In 2020, the Kentucky legislature proclaimed the Wednesday of National Farm Safety Week "Farmer Suicide Prevention Day." Suicide is the 11th leading cause of death among Americans. Unfortunately, farmers experience an even worse toll. From 2004 to 2017, 109 Kentucky farmers died by suicide, with those over 64 most at risk. Currently, stressors are the highest they have been in years, with producers suffering with supply chain issues, changing weather patterns and increasing input prices. 

The Centers for Disease Control and Prevention found that between 2012 and 2015, male farmers died by suicide at rates twice as high as the national average in 17 different states. Though, this may actually be an understatement because the data collection process overlooked some agricultural states. 

However, the University of Kentucky College of Agriculture, Food and Environment and College of Nursing are working to address these issues through a joint program coined BARN, or Bring Action Right Now.   

One way the program addresses the industry’s mental health issues is through the "Farmer Dinner Theater." These gatherings assist farm families in discussing health issues affecting their communities through dramatic presentations starring local community youth as actors. The program encourages an open dialogue about mental health and reassures farmers and their families that it is okay to seek treatment if needed. 

“The BARN program delivered in Kentucky has helped increase awareness about mental health challenges, farm stress and suicide prevention in Kentucky,” said Paul Norrod, extension specialist for Rural Health and Farm Safety as well as health instructor in the College of Nursing. “Dinner theater attendees have stated that mental health challenges can affect anyone and that it is important to talk about them in the community to help prevent suicide.” 

Through the program, participants expose themselves and their families to a variety of proven mental health interventions, ranging from basic suicide intervention resources to breathing techniques. However, all of the scenarios are reenactments based on real-life situations that farm families may have faced. 

The overarching BARN initiative, created by the Kentucky Nurses Action Coalition, has dramatically expanded its impact since receiving their first innovation award in 2020. In 2021, a KNAC innovation award allowed the BARN program to expand to address mental health issues and suicide among young people, with the participation of 100 school nurses. 

The same training and tools will be used to address nurses' well-being, an urgent priority in The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity by the National Academy of Medicine. 

However, the increased impact extends beyond any single program. New strategies and connections developed in recent years have helped Kentucky's nurses become more influential on policy issues. For example, the state recently mandated that nurses receive continuing education in suicide prevention. 

All of this will hopefully provide the resources needed to cut down on a tragic trend of suicide among farmers and residents of rural communities. 

Janie Heath, dean and Warwick Professor of Nursing in the UK College of Nursing and president of the Kentucky Nurses Action Coalition says anyone looking to improve their mental health and wellness can use strategies highlighted in the BARN programming. Some of these strategies include: 

1. Staying focused on what can be controlled – for example, one cannot control the weather, but one can control how we react to or prepare for the weather. 

2. Breathing – focusing on breathing and practicing breathing exercises is a proven method for combating stress and refocusing your mind away from stressors. 

3. Practicing gratitude – take time each day to identify something to be thankful for, as this helps promote positive thinking and perspective. For example, being thankful for a sunny day, talking with a friend or spending time with a pet.  

4. Prioritizing time for ourselves – prioritize “me time” at least once a day by taking the time to do something beneficial for yourself, such as reading, exercising or watching a favorite TV program. 

5. Embracing resources – use free and/or paid professional counseling services, mental health apps or other treatment that aids in your mental wellness, especially if in a crisis situation. For example, the National Suicide Prevention Lifeline at 1-800-273-8255 is available for free 24/7 to those experiencing suicidal thoughts.  

“If you are concerned about a friend or family member or they are having thoughts of suicide, you can call or text our crisis hotline,” Norrod said. “Text ‘KY’ to 988 which indicates that you live in Kentucky or call 988 and indicate you live in Kentucky.”  

“We are thrilled to partner with colleagues who are dedicated to addressing mental health and well-being needs for healthier and stronger Kentucky communities and farm families,” Heath said. 

The BARN Farm Dinner Theater has been developed into a toolkit that will allow County Extension Offices to easily replicate the program.  As part of a USDA Farm Ranch Stress Assistance Network, the toolkit will be disseminated through the Southern Ag Exchange Network to 15 southern states.  A southern region train-the-trainer program is slated for 2023. 

The BARN Farm Dinner Theater program is possible through support from the Center to Champion Nursing in America, a joint initiative of the American Association of Retired Persons Foundation, AARP, the Robert Wood Johnson Foundation and the Kentucky Beef Council.