On the Record: Debra Kawahara talks mental health in agriculture

Debra Kawahara is president of the American Psychological Association and associate dean of academic affairs at the California School of Professional Psychology, Alliant International University. Her family farms in San Diego County. Kawahara responded to questions during
an interview with Ag Alert^®.
The below conversation was edited for length and clarity.

How did you become a psychologist? I had decided I wanted to work with underserved communities that were not getting mental health services. My goal was to become an executive director of a community mental health center. My career took a change because I met my husband. He has a farm, and you can’t just up and move the farm. So, I pivoted to academics, and I have a small independent practice. 

Can you tell me about your family’s farm? We live on a 160-acre farm in San Diego County. My husband, Neil Nagata, is a third-generation farmer. He grows strawberries, blueberries, cherimoyas and some assorted vegetables. 

How has being part of a farming family affected your outlook on life or your approach to psychology? It has taught me to be flexible and accept that some things are out of my control. In farming, there are lots of factors you can’t control. Even if you put all that investment into it and work really hard, it doesn’t guarantee a successful outcome. You can plan, but things don’t always go according to plan. It’s important to be able to cope with and manage that. 

What are some of the stressors farmers deal with that can affect mental health? First and foremost, it’s finances. Whether it’s the market, trade, tariffs, interest rates, minimum wage increases, all of these are things farmers have to contend with, and for a lot of farmers, it’s becoming harder and harder to make things pencil out.

It’s not only about the finances and the business. Farmers take such pride in what they do. I think about my own husband and him wanting to sustain his family’s farming legacy. When you’re not able to, it can be heartbreaking. Farming can be a lifelong identity that has been woven into the fabric of who they are. When that falls apart, it’s devastating.  

That’s what the financial part is really about—the stress of not being able to make it. We all know what it’s like when things are hard financially, but it carries so much more weight for them. Farmers also think about their workers and how they could be affected if they can’t sustain their business. 

What role does stigma play in deterring farmers—or people in general—from seeking mental health treatment? Rural communities tend to be close-knit, and farmers tend to pride themselves on being independent and self-sufficient. They want to stand on their own two feet. Oftentimes, mental health concerns are seen as a weakness, so stigma does play a role in the reluctance we sometimes see in seeking mental health treatment. 

One of the things we do to try to reduce the stigma is called mental health literacy, which is about educating people about mental health and promoting the mindset that it is part of a person’s overall health, which includes their physical and mental health. Another thing is putting mental health services in buildings where other services are offered, such as a county agriculture building, so people can seek out mental health services without everyone knowing where they’re going. 

There are well documented gaps in health care services in rural areas. Is there a similar lack of rural mental health services? Yes. There are many rural communities that do not have enough mental health care providers. We also know that a lot of rural mental health clinics are closing because they don’t have the finances to stay open, and so the distance that people in rural communities have to travel to access care can be an obstacle. 

How do you think attitudes around mental health have changed—or not changed—during the past 20 years? I think there’s been an acknowledgment in society at large, and also on farms, that mental health issues are important. But there is still much work to be done to overcome the stigma and encourage help-seeking behaviors.  

Data consistently show suicide affects farmers at higher rates than the general population. What can be done to help? It is very concerning. I think part of it is the stressors we talked about and the stigma around mental health in rural communities. There’s a belief that “you don’t hang your dirty laundry out for everyone to see.” One thing that can help is educating people to notice behavior changes in friends and family—whether it’s withdrawing or seeming like they don’t have the energy they used to have or giving away prized possessions. Then, it’s about trying to talk to that person, supporting and encouraging them, letting them know they’re not alone, and trying to get them help if they need it. 

What are some of the mental health benefits that working in agriculture might provide? That’s a great question, and it’s something that’s often not talked about. The close-knit community that exists in agriculture is a big strength. It provides stability and resilience, and creates a community where people come together to help each other. That kind of social connection is really valuable for our mental health. Farming communities also tend to hold on to cultural heritage, values and rituals, and all of that produces a positive identity. Another benefit is having access to fresh fruits and vegetables. Having that in your diet can also improve mental health. 

What kinds of mental health resources are available for farmers? There is free online training from the National Farmers Union, Farm Credit and the American Farm Bureau Federation designed to help family members, friends and neighbors address the farm stress crisis in their own communities, reduce stigma and connect farmers and ranchers with appropriate resources. 

The AFBF Farm State of Mind campaign is at www.fb.org/initiative/farm-state-of-mind. The Farm Stress Education training can be found at nfu.org/education/farm-stress-education/. 

The American Psychological Association has a list of licensed psychologists and mental health indicators at www.apa.org/workforce/data-tools/mental-health-indicators. 

Another resource is the Farm Aid Hotline, which is 1-800-FARM-AID. It operates Monday through Friday from 9 a.m. to 5 p.m. Eastern Standard Time. The Farmer Resource Network is Farm Aid’s online directory of more than 750 organizations that work with farmers on a variety of issues. 

The National Suicide Prevention Lifeline can be reached by calling 988.