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States struggle to meet rural behavioral health needs without federal funds
Facing increased demand for behavioral health services in rural areas that rivals what was seen during the 1980s farm crisis, agencies in at least 28 states have been looking to Iowa for advice on the problem.
“I’ve spoken with people from the states of Oklahoma, Utah and Colorado — and that has just been in the last week,” said Dr. Mike Rosmann, executive director of Harlan-based AgriWellness.
Along with Iowa State University Extension, AgriWellness operates the Sowing the Seeds of Hope program, which provides residents in seven states a support hotline and up to five free visits with a counselor that can help with martial and family conflict, financial concerns, general stress and overall crisis situations. The program is geared toward rural patients and is open to families who do not have mental health coverage or are under-insured.
A global economic crisis and significant fluctuations in commodity markets have severely impacted agricultural interests throughout the nation, and crises related to unmet behavioral health needs are affecting farming communities everywhere. But evidence suggests that states like Iowa, where an assistance network is already in place, have avoided the worst of it.
“In the other states, agencies get calls from rural people who don’t know who they can speak with or where they can go to get assistance,” Rosmann explained. “It was difficult for states to provide behavioral health services before, but now, because of financial difficulties, the number of farmers and ranchers who need assistance is growing and, without a hotline and additional services like our Sowing the Seeds of Hope in place, states are scrambling to meet these needs.”
Although other states began contacting Rosmann and AgriWellness about two years ago about providing similar programs, interest has intensified over the past year, coinciding with increased financial strain in several agricultural sectors. While Rosmann can offer advice about operating mental health services for rural residents, the one question he does not know the answer to is how states will find the money to fund the services.
“Although the Farm and Ranch Stress Assistance Network has been authorized as a part of the Farm Bill, Congress has unfortunately not made appropriations for it,” Rosmann said.
With federal appropriations in place, the program would have made competitive grants available through extension services to establish hotline services as well as provide behavioral health care access in the nation’s most geographically rural areas. Without the funding, individual states must use their own resources to begin outreach and assistance to rural areas — a task made more difficult by strained state budgets nationwide.
“We are still hopeful that a federal appropriation will come through. Without it, I just don’t see how these other states are going to be able to get the ball rolling,” Rosmann said.
Although appropriations were not contained in either the U.S. House or Senate versions of the relevant appropriations bill, U.S. Sen. Tom Harkin (D-Iowa) said Thursday morning that he will continue to fight for the program both through the appropriations bill conference and through direct negotiations with the U.S. Department of Agriculture.
“In Iowa we have things like Sowing the Seeds of Hope, which is a program available to farmers. Farmers in other states might not be so fortunate,” Harkin said by phone. “That’s why I’m going to continue to fight for funding for this as it moves through conference. I recognize the need to provide this, and I’m going to continue to fight for it.
“I’ve got to tell you that getting the funding is going to be an uphill battle, but I’m going to do everything I can because I remember what happened in the 1980s and I don’t want a repeat of that — where farmers were committing suicide and families were breaking up because of the undue stress that happened in the 1980s. And, for a meager amount of money, you can provide a lot of assistance to farmers and ranchers who are in real trouble.”
Specifically, Harkin is hoping to redirect money that is either already included in the farm appropriations bills or at the disposal of the USDA.
“I hope we can be successful,” Harkin added. “As I said, we know it is needed. We learned from the 1980s that some of these things can be very, very helpful in getting people through a rough patch. I just can’t tell you whether or not we will be successful or not, but we’ll do our best and see what happens. … We know we have some hurdles, but we’re going to continue to try.”