By Olivia Groeteke, LIMHP
Rural Nebraska lives and mental health continue to have a relationship that feels long-distance, whether it is access to resources, an increase in suicide completions, normalized unhealthy coping skills, or the traditional roles and responsibilities that struggle to ask how the farmer is feeling. Unfortunately, research has shown that over the last 20 years, rural men in Nebraska die by suicide almost 2.5 times more than men living in the Lincoln and Omaha metro (Shanahan, 2025). On top of this, there are high reports of thoughts about suicide and attempts that are unsuccessful in rural areas. Recently, there have been more conversations about increasing access and awareness of these challenges, which is a great first step to acknowledge the problem and begin creating solutions. I am writing this to acknowledge some of the factors at play, but more importantly, to instill a sense of hope for communities that have been struggling.
Farming families live a lifestyle that is nonstop, from planting season to summer irrigation and baling hay, then silage and harvest, and potentially calving season in the winter; there is always something to do. While the occasional rainy day might slow operations down, farmers are often thinking about the next thing and rarely giving themselves the chance to ask what they might need for their own health or well-being. A career that is highly dependent on the external world and weather does not align with a “mental health check-in” that farmers might feel they don’t have time for. Insurance for farming families is often expensive, if insured at all, with high deductibles and copays. This limits access to care at a systemic level as well and can make mental healthcare costly.
This sense of responsibility for their operation, crops, and livestock often translates to their roles at home. If farmers have a family at home, they are usually viewed as the head of the household and responsible for providing in a variety of ways stemming from traditional family beliefs and norms. When there is perceived pressure from their career and the outside world, and also at home, it can lead to hopeless thoughts or feelings of being stuck. Feelings of overwhelm, hopelessness, and worthlessness are highly tied to suicidal ideation. If we combine these feelings with a rural culture that does not often prioritize asking men how they are feeling, and a lack of access to resources, suicide risk remains very high.
While this blog post places a high focus on men in rural areas, I would be amiss to not acknowledge the strain this puts on the other family members. Spouses or partners of agricultural workers know the long hours their partner puts in because of the extra responsibilities they make up for at home. Wives may assume all of the household or child-care responsibilities, while working outside the home as well, adding stress to their plate. Children may already be asleep by the time one parent gets home in the evenings. Everyone in this family system is experiencing some form of loneliness, stress, and isolation.
When feeling this low, it can feel very appealing to gravitate towards something that immediately relieves some of this discomfort. Alcohol use in rural areas is normalized at social events, after a long day, or to celebrate. Substances immediately create a chemical reaction in the body, which can make it a more difficult habit to break. The chemical makeup of alcohol is a depressant to the body. It makes you tired, more lethargic, slurs your speech, and impairs decision-making processes. If someone who is already depressed begins drinking, it can intensify these emotions and lead to conflict with others and impulsivity. Impulsivity can be viewed as “fun and exciting,” but it can also look like acting on harmful, even suicidal thoughts someone may already have been experiencing. A specific group of young agricultural workers, who are single and male, have shown higher rates of alcohol misuse (Chasek et al., 2023). Multigenerational young farmers may feel an increased pressure to assume all of this responsibility, adding additional stress to an already busy and risky business due to the ever-changing markets.
Now let’s look at the resources: they are few and far between, literally. In these rural areas, it can be difficult to have a medical clinic or hospital nearby, let alone mental health counselors. And the ones that are nearby can require at least an hour's drive. This could mean easily three hours out of someone’s day, and during busy harvest season, like we are in now, it makes it extremely difficult to make time. If there are nearby practices, we start to see how strong or heavy the stigma remains. Small towns mean you know everyone, and everyone knows your car, and therefore what you’re doing in town. Word spreads fast, and if people see your car parked out front of the “shrink’s” office, there may be fear of rumors being spread or having to explain already personal challenges. While there may be many downsides to the rise of technology, this is one of its benefits: more access! For the farmers who can’t take multiple hours out of their day, they can hop on a video call for 40 minutes from the field in the privacy of their tractor or pickup. And for the people nervous about going into a local office, they have the privacy of doing it where they feel safe. This also reduces the strain on local mental health providers to provide every service possible to all populations. If someone needs a specific referral or specialized treatment, for example, substance use or OCD, local providers can more easily provide a referral to a specialist who conducts virtual sessions.
So how do we find these resources? An easier first step is going to your physical doctor and requesting a referral for mental health support. Some mental health departments of rural hospitals require a referral from your medical provider, and communicating these things to multiple people is vulnerable and stressful. However, reminding oneself that it is a confidential space can provide reassurance. Google searches and using platforms like Psychology Today allow you to specify your search. The Rural Response Hotline provides financial, legal, and disaster assistance, as well as providing vouchers to rural Nebraska residents needing mental health support.
Aside from the professional support, we also need to support each other within the community. Encouraging conversations about how agriculture workers are feeling and doing can help normalize talking about our feelings. Everybody has them, and they are simply signals in our body that we need something, just like our stomach growling that we are hungry and need food. Creating community groups for men to come and chat, without alcohol, can help increase feelings of belonging and reduce isolation. We need every part of our communities, and that also means not ignoring people’s emotional needs. A nonjudgmental listening ear goes a long way. A village doesn’t function alone; it needs all its members.
Resources
Chasek, C., Watanabe-Galloway, S., Rutt, R., Olson, A., & Yoder, A. (2023). A cross-sectional study of alcohol, opioid use, and anxiety in agriculturally based occupations. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 39(4), 816–823. https://doi.org/10.1111/jrh.12749
Shanahan, D. (2025, October 27). Addressing suicide: Nebraska’s efforts to break the silence and save lives. Addressing Suicide: Nebraska’s Efforts to Break the Silence and Save Lives | University of Nebraska Public Policy Center. https://ppc.unl.edu/addressing-suicide-nebraskas-efforts-break-silence-and-save-lives
