KIEL — More than 47,000 people killed themselves in the U.S. in 2017, including 915 in Wisconsin.

It’s generally agreed upon that farmers are at higher risk for suicide due to their self-reliant nature, limited access to mental health services, reluctance to seek help, a “farm comes first” mentality, access to lethal means, and lack of control over weather, prices and regulations, among other things.

Suicide prevention was a key topic during the recent “Supporting Farmers During Challenging Times” meeting held in Manitowoc County and organized by regional UW-Extension leaders.

Among the featured speakers was Tammi Kohlman, coordinator of CSI Destination Zero, who presented “Coping with the Pressures of Farm Life.”

The Destination Zero initiative aims to eliminate suicides in Fond du Lac County by promoting collaboration across sectors to ensure policies and procedures are in place across the county that lead to better care for those at risk.

“Farming in good times is stressful. There are a lot of stressors that are part of normal farming situations,” Kohlman said.

“And then when you add to that the additional stresses that are caused by some of the financial crises ... it’s setting up a situation where individuals either don’t have the right coping skills or the things they used in the past are no longer sufficient. And there are negative things that result.”

Kohlman said signs of increased farm stress may include:

• Change in routines: Members of the farm family stop attending church, drop out of 4-H or other groups, no longer stop in at the local feed mill, etc.

• Increase in illnesses: Colds and flus become more common, as do aches, pains and persistent coughs, for example.

• Farmstead appearance declines: Members of the farm family no longer take pride in the way the farm looks.

• Care of livestock declines: Cattle may lose condition, appear gaunt or show signs of neglect or physical abuse.

• Increase in farm accidents: Higher levels of fatigue or loss of ability to concentrate may result in more accidents.

• Children show increased stress: They may act out, miss school or exhibit a decline in academic performance.

“Long-term, chronic stress can impact pretty much every part of your being,” Kohlman said.

The impact can be felt physically (headaches, backaches, sleep disturbances, frequent sickness), emotionally (sadness, anger, loss of humor, anxiety), behaviorally (withdrawal, increased alcohol/drugs, irritability), cognitively (memory loss, unable to make decisions) and in decreased self-esteem (feelings of failure, doubting abilities).

Kohlman’s stress-management tips include positive self-talk and reframing, talking openly with family members, dealing with conflict appropriately and building a positive support system.

“A very common response to stress for people is to withdraw and isolate themselves, and that’s really the worst thing they can do when they’re under a lot of stress,” Kohlman said.

Suicide rates have continued to increase over the past two decades, she said, noting the rate has increased the highest in more rural areas. Additionally, she said the suicide rate for males age 45 to 64 is double that of the general population, with four times as many men dying by suicide than women (although she said women attempt suicide more).

It’s important to understand myths and misconceptions regarding suicide, Kohlman said. Among them, she cited:

Myth: “Suicide is unpredictable, there’s no way to know.” In reality, she said there are almost always warning signs prior to a suicide, but others are often unaware of the significance of the warnings or unsure what to do in response.

Myth: “Asking about suicide will give them the idea or make them mad.” In reality, she said, asking “Are you thinking about suicide?” in a direct and caring manner will often minimize a person’s anxiety and act as a deterrent to suicidal behavior; it won’t “plant the idea” or trigger suicidal behavior.

Myth: “If their mind is made up, there’s nothing I can do.” In reality, she said, heightened suicide risk is often short term and situation-specific, with most suicidal individuals wanting to end their pain, not their lives. Reducing access to highly lethal means saves lives, she added.

Misconception: “I’m not a mental health professional.” In reality, she said, although the statement may be accurate, “we all have a role to play in preventing suicides.” Those who interact with individuals on a regular basis are often in the best position to notice and respond to someone in emotional distress, she added.

Warning signs increase the likelihood that a person is in immediate mental distress. Depending on the situation, behavioral clues may include obtaining guns or pills, putting affairs in order, giving away possessions, exhibiting sudden interest/disinterest in religion, showing unexplained anger or aggression, abusing alcohol or drugs and withdrawing from activities.

There are five steps someone can follow to help a person who’s struggling. They include:

• Ask: When someone you know is in emotional pain, ask them directly, “Are you thinking of killing yourself?” Said Kohlman: “It reduces, does not increase, the risk of suicide. It opens the door to have a conversation with them. It makes them feel seen and heard.”

• Keep them safe: If they are suicidal, ask if they’ve thought about how they would do it. Then separate them from anything they could use to hurt themselves. “The more steps the individual has already taken, the more pieces of their plan that are already in place, the more at risk they are,” she said.

• Be there: Stay with them and listen to their reasons for feeling hopeless and in pain. Listen with compassion and empathy, and without dismissing or judging. “If somebody is in a time of crisis, just you being there can increase their feelings of connectedness with others, which is a huge protective factor against suicide,” Kohlman said.

• Help them connect: Put them in touch with ongoing supports such as family, friends, therapists or clergy so they have a network to reach out to in times of crisis.

• Follow up: Stop by, call or text. Making contact in the days and weeks following a crisis can make a difference. See how they are doing, let them know you care.

UW-Extension Fond du Lac County dairy and livestock agent Tina Kohlman (no relation to Tammi Kohlman) added that suicide is “a topic, as an agriculture community, we really don’t want to talk about. We really don’t know how to talk about it.

“But we need to realize how we can help support positive mental health and prevent possible suicides for our farming community, especially now with the financial stresses they’ve been facing for quite some time.”

The National Suicide Prevention Lifeline is 800-273-8255, or the Lifeline Chat is available 24/7 at https://suicidepreventionlifeline.org/chat.