something. I'm paraphrasing along those lines. As a social worker, that's absolutely our goal, being able to take the multidisciplinary knowledge from the team around stress and behavioral health and well being and health and bring that to the community in a way that's accessible to the community and acceptable to the community has been really important and really helpful. And I'll give you an example of this. It's an initiative that we're doing that we call the Farm Stress Production meetings. Jennifer Dunn is the person who does these trainings, and I've been doing the evaluation. But one of the things we've learned from talking in rural communities, particularly in farming communities, is that farmers have no time whatsoever, and farmers are very, very independent, self sufficient, I'm not going to ask for help, I'm going to figure this all out myself. So if you're going to provide farmers with information around stress management, and ways to be healthier, so they can continue farming, you can't have a program on farmers and mental health and expect people to show up, they don't have the time and nobody's going to walk into something called mental health. So instead, what we've done is at the production meetings that Extension does, so you know, January, February, there's a cotton production meeting and the cotton agronomists come and all the cotton farmers come and listen, and there's a meal and you've got sort of a captive audience of 30 to 50 farmers. The first 10 minutes, Jennifer goes in and does a really simple conversation about stress. What's stressing you all out these days? What is stress, what's good stress, what's bad stress? How do you cope with stress? That one's really interesting, because we hear a lot about tequila and prayer, which is sort of an interesting continuum. And then, what are good ways to manage stress? What are not-so-good ways? 10 minute conversation, very relaxed. And then we have a packet of information that gets put in the stack along with all the cotton information or whatever that they're going to get. So we're not wasting their time, we're coming to them as a farming community and we're talking about stress, and we're using language that's acceptable. And I think that idea of in the community trying to be both evidence-based, but accessible and acceptable in how you collaborate is really important. And it's, I think, been a big part of why we've been able to have some success with this work.

Emily Davenport: 7:11

Accessibility is frequently used as kind of a buzzword these days, but it's so important.

Jordan Powers: 7:16

It's so important.

Anna Scheyett: 7:17

And it means so many different things to different people. We've done some work also with farm wives, and one of the things they talk about is thinking about what are messages that you can give to farmers that will be in places they already are. Like, what's the restaurant in town where all the farmers sit together for lunch? And you can have your posters and your flyers there? Or what could be something that could be read briefly while they're sitting at a tractor or put in a calendar that they've got on their desk? How do you make it where they are as opposed to make them have to come to us for this information when they just don't have a minute they're working sunup to sundown.

Emily Davenport: 7:55

I like that, meet them where they're at.

Anna Scheyett: 7:57

Exactly. Smart.

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Jordan Powers: 8:01

One of the ways Anna is meeting farmers where they are is through her blog, Thriving on the Farm. We'll let her tell you about it.

Anna Scheyett: 8:08

Quick plug for the blog?

Jordan Powers: 8:09

Please do.

Emily Davenport: 8:10

Absolutely.

Jordan Powers: 8:11

We love your blog. And we will link that in our show notes.

Anna Scheyett: 8:19

Thank you, I appreciate that. Oh, thank you. One of the things that, again, as I was mentioning, farmers don't have any time, People have talked to me, the wives particularly, you've got to have snippets kept being the word that they were using. That you've got to have things that people can do or read in five to 10 minutes, because you don't get more time than that. So the whole point of this blog that I created, Thriving on the Farm, it's something for someone to think about that has to do with stress and self care, though I would never use that word, that you could read in five to 10 minutes. And in fact, you can click the little button and it will read it to you, or it's something you can do in your daily life in five minutes a day, it doesn't take any time to make sure you drink enough water, it doesn't take five minutes to stretch four times a day, those kinds of things. So pragmatic tips, and then just things to think about, but that take very little time. So site.extension.uga.edu/thriving.

Jordan Powers: 9:07

I know I subscribe and I love getting it in my inbox every week. So that makes, and other stuff that makes it even easier. I don't have to go look for it. It just pops up in my inbox. And it's right there.

Anna Scheyett: 9:21

Exactly. And I've made some really nice connections through it. There's one of the agronomy specialists, Camp Hand, who just rocks. I love that man. He's amazing. And I was talking to him about something else and he's like, I really love what you're doing. This is really important. I'm like, you're really invested. And he said, Yeah, it's because I had my own personal experience. And he told me a story and I said, would you be willing to go public? He said, absolutely. Oh, yeah. You know, so his story's on the blog. I got an email out of the blue from a woman in Emmanuel County who's a therapist whose husband's a farmer.

Jordan Powers: 9:56

Wow.

Anna Scheyett: 9:56

And so she's been promoting and sharing the materials that we've got. So it's been a nice way to start to connect with some people, both in Georgia and in other states as well. And other countrie. Australia is doing some really cool stuff. And New Zealand, like at some point, when you have five minutes, Google Farm Strong, it's a website. And I've actually taken clips from it and put it on the blog because they have farmers talking about their mental health. And it's really, it's really amazing.

Emily Davenport: 10:25

That's really cool.

Anna Scheyett: 10:26

So there's some cool stuff going on all over the world.

Jordan Powers: 10:29

Incredible.

Emily Davenport: 10:29

We can add a link to that in our show notes, too.

Jordan Powers: 10:32

Absolutely.

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Emily Davenport: 10:34

National Rural Health Day is held on the third Thursday of November, and this year, it's on November 16. Can you tell us more about this day and how our listeners can celebrate the power of rural?

Anna Scheyett: 10:46

This is something that's been organized by the National Association of State Offices of Rural Health and their partners to celebrate rural. I think one of the first things that people can do with this is learn more. People don't understand, and I know that because I was one of them until five years ago, when I started to do this work, people don't understand. Rural communities make up almost 20% of the population of this country, depending on how you count it, and about 85% of the land. So it's a big piece, it's not a little niche interest. And these are the people that feed us and clothe us, you know, food and fiber. If you eat food, or you use fiber, then you should care deeply about rural communities because of the agricultural piece, and then everything that supports that. From everything I've seen this year with celebrating the power of rural, it's about understanding rural, and it's about looking at it from a strengths not a deficit perspective. There's all sorts of health disparities and challenges in rural communities. Rural communities are poor, they tend to have higher substance use rates, they tend to have higher mental health and stress challenges and all sorts of things, but they're also amazingly strong and resilient communities. And I think that's what this day is about, is celebrate the fact that these communities sustain us all. They feed the world. And they solve problems in ways that are innovative and creative, because they have to, because they're often very resource-poor. But those are great things we can all learn from. The formal and informal network collaborations that happen in rural communities around how you take care of kids and address the risk of substance use with children. Communities have done really innovative things with that, and we need to look at that, we need to appreciate that, and we need more health providers to go work in those areas. That's a huge issue. 70% of the areas in this country that don't have enough health care providers are rural.

Jordan Powers: 12:43

Wow.

Anna Scheyett: 12:43

Healthcare providers, dentists, and mental health providers, all of them. So there's a lot of need, and it's a great place to work. I love going to, you know, South Georgia is where I do most of my work. And I love going to Tifton and to Moultrie and being out in the community. And it's a wonderful place to work. And I think appreciating that instead of looking at morality from a deficit perspective is really what we celebrate when you celebrate Rural Health Day.

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Emily Davenport: 13:11

Each year, the National Organization of State Offices of Rural Health and its partners set aside the third Thursday of November to celebrate National Rural Health Day. We'll include some links for you in the show notes.

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Anna Scheyett: 13:24

One of the things, I want to go back for a second to that whole "suburban kid" thing, because that's always been my identity. But then when I was pushed a little, it was like, don't you have some connections? It would really make a difference if you had some connection. Andrea Scarrow taught me that and I started thinking, and my mother's father, my mother's from Puerto Rico. My mother's father had a coffee farm. So I do have a connection, but it wasn't the stereotypical red barn kind of farm, so it just never came to mind and it's never been part of my identity. But my grandfather was passionate about his land. And my husband's family were all peanut farmers in South Alabama for many generations. So I do have connections and we all have connections. You just have to think about them.

Jordan Powers: 14:11

Absolutely. Another exciting initiative, an impactful initiative through CAES and UGA Extension is the Rural Georgia, Growing Stronger initiative. Can you tell us about how this cross-college collaboration is helping rural Georgians?

Anna Scheyett: 14:27

Absolutely. That's sort of the hub where our work comes from. And it is both multidisciplinary and transdisciplinary in that we really blend and work together across the College of Agriculture, Family and Consumer Sciences, Public Health, Social Work, Pharmacy, people in Arts and Sciences also. So it's bringing together and integrating knowledge from a lot of different perspectives, like I was talking about what social work brings to the table before. But it's also looking very holistically at Georgia. So health, behavioral health, well being and success of children. I mean, the projects that people are doing who are involved in Rural Georgia, Going Stronger, because it's sort of this collaborative, and then we each have our own initiatives. And we come together and we share information and have ideas together, but we've got our own projects that we're all doing. But they're about health and obesity. They're about marital relationships or couple relationships. We have people who are working on opioids in rural areas, and how can communities build their own capacity there? We have people who are working on vaccine education and that aspect of health and health education. One of the big challenges in rural areas, if you do behavioral health work a lot, is just the stigma of mental health. So we have colleagues who are working on that in addition to working very specifically on farmer and rancher stress. So you pull all of this together, and it becomes this whole is greater than the sum of the parts. And what we're working to build, really, is to be a resource team. In the same way that there's, in Extension, there's a cotton team, there's a soil team, Dr. Perry Johnson's gotten a behavioral health team within Rural Georgia, Growing Stronger, and we want to be a resource both to Extension and the university and the state.

Jordan Powers: 16:21

A hub is the perfect way to put it because when I first saw the website, which we will link to in the show notes for our listeners, it is. It's so much information in so many areas of expertise. And it's just, I'm biased, but a brilliant resource for us to have. So we will be sure to link that in the show notes for our listeners.

Anna Scheyett: 16:38

Great, thank you.

Emily Davenport: 16:39

Definitely.

Anna Scheyett: 16:39

And you just used the word hub, which reminded me of something which I think is really important that we've been working on. Dr. Virginia Brown and Maria Bowie have led some of this conversation, along with Diane Bales from FACS, thinking about Extension as a hub, in general. We have actually written a couple of papers on thinking of local extension as a potential behavioral health hub in the community. It can be a place where you can go for information about behavioral health It could be a place where there was a telehealth kiosk, maybe. It can be a place where peer support groups could happen, where educational opportunities could happen. And the thing that's lovely about using a local Extension office, is that in the community, Extension's trusted. Extension agents live in those communities. They're part of the community, they are a trusted community member. And we did a poster session, the title was Trusted Spaces in Rural Places. And it was about using Extension as that hub. And there's no stigma going to Extension. I've heard people say I'm not parking my truck in front of the mental health center, everybody will see it. Everyone goes to Extension, you could be going to get your soil tested or dropping your kid off at 4-H or whatever. And you can go in and you can get information and resources and get referred to the help that you need. So Extension, just like Rural Georgia, Growing Stronger, can kind of be the hub at the university for this information. Each local Extension office, if we provide them with the resources and the information, can be a local hub in the same kind of way.

Jordan Powers: 18:12

That's quite a network.

Emily Davenport: 18:14

Yeah. I love that, thinking about it like a hub to get your one stop shop for all that you need.

Anna Scheyett: 18:19

Exactly. That's exactly it.

Jordan Powers: 18:21

That's great.

Emily Davenport: 18:21

We've talked a lot about how rural is maybe associated with farmers and farming, but that rural goes much further than farmers. Can you tell us more about the scope of these programs and how they impact all rural Georgians?

Anna Scheyett: 18:35

That goes back to what I was saying before about all the different projects that the people who are involved on this, with us are doing. And it really has to do with thinking about the well being of people in rural areas, irrespective of whether or not they're doing agriculture, because everyone in a rural area has challenges in getting to health care. So all our work around health education and health access fits with that. We know that people in rural areas are at higher risk of substance use. So the opioid work that we've been doing, dealing with the stigma, which is really kind of a cultural issue, though it's not just rural. So I think we're coming at it with the exception of the farmer stress, which is sort of the the lane that I do most of my work in, which is much more targeted at agriculture, it's really much broader about the well being of rural communities. And the flip side of it, too, is that not all agriculture happens in rural areas, and urban agriculture can be very stressful. It was interesting, a colleague of ours at Mercer University, they did a survey of farmers, and they were asking questions about stress and health and mental health and concerns and all sorts of things. And it was a great report and they had well over 1000 responses. But the thing that stuck with me is one of the questions had to do with how often do you think about suicide? And when you broke it out when they looked at the first generation farmers, which is more likely what an urban farmer's gonna be, not only but more likely, when you looked at the first generation farmers, 9% said they thought about suicide daily.

Jordan Powers: 20:16

Wow.

Anna Scheyett: 20:17

So it's not just rural, we've got a lot of work to do. It's sort of overlap. Rural has its risks and stress, and agriculture has its risks and stresses.

Emily Davenport: 20:27

Rural or urban, the COVID-19 pandemic impacted everyone in some way. How did the pandemic impact or change the trajectory of your work? And where do we go from here?

Anna Scheyett: 20:37

Oh, that's a simple question.

Jordan Powers: 20:39

Right? We threw a big one in there.

Anna Scheyett: 20:42

Yeah, a real"where do we go from here?" That's like a whole section in the paper that you write. COVID did a number of things in terms of how I think about my work. One is it brought to the forefront the importance of high speed internet, and what an issue that is in rural communities. In a lot of the focus groups that were held around opioids, the conversation shifted to the impact of COVID. And how hard it had been for the children because they couldn't go to school. And not everybody's got internet. So kids weren't able to participate virtually. Some Extension offices were opening up their site, so kids could do their homework there because they did have broadband, but the lack of broadband and the lack of awareness of the lack of broadband has really become something that I'm much more aware of. And part of that's because during COVID, we started hearing more and more about telehealth, well, people can't get to their appointments. Well, telehealth is the answer. It's only the answer if you've got the internet. Telehealth is not the way to fix the accessibility problem. I think COVID really highlighted that. The other thing that I think COVID highlighted, for me, at least in the work as I think about it, is just the importance of networks, not internet networks, people networks, and that one of the big challenges with COVID was the isolation, the people who had lost their networks, and the creative ways to try to pull that together again is really important, peer support, hugely, hugely important. And something I've been thinking more and more about, one of the things that we learned that COVID did when you think about behavioral health services in a rural community, in rural communities, they have what I like to think of as just a de facto system. There's some mental health provider somewhere, but the schools do some of it. And juvenile justice does some of it, and 4-H does some of it. And there's this network of agencies that are called behavioral health, but together they create the network that catches children. It's their safety net. And with COVID, that gets shattered in a lot of places. Because it was built on personal relationships. It was built on the 4-H person being able to go to the school. In one of the focus groups, people were talking about how when people didn't have eyes on children, how difficult that was for Child Protective Services, it just kind of broke a very tenuous system. So rebuilding networks and the importance of networks is a place to move forward. And you know, that's not the answer to "where do we go from here?" but that's one of the places I think we need to build more strength and more intentionality in.

Jordan Powers: 23:15

It's a path forward to where we're going.

Anna Scheyett: 23:17

Yes, it's one of the steps.

Jordan Powers: 23:19

It is a step. And sometimes that's where we have to start is a step closer.

Anna Scheyett: 23:24

That's right.

Jordan Powers: 23:25

When we're speaking of communities, rural and urban, we do know that Georgia has a growing community and population of Spanish speakers, especially in the rural communities where the H2A program is highly utilized. Are there efforts underway to serve the growing Spanish speaking population?

Anna Scheyett: 23:42

Yes, and that is something where the Vaccine Education has been particularly powerful. There's been three waves of efforts around vaccine education through some NIFA grants, an Extension Foundation, and in the first two, because the third ones just starting. But in the first two, there were very specific efforts. There were focus groups in the migrant communities, in the H2A worker communities. There was education going out, there were people partnering with local public health and bringing the vaccines out to people, all the materials were translated into Spanish. So we're really aware of that and we're trying to build more capacity in that area. That's something that we're very aware of, and very much wanting to continue to involve the Latinx community with.

Emily Davenport: 24:28

Glad to hear that.

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Jordan Powers: 24:31

NIFA is the National Institute of Food and Agriculture, part of the United States Department of Agriculture. NIFA provides leadership and funding for programs that advance agriculture related sciences. We'll add a link in the show notes.

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Jordan Powers: 24:47

What have we missed?

Anna Scheyett: 24:48

The piece that I would want anybody who's listening to this to think about really have to do with the myths and the realities of rural life, and we've touched on that a little bit, but how important it is for people who know and understand rural communities, to not just work with the rural communities, but to educate people who don't know about it, because most of them are policymakers. I mean, there are really not that many people who are writing laws, who are passing policies, who are intimately familiar with the reality of rural life. If you think about it, rural communities live under predominantly urban laws. And I read a fascinating article that I can't remember the author's name, but he talked about rural areas as being areas of extraction. It's the place where we take things, like food and coal, for the benefit of sort of everybody but predominantly urban areas. And we dump a lot of waste back. And we don't give back. What's the number, 14 cents out of every dollar that's spent on food actually makes its way back to a farmer? It's some number like that. So for people who understand and know, I think we have a responsibility to educate the rest of the world. Now I'm on a personal mission to get every social worker to understand that social work has been built with an urban bias. We came out of tenement houses and urban areas, and that rural social work is not a boutique topic. It's something we all need to be caring about and talking about. So I hope that everybody does that, all the people who know about rural communities, work to educate others and people who don't work to educate themselves.

Jordan Powers: 26:27

We have laughed, we have talked about some very deep topics, we really covered.

Anna Scheyett: 26:34

We've done it!

Jordan Powers: 26:36

We covered the continuum of emotion, but all for such an essential and important topic that we do need to be talking about more, and we're very grateful for the work that you're doing to that end, and for your time today to come and join us on the show. So Anna, thank you so much for joining us this afternoon.

Anna Scheyett: 26:54

Well, thank you for your interest, and really thank you for continuing to expand this conversation that we all need to be having. Appreciate you greatly.

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Emily Davenport: 27:04

Thanks for listening to Cultivating Curiosity, a podcast produced by the UGA College of Agricultural and Environmental Sciences. A special thanks to Mason McClintock for our music and sound effects. Find more episodes wherever you get your podcasts.