Taking a Holistic Approach to Addressing the Needs of a Farm Family in Crisis

1. Taking a Holistic Approach to Addressing the Needs of a Farm Family in Crisis Presented by: Jennifer Hobby, CSW Program Coordinator AgrAbility of Utah

2. Workshop Objectives Assessing the environmental, emotional and social support needs of a farm family in crisis Creating, organizing and maintaining a comprehensive crisis support team to provide a multi-level interventions system Effectively utilizing resources for post-crisis, follow up sustainability and support

3. Stress vs. Crisis • Stress: • Any event in which environmental and/or internal demands tax or exceed the adaptive resources of an individual • Crisis: • A major upset in our psychological equilibrium due to some harm, threat or challenge with which we cannot cope

4. Three stages of crisis episodes: • Level of tension increases sharply • Attempts to cope with the stress have failed. Resulting in further increases in tension and a sense of being overwhelmed. • The crisis is resolved positively or negatively We are particularly receptive to seeking out or receiving help at stage two

5. Understanding Stress in Farming

6. Occupational Stressors • Uncertain weather conditions • Complex world economic markets • Little price control over their product • Changing agricultural tax policies • Agricultural diseases and livestock predators • Land development pressures • Limited rural resources • Increasing operational costs • Limited sources for operating loans • High rates of job related injury and disability

7. Utah Farming and Ranching • The critical economic facts: • Total number of farms: 16,700 • Farm households contain 63,981 individuals • Average household size for a farm family in Utah: 3.83 • Net income per farm/ranch in 2007: $15,533 • The Federal poverty level for a household size of four: $22,040 • 60% of Utah farms reported a net loss in 2007

8. Additional Stressors • Lack of health insurance coverage • Complex extended and farm family relationships • Limited access to and utilization of medical and mental health services • Social Perception • Cultural identity and accountability • Societal expectations

9. Access to health care and related services • The rural west has the lowest availability of primary care providers of any region in the country. • A higher percentage of frontier people live in poverty. All 50 of the poorest counties in the US are frontier counties • Isolated nature of farming as an occupation increases risk of injury and limits access to formal support systems Weigel, R.R., (2004) Ranching in the west is it Hazardous to your Health? Traumatology, 10 (3)

10. Complex familial relationships The family that works together • Most often, a farm family’s relationship with each other is very intertwined with their relationship to the farm. • The value and legacy related to an operation often lead to tension or conflict within a family with respect to succession planning.

11. Social Perception • Positive-stereotyping • Social Status • Positive stereotyping can generate an enormous communication gap by preventing the farmer from talking about his problems and preventing the listener, whether professional or not, from understanding (or believing) that this person needs help

12. Cultural identity and accountability • Farming is an identity, a heritage and a legacy. • Farmers internalize these aspects of their occupation and are accountable for maintaining this identity

13. “Ownership of a family farm-sometimes a farm that has been in the family for generations-is the triumphant result of a multitude of struggles. Losing the farm or the livestock is viewed as an ultimate loss, one that brings shame to the generation which has let down it’s forbearers and has dashed the hopes of successors” Mike Rosmann, PhD Executive Director AgriWellness

14. Societal Expectations • Social norms expect positive statements about rural living • The mythology of farm life is that it is hard work, but rewarded by peace and quiet and therefore superior to the urban rat race • Farming has deep ties to the founding of our nation. • This can create an obligation for modern farmers to “live up” to the mythological giants that set current expectations.

15. Of Note…: • Taking a holistic approach means not only assessing the identified client but also family. • More often than not one individual within the family system will draw the most attention (e.g. the one who is injured, exhibiting negative behavior or under obvious distress). • Nevertheless the strain on other family members cannot be overlooked.

16. Assessing a farm family in crisis

17. Farm families in crisis experience: • Hopelessness • Financial burdens • Difficulty managing the operation • Depression/anxiety, strain in inter-family relations • Confronting the expectation that they can or should “suck it up” and put their best face forward

18. Barriers for a farm family in crisis: • Financial constraints • Lack of accessible healthcare/health insurance • Lack of knowledge of resources • Lack of ‘bridging’/transitional services and coordination of care • Lack of accessible resources • Namely resources to provide on farm support

19. Unaddressed these can result in chronic problems such as: • Chronic mental/behavioral health problems • Serious losses of farm productivity • Operation loss • Overwhelming medical expenses • Long-term interrelation problems within the family

20. The Essential Assessment

21. Assessment defined: The process of gathering and analyzing relevant information • Beyond understanding what is wrong assessments should consider: • Strengths • Resources

22. The essential assessment • Important aspects of an assessment: • Interviewing: An effective means for eliciting essential information • Confidentiality: Client must be assured the information shared will not be disclosed without their consent (see consent form) • Ethics: The interviewer should adhere to a organizational code of ethics (see NASW code of ethics, for example)

23. Interviewing • A face to face conversation between the client and the worker • Outcomes should include • Building rapport and a working relationship with the client • Identifying the needs of the client and environment (family, operation etc.) • Setting a preliminary course of action to address identified needs • Instilling hope that things can and will improve

24. Important Aspects of Interviewing: • Setting the client at ease: Remember to be a human being. Be relaxed • Ask pertinent questions. Even if it feels awkward. When asked openly and in a non-judgmental fashion, people will open up. • Listen: Listen to what is said, tone of voice and manner of speaking. • Silence: Give the client enough time to muster their thoughts • Summarizing: Periodically summarize what is said to ensure what is being said is being accurately understood • Structuring: Use time wisely and be organized • Convey interest nonverbally: this is done with tone of voice, facial expressions, gesture, posture attentiveness etc.

25. Desired assessment outcomes Understanding: • The nature of the client’s problems. • The functioning of clients and significant others (how are they coping?) • Whether the client is motivated for change • Relevant environmental factors which contribute to the problems • Resources needed to address the client’s difficulties

26. Goals should be: • Collaboratively decided on between the helper and the client • Achievable • Measureable • Believable • Value-oriented (client’s values) • Ultimately and primarily the client’s responsibility to obtain

27. Reality check • You cannot work miracles • “We the unwilling led by the unknowing are doing the impossible for the ungrateful. We have done so much for so long with so little we are now qualified to accomplish anything with nothing”- Mother Teresa • “In this life we cannot to great things we can only do small things with great love”-Mother Teresa Never underestimate the value of simply listening

28. Creating, organizing and maintaining a comprehensive crisis support team to provide a multi-level interventions system

29. Ensure that your agency has established protocols: • Staff have identified roles and responsibilities for addressing the needs of clients and maintaining the project’s status and goals

30. Example:

31. Case management: • Service delivery model which emphasizes working with the individual in their environment and community • Primary functions are to • Assess: the client’s needs • Link: the client with services which can support their goals • Coordinate: the delivery of services and • Monitor the delivery of services and client progress

32. The Players Legal Advisors USDA Staff Members Financial Advisors Client/ Family AgrAbility (case manager) Clergy Community Human Services Extension Extended Family

33. Creating a Network

34. Step One: • Identify potential network partners • Beyond VR and independent living centers consider: • Medicaid • Community mental health centers • Area Aging Authorities • Federal Housing Programs • Assistive Technology programs • Food and Financial assistance • Local non-profit organizations

35. Step Two: • Homework time! • Research the services, goals and objectives of potential network partners. • Identify common objectives • Inform key individuals within the proposed network of AgrAbility, the services provided, and specific areas where collaboration would benefit the client population

36. Strengths in the AgrAbility Projects: (A.K.A. How to get these agencies attention) • Farmers and Ranchers are a sympathetic population • Policy beginning to reflect improving services in rural communities • Emphasis on preservation of family farms • Emphasis on encouraging individuals to remain in employment despite age/ability barriers Handy read: President’s New Freedom Commission on Mental Health, 2002 (recommends a mandate for human services to focus on service delivery in rural areas)

37. Strengths of AgrAbility Projects: cont. • Increased interest in addressing civil rights issues and violations within the USDA. • Handy Read: Memo from Secretary Vilsack dated April 21, 2009, A New Civil Rights Era for USDA Most Importantly, AgrAbility Projects have (or should have) a positive relationship with farmers and ranchers within their state. As such the projects are uniquely poised to be the essential link between human services and other programs and our clientele.

38. Step Three: • Once the need has been established (e.g. access to Medicaid services). Discuss collaborative means for addressing the need Tip: encourage agencies initially to identify a specific individual to work with AgrAbility staff. This enables: • Cross training on program rules and regulations • Consistency in working out kinks in the process

39. Networking: Points to remember: • Not all individuals in an agency will be responsive to collaboration. (Even when doing so will allow both parties to meet program goals) • It is strongly encouraged that the projects administrative staff meet with the administrative staff and boards of directors first where possible. (Just make sure to do your homework)

40. Networking: Points to remember: • Disagreement is part of the process • Advocacy requires assertiveness, most individuals within other agencies know this. • …Its okay to be wrong

41. Effectively utilizing resources for post-crisis, follow up sustainability and support

42. Effective networking requires consistent maintenance • AgrAbility is an essential link between farmers and ranchers. This link must remain consistent through the process.

43. Effective Networking tips: • Know your partner contacts by name. Maintain a respectful relationship Meet regularly and follow through • Follow through. Only slightly less effective than no referral is a referral which consists simply handing the client a business card. • Understand that linking can take a long time (e.g. it can take up to two years to receive social security disability benefits) • Save the venting of frustration for colleagues. With clients be honest about the length of the process-but continue to assure them that achieving the ultimate goals (health and independence) are worth it.

44. Agri-Culture Barriers to Help Seeking Behavior • strive to be respected for successful achievement (and own their success) • not show weakness • seek out adventure and risk • maintain independence and self-reliance • Releasing some of their control, by seeking help, taking advice and participating in a team approach is foreign. This simultaneously heightens their sense of failure and can bitter the sense of accomplishment that comes from success

45. Agri-Culture cont.: Stigma • Concern that revealing their disability to eligibility staff may hinder their chances for operating loans • Anxiety that they will be seen as incapable and be viewed as a "welfare case" or marginal producer • Worry that they will be considered inadequate because of confusion about where and how to apply for a variety of programs and services • Concern that their disability may prevent them from meeting the standards of the assistance program

46. Agri-Culture • Farmers are sole-proprietors. The weight of struggle or failure, generally rests solely on their shoulders. • Farmers have a daily, love/hate relationship with stress. When stress is overcome, and the crisis resolved, the farmer is validated that he can maintain control • When attempts to resolve the crisis have failed, or problems become too numerous to address the farmer is most vulnerable. And the most likely to seek, or accept assistance

47. Contact Information Jennifer Hobby Program Coordinator AgrAbility of Utah USU ASTE Dept UMC 2300 Logan, UT 84322-2300 Phone: (877) 225-1860 E-mail: jennifer.hobby@usu.edu