The Landscape of Farmer Mental Health Programs in the US Midwest.

Purpose: Agricultural sector crises have historically led to a sharp increase in resources for farmers' mental health. Yet, our understanding of the effectiveness, acceptability, and long-term sustainability of these is limited, and research rarely assesses the offering of programming within a geographic region.

Methods: We conducted online environmental scans in 2019 and 2022 (a period that encapsulates a farm income crisis and the height of the COVID-19 pandemic) in three Midwest states to understand: 1) what the mental health programming landscape looks like, 2) how it has evolved in response to crises, and 3) the progress made toward addressing major stressors and key barriers to care.

Findings: The number of organizations providing resources more than quadrupled, and the number of programs and resources more than tripled. Organizations most represented shifted from the farm sector in 2019 to the health sector in 2022. Educational material remained most prevalent, followed by programming to increase health care access. Meanwhile, the share of programming addressing key stressors was halved. Programming was overwhelmingly targeted at the farm population over service providers, with visual representations overall lacking diversity.

Conclusion: Findings around the sharp increases in programming and organizations involved hint at challenges connected to the coordination and sustainability of programming. The emphasis on addressing the manifestations of mental health challenges in tandem with limited linkages to financial resources raises questions about the efficacy and acceptability of programming. It also hints at the potential (re)enforcement of norms and stigma around mental health and help-seeking.