farm land during sunrise


Growing Stress on the Farm: The Expanding Economic and Mental Health Disparities of Rural Missouri


Mat Reidhead

Mat Reidhead

Vice President of Research and Analytics





  • Behavioral Health
  • Rural Health


behavioral health report rural health

The mental health crisis in rural Missouri is more challenging than in urban communities, but may be particularly severe for the agricultural community. Recent studies, media coverage and congressional action suggest the unique set of external challenges faced by farmers and ranchers are resulting in extremely adverse mental health outcomes in agricultural communities. Contributing to mental health challenges on the farm, recent extreme weather events, economic pressure and foreign trade policies have combined to produce a series of lean years for agricultural producers not seen since the farm crisis of the 1980s.

While the U.S. economy has experienced quarter-over-quarter growth since the end of the recession in 2008-2009, the farm sector has experienced six periods of recession.

Missouri has nearly 16,000 fewer family farms today compared to 20 years ago, and bankruptcies are on the rise. Bushel prices have fallen by 47% since 2012, while farm income and credit conditions have deteriorated.

Pervasive stigma and geographic barriers to accessing mental health care can prevent all who seek behavioral health services in rural Missouri from seeking help for stress, anxiety and depression. Each of Missouri’s 99 rural counties is a designated Mental Health Professional Shortage Area, and with just 3.7% of the recommended supply filled, Missouri faces the largest shortage of behavioral health care providers in the U.S.

Suicide is growing at an alarming rate in rural Missouri. Between 2003 and 2017, the suicide rate among rural Missourians grew by 78%, and throughout the last decade, their hospital emergency department visits for suicide attempt or ideation increased 177%. Rural men between the ages of 35 and 44 have triple the statewide suicide mortality rate.

Missouri is home to multiple innovative programs designed to improve mental health access and outcomes for rural residents, but additional investments are needed.


Full Report


  • Talking about wanting to die
  • Looking for a way to kill oneself
  • Talking about feeling hopeless or having no purpose
  • Talking about feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious, agitated or recklessly
  • Sleeping too little or too much
  • Withdrawing or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings

The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide but may not be what causes suicide.


If someone you know exhibits warning signs of suicide:

  • Do not leave the person alone
  • Remove any firearms, alcohol, drugs or sharp objects that could be used in a suicide attempt
  • Call the AgriStress Helpline at 833-897-2474, the Suicide & Crisis Lifeline at 988 or the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255)
  • Take the person to an emergency room, or seek help from a medical or mental health professional
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