MODELS FOR PRACTICE

FOCUS AREA: MENTAL HEALTH AND MENTAL DISORDERS

 

 

Program Name: Sowing the Seeds of Hope

Location: Iowa, Kansas, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin

Problem Addressed: Mental Health Access for Rural Farm Families

Healthy People 2010 Objective: 18-7, 18-9

Web Address: http://www.agriwellness.org

 

 

SNAPSHOT

 

Sowing the Seeds of Hope: Responding to the Mental Health Needs of Farm Families is a collaborative effort of project leaders in seven predominantly rural states: Iowa, Kansas, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin. The program is establishing an integrated regional network of behavioral health care supports for the rural agricultural population.

 

THE MODEL

 

Blueprint: Sowing the Seeds of Hope provides behavioral health assistance in participating states to those involved in the agricultural business and their families. The project in the seven states addresses the underserved rural agricultural population without regard to age, income, availability of insurance, racial/ethnic group, or location.

 

The program provides services to individuals and families who do not have health insurance or adequate behavioral health coverage, and others who are unable to pay for necessary care. Often, these individuals and families experience an accumulation of stresses that result in the breakdown of coping mechanisms. Common associated behavioral health problems include interpersonal distress, depression, anxiety, substance misuse, and loss of hope. Negative stigma about mental health services, geographic barriers, and a perception that providers do not understand their agricultural issues often deters some families from seeking necessary assistance. Additionally, there is a scarcity of qualified professional service providers in rural areas, necessitating the training and utilization of informal networks of support, such as clergy, Extension staff, trained natural helpers who reside in the farm community, and primary care providers (e.g., physicians, nurse practitioners, and physician assistants).

 

Sowing the Seeds of Hope was designed and initiated in 1999 by the Wisconsin Office of Rural Health and Wisconsin Primary Health Care Association. It was supported by grants from the U.S. Department of Health and Human Services Office of Rural Health Policy and Bureau of Primary Health Care. Administrative support for Sowing the Seeds of Hope is now coordinated by AgriWellness, Inc., a 501(c)(3) nonprofit corporation that assists project leaders in the seven states, provides proposal and grant writing, and explores funding opportunities.

 

Many individuals and organizations serve voluntarily in their specific states to carry out portions of the work. A central aim of each state project is the formation of a coalition of individuals (both paid staff members and volunteers), agencies, and organizations to maximize information about access and cost of services, options for additional funding, and continuation of the state projects.

 

Project leaders identified 11 core services for the underserved rural agricultural community:

 

·         outreach;

·         training and education of traditional and non-traditional behavioral health care providers;

·         education of the community on agricultural behavioral health issues;

·         information clearinghouses;

·         crisis hotlines;

·         direct services through vouchers, contracts with approved providers, and other means to ensure access to necessary services;

·         prevention of more serious difficulties through early intervention;

·         coalition building with organizations, agencies, and communities;

·         advocacy for behavioral health of the underserved;

·         social marketing through publications, press releases, and other media activities; and

·         retreats and support group activities for farm couples and families.

 

Making a Difference: To evaluate the core activities of the program, the following evaluation measures are used:

 

  • outreach: documentation of the type of outreach and purpose;
  • training and education: community education¾documentation of the type of participants and training, numbers of people and sessions, and duration of sessions;
  • clearinghouse: number of requests, referrals, and types of information;
  • crisis hotline: number of people calling, referrals, and outcomes;
  • direct services: numbers of vouchers, types of services, demographic information, and dollars allocated;
  • prevention/early intervention: numbers of people served, type of activity, and demographic information;
  • coalition building: type and number of meetings; direct/indirect;
  • advocacy: number of contacts, amounts of finances received/leveraged; and
  • retreats/support activities: type of activity, numbers of participants, and duration of sessions.

 

Since the outcome criteria were not established until December 10, 2001, not all the reported data are usable. Thus, the outcomes/results reported here for 2001 are probably underestimates.

 

More than 14,000 farm residents were reached in 420+ outreach events. More than 400 providers were documented as having received professional training in 40+ documented training programs. At least 5,850 farm residents received community education. The crisis hotlines in the seven states reported more than 20,000 callers during the first two years of the project. At least 3,811 farm residents received direct services, which were partially or completely funded by Sowing the Seeds of Hope. Project personnel were successful in generating an additional $3,150,000 of federal, state, and private funds to augment $1,035,000 received from the Federal Office of Rural Health Policy, $90,000 from the Federal Bureau of Primary Health Care, and $28,000 from the Land O’ Lakes Foundation. At least 556 persons participated in 95 support group meetings or farm couple/farm family retreats.

 

Beginnings: The Sowing the Seeds of Hope project was developed to respond to the mental health needs of farm families in the seven-state region. Behavioral health threats increase among the rural agricultural population during eras of economic stress. The suicide rate among farmers rose three to four times the national average during episodes of financial distress in several of the states in the Sowing the Seeds of Hope region.

 

The program began in May 1999 and was fully implemented in September 2000. The first three years of funding were considered the pilot phase. The Sowing the Seeds of Hope project leaders are now ready at the next level¾implementing the basic services on an ongoing basis.

 

Challenges and Solutions: Insufficient funding is the greatest challenge to the projects in each state. Although project leaders in each state have been very successful leveraging additional state, private, and federal resources to augment their projects, the needs of the population surpass available resources. The program is working very actively with federal, state, and private organizations to both secure additional funds and to maximize pursuit of the program’s objectives.

 

PROGRAM CONTACT INFORMATION

 

Michael R. Rosmann, Ph.D., Executive Director, AgriWellness, Inc.

1210 7th Street, Suite C

Harlan, IA 51537

Phone: (712) 235-6100

Fax: (712) 235-6105

E-mail: info@agriwellness.org