BURLINGTON, Wash. — Fire draws people together.
Throughout history, people have cooked food, found warmth and gathered with others around kindling — a sign that it's safe enough to rest.
The flames burning in a wood-fired oven on an October Thursday served as that gathering place — a spot to cultivate community at a program for farmers and farmworkers. Don McMoran, the director of the Washington State University extension office in Skagit County, had invited people who work in agriculture, also known as producers, to learn to make wood-fired meals from scratch, like a pizza using whole grain wheat, locally grown tomatoes and cheese from nearby dairy farms.
On the surface, the demonstration — pushing and pulling the dough into a perfect circle, crisping the toppings in a kiln until the pizza turns golden brown — was an effort to show that making delicious food only takes a few ingredients. But the primary purpose of this "Pizza for Producers" event lay in between the making and baking: Farmers and farmworkers, many of whom labor in solitude, came together, ate and opened up about their work and themselves.
It wasn't advertised as such, but the event was intended as a mental wellness workshop for people working in agriculture, an industry that faces particular mental health challenges. Climate change threatens farmers' and farmworkers' livelihoods. Rising inflation creates extreme financial worries. They often work in rural areas, where help is hard to find but guns are easy to access. And cultural attitudes discourage seeking help.
That means many agricultural workers experience depression in isolation.
McMoran knows this personally. He grew up as the fourth-generation farmer on a 2,000-acre potato farm in Skagit. As a child, he experienced the suicide of a man who worked on his family's farm. Between 2016 and 2019, he experienced three more.
After that, he said, he slammed his fists on his kitchen table and said, "That's it. I'm not going to have this in my county anymore. I need to get off the sidelines and do something."
Funding from the state Department of Health enabled him to start a suicide prevention pilot program in Skagit, and a grant from the United States Department of Agriculture allowed him to expand outreach throughout the West. It's with that money that he's starting the Pizza for Producers.
Farm-related stress is an increasing concern among producers and researchers. A survey of nearly 800 agricultural producers in 13 Western states found that 78% of respondents are experiencing stress that is impacting their sleep, physical and mental health and relationships. Another 4.4% reported even higher levels of stress, like those associated with depression and anxiety. Workload, lack of time for production, and financial worries topped the list of stressors, according to 2021 Western Regional Agricultural Stress Assistance Program data.
Barriers, both internalized and lack of resources, stop many from seeking help.
In rural areas, the availability of mental health providers, and especially those who offer specialty services, is scarce. Only 12% of Washington residents live in an area where they can expect their mental health needs to be met.
"Even if services are available, they may not be accessible," said Allison Brennan, an assistant professor at Montana State University studying behavioral health. Cost can be a major obstacle, especially among farmers and farmworkers who don't have health insurance. Wait lists for therapists can take months.
The idea that farmers should be self-reliant and not need counseling also creates challenges, Brennan said. "In small communities, everybody knows everybody. If there is a mental health clinic and I go there, someone will see my vehicle parked outside and then I'll get labeled."
A 2021 American Farm Bureau Federation report, conducted by Morning Consult, found that 59% of rural adults believe there is some stigma around mental health in the agricultural community. That rate rises to 63% among farmers and farmworkers.
"You're taught to focus on the task at hand, and that emotions are not important," McMoran said. "So you internalize those things until you can't internalize them any more, and then they explode."
Farmworkers, responsible for the physical labor of production, carry their own stresses from low pay and long hours in all weather.
Maria Dod, who has worked at a tomato cannery near Sacramento, California, for four years, often works 12-14 hour shifts, standing the whole time. Even when her feet are covered in mud or sore, the expectation is "to keep working."
"It's a hard job," she said. "Production is go-go-go."
The National Agricultural Workers Survey, which was administered in 2009 and 2010 and was the most recent version that asked about mental health, found that 9% of agricultural workers experienced depressive symptoms.
There isn't reliable data on depression and suicide rates among farmers and farmworkers, as compared to the general population. Esmeralda Mandujano, a community health program manager at the University of California, Davis, said the 9% depression rate is likely an underrepresentation because many farmworkers are reluctant to share mental health information in a survey, especially if they don't primarily speak English.
Many workers are migrants and face language barriers, worries about immigration status and social and cultural isolation that add to their burdens.
Physical health also impacts mental health, studies have found, and farm work is backbreaking.
"Farmworkers experience physical injuries on a daily basis," Mandjuano said. "They work through musculoskeletal discomfort, injury and illness every single day. And if you suffered an injury at work, you're ."
Years of bending over or clenching your hands can cause arthritis, and unregulated meal times can contribute to diabetes. Physical health challenges can create stress for workers, many of whom are paid by piece rate. "The fastest worker is paid more, and everybody wants to be the quickest," she said.
Dod, who experiences mental health concerns, said she didn't seek treatment for many years because of cultural stigma. She has since found a psychiatrist and counselor and stays at the job despite the stress.
"I need to feed my kids and make money somehow," Dod said.
The health challenges, both physical and mental, that farmworkers experience are closely related to those of farmers, who Mandujano said are "all interconnected."
"The mood of the farmer affects the farmworker. And if the farmworkers are doing well, so will the farm," she said.
Chad Reznicek, a behavioral health specialist in Colorado, grew up as the grandchild of farmers, but was still puzzled by the lifestyle: "There's a part of me that goes, 'Why the hell would someone want to do this?'"
They do it because they find meaning in the work, he said, otherwise known as the "Agrarian Imperative" — a term coined by Michael Rosmann. It's a genetically programmed instinct that drives farmers to hang on to their land at all costs, tolerate unusual pain and adversity, and take uncommon risks.
"We develop an intense attachment to the land we work. We take great pride in our crops and livestock," Rosmann wrote. "Farmers are aware that we are producing essentials for life."
Many people inherit farm work from generations before and feel like failures if they struggle to maintain the land or produce the same quantities of goods, he said, despite the introduction of new threats like climate change or rising production costs.
Your ancestors "found this perfect place to farm. You're gonna get it someday and, by God, you better not screw it up," the mentality goes for many farmers, McMoran said.
Unlike most of her peers, Anne Schwartz, who produces bamboo and organic foods in Skagit, is a first-generation farmer. She planned to work in veterinary medicine, but a detour working on a dairy farm changed her course.
"I loved it and never looked back," she said. Farming allows her to pursue her passion of environmental justice by focusing on sustainable agriculture.
She faced a "perfect storm" in 2008, however, "with major crop losses and market failures and employee challenges," she said. "So I kind of went through my own crisis situation."
Because of the culture of farm work, it was difficult for her to talk about her mental health needs. "As a woman, you feel like you're supposed to toughen up," Schwartz said.
It was finding a "wonderful counselor" and a supportive group of peers that helped her feel comfortable returning to work. When she had hip surgery and couldn't move, much less work, for months, people came to her door with food and a listening ear.
"Community is everything in terms of being connected to people who don't want you to fail," she said.
On stage several decades ago, the musician Bob Dylan asked, "Wouldn't it be great if we did something for our own farmers right here in America?" Willie Nelson, Neil Young and John Mellencamp agreed, and Farm Aid was born.
Together, they put on the first show, which has since become an annual tradition.
After that 1985 concert, farmers started calling the Farm Aid headquarters. They were asking questions about farming, but it became clear they had underlying mental health needs, said Lori Mercer, a farmer hotline operator. Staff answered those calls and connected them with people on the ground to help. That evolved into a small farm-stress hotline team, and in the last two years, the staff has grown to six to cover a broader range of the country and offer longer hours of access, especially on the West Coast.
"A farm stress call may be about a drought, it may be a call about recovering from a hurricane, but along with all that heartache and damage, the stress is there," she said.
Staff are trained to provide mental health first aid on the hotline, but Mercer recommends calling 988, the National Suicide Prevention Lifeline, for someone experiencing a mental health crisis.
Farm Aid is also teaching counselors to use LandLogic, a method that seeks to integrate therapeutic work by bringing more mindfulness to a farmer or farmworker's daily operations.
"Many farmers are reluctant to see a counselor who's going to tell them to take a week off and relax, because there is no taking a week off in farming," Mercer said.
Specialized understanding in counselors is also needed for farmworkers, Mandujano said.
"If there's a lack of counselors in rural areas, there's going to be even more of a lack for farmworkers because you need somebody that speaks the language, understands the culture and understands the migration," she said.
McMoran, the WSU Skagit office director who organized the Pizza for Producers event, is working on a program to offer vouchers that farmers and farmworkers can use to get free or reduced-cost counseling.
McMoran is also focused on decreasing deaths by suicide using firearms. Research has found that people often make a decision to die by suicide within a matter of minutes. During a recent tractor-safety course, McMoran gave away gun safes: The process of unlocking a safe can make "a producer stall for enough time that it might make the difference," he said.
McMoran launched Pizza for Producers as a way to reach people who were reluctant to talk about mental health.
"The whole premise behind this idea is getting people back together, building community, and being able to share some of those things, hopefully breaking down some stigma and reducing suicides in the process," he said.
On the second day of the two-day workshop, Robin Morgan, who is pursuing a Ph.D. in crop sciences at WSU, showed Mandujano and Dod how to make dough for pasta al forno, which they cooked in the wood-fired oven.
After working the eggs and whole wheat flour together, he let the dough rest.
"If you pull on it right now, it breaks. If you let it relax for a little while, it will stretch but not break," he said.
"Just like the farmers and farmworkers," Mandujano said.
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