 Welcome to our webinar that we have for preparing your Ranch for Drought, a couple quick housekeeping things. My name is Dr. Travis Hoffman. I serve as your NDSU Extension Sheep Specialist and all of our webinars will be recorded and posted at www.ag.ndsu.edu-drought. One of the quick things is that we will have our discussion amongst our panelists. Again, we have a talented group of panelists that we will introduce here shortly. And our question and answer, please use the question and answer function for our information today so that we can provide the guidance and help to facilitate it as best that we can for you as well. So today's speakers, and this is our quick evaluation of our speakers. And so with our presenters here, the first one that we have is Dr. Sean Brotherson. Sean Brotherson is our Family Sciences Specialist and our Farm Stress Educator for NDSU Extension. Dr. Charlie Stultz now serves as the NDSU Extension Assistant Director for Agricultural and Natural Resources and is our Extension Veterinary Specialist as well. Andrea Bowman serves with North Dakota State University Extension in our Leadership and Civic Engagement Specialist and is also a cattle producer. Joining us is Becky Copdunham that is helping us for together counseling, which is a Farm Stress and Mental Health Counselor and also is a farmer. Philip E. Step is a Mental Health and Addictions Counselor here with North Dakota State University and Lila Krebs works with the North Dakota Beef Commission Board Member, is a dairy producer and also previously worked as an alcohol and drug rehabilitation nurse. And so with our individuals that we have, we are going to have this in terms of the discussion and be able to start this off. But the first thing that we're going to do is to have each of those individuals just provide a little bit of background of what mental health and managing the stress of farming or ranching is. But we're going to start with Dr. Sean Brotherson for their quick introduction of himself. And we'll go through in the order that we had listed there initially. Thank you, Sean. Thank you Travis. And thanks to all of you who are tuning in today or who will I'll listen to this web webinar in the future. As Travis noted, my name is Sean Brotherson. I'm Family Science Specialist with NDSU Extension and have worked on farm stress issues for a little over 20 years here in the state of North Dakota and across the United States. My background has roots in agriculture. My family has run a multi-generational cattle and sheep ranching operation in eastern Utah for about five generations. I grew up on a 500 cow calf beef cattle operation. And so that's a little bit my background with this topic. And delighted to be with you today. Well, I thank everybody for joining in. I'm Charlie Stoltano, the Assistant Director for Extension. I've been here for 24 years, but related to mental health, I graduated from NDSU during the 80s and watched my family have to go through the farm stress and all those related activities back in the 80s. So farm stress, mental health has been something that has been on my mind for a very long time. And then also as a veterinarian, veterinarians have the highest suicide rate within all the professions. And so it's something that I've seen and affects us. And so I just want to thank again everyone for your interest and attention because this is a really serious issue within air culture throughout the whole thing. Thank you, Dr. Charlie. Andrea? Hello, everyone. I'm Andrea Bowman. And I farm in ranch, mainly ranch, with my husband and three kids in extreme southwest North Dakota. Our address is Rame, highest elevated town in North Dakota. A little bit of trivia for you. And we raise registered Angus cattle and commercial Angus cattle. We also have a custom backgrounding feedlot and a custom AI business. I also have worked for NDSU Extension for over 10 years as an agriculture agent at the county level. And now I work in the area of leadership and civic engagement. So I'm glad to be here with everyone today and just share some of my experiences along the way. And I'm excited to learn from everyone else as well. Thank you. Becky? Hello, I am Becky Topbenham. And my husband and I and our three children farm barely over the river in Minnesota. My extended family farmed and I have a special interest in working with farming and ranching families and rural mental health and obviously living that life and having the job that I have. It puts me in, I think, a unique position to be able to work with people that are in a similar situation. Okay, thank you. And Phillip? Yeah, so I have a background in mental health and addiction counseling. I've primarily worked with people in rural populations, specifically rural Appalachia before moving to North Dakota. I'm currently a doctoral student at NDSU's developmental science program. And I work closely with Dr. Brotherson on issues regarding farm and ranch stress. Thank you. And Lila? Yes. My husband and I run about 350 beef cows, milk about 80 milk cows. And we also do some farming. Three out of our six children are here on the farm with us. And after working 19 years in alcohol and drug rehab facility, I just have a very strong interest in mental health and alcohol and drug rehabs. Thank you. Thank you all for joining this. As we kind of discuss, I will provide the individuals at least initially that we will ask a question to. And so this first one is for Becky. And then also Sean Brotherson can add with that one. And the first question that we're going to begin our discussion with her, what are some of the signs of struggle or difficulty to watch for during times of farm and ranch stress? So what are our indicators, Becky, that we should look for? I think some of the things that you can look for are what is different, right? So sleeping too much or not enough, eating too much or not eating, maybe some personality changes, not doing chores, right? Like the animal care going down or not tending to the work the way they had in the past, social isolation, not engaging, I guess is what I mean by that is those they had in the past, not finding, not getting joy out of what they used to anymore. And you just kind of sense that change. Those are all some indicators. Sometimes some other sorts of addictive behaviors can show up to sort of numb out sort of in the area of drugs and alcohol, gambling, pornography, those are some things that kind of work to sort of numb out or to check out from regular life, so to say, and would be some indicators. Okay, Sean. Becky, I've often used the analogy that signs of stress or mental health strain in a person's life are like the blinking light on the dashboard of your vehicle when it says you need to check your engine. And of course, anybody who works in agriculture is often reliant on equipment and for it to be functional. And the same is true of your health and stress levels. When your stress levels become too high, then you'll see these signs just like the blinking light on the dashboard of your vehicle that say, hey, the stress is too high, something might be wrong, you need to get this vehicle checked. And so when you see in yourself or in others any of these signs of stress, it's a really good time to slow down, schedule an appointment with a health professional, and just begin with a checkup. Some of those signs I like to think of that typically you see them in your physical health, your mental health, your emotional health and your relationship health. So the things that were mentioned by Becky, you'll see physically, you'll see exacerbation of existing physical health conditions if you already have some health challenges, you'll see things like headaches, neck and back strain, difficulty sleeping, digestive issues. So those are some physical health indicators. With your mental state, you'll have trouble concentrating, maybe inability to make decisions, you might feel paralyzed in your decision making, some things like that. Emotionally, you'll see things like a low mood, you will maybe have a sense of irritability, a sense of hopelessness or discouragement. Those are some things you'll notice in your emotional experience. And then in your relationships, you'll just find that you may, you or people around you, you may see isolation, people avoiding, having conversations or not engaging in regular activities that they normally would, not showing up at the coffee shop, things like that. So these are all indicators that you want to pay attention to that something has changed, something is happening, and you need to prioritize your health at that point. Thank you, Sean. I appreciate that. And I'm thankful there that yourself and Becky helped to provide some guidance of what happens when maybe things are just a little bit off in those indicators of stress and mental health that we need to keep in mind. Our next step then is actually going to be pointed towards Philip and Lila. And so we have those indicators. And Philip, I'm going to allow you to start off there of how do I help someone that is so stressed that they're struggling kind of with decisions and their farm stress. And so we've identified it as we realize that that's the first step. Philip, where can we kind of move on? And what have you envisioned? And I know that you have some experience as well, and that you can help to share with us. Yeah. So there are a few things you can do to help someone struggling with decision making due to stress. So the first thing is to encourage them not to make decisions when they're stressed out under pressure or emotional. I'm sure everybody can think to a time where they've made a decision that was a brush when they were emotional stressed out or under pressure. And it didn't turn out the way they envisioned stress can lead to tunnel vision. So it becomes difficult to see the broader consequences of your actions. So a very practical first step is to encourage them not to make decisions when they're in that kind of state. The age old advice of sleep on it is particularly helpful. So take some time before you make a big decision, be it a day or two, so that you can really think about the consequences. A second thing you can do is model decision making strategies. So this is far simpler than it sounds. You can do a pros and cons list where you list out the pros of the decision, the cons of the decision, how it impacts you and others. Another thing to remember is to avoid dichotomous thinking, which is thinking that you only have option A and option B when in reality there's usually an option C and an option D. And so when you're talking to someone who's very stressed out, helping them see the alternatives is something that you can do that will be very useful. And a third thing is to just talk about with someone, be encouraging and not get frustrated with the person who's already stressed out. So by being that objective voice, that rational voice, you can really help someone who's trying to make decisions when they're under that kind of pressure and that kind of stress. Thank you Lila. Philip hit most of the highlights on that, but we have to remember that stress affects your concentration. And so it also affects your ability to perceive new information. So it's very hard when you're under the stress to make these decisions radically. I mean, you make these decisions and they're made quickly when you're under stress. Whereas, if you wait until things are, you can talk things out a little bit, you have a better rationale on what's going on. Absolutely. And so I'm going to transition then maybe just a little bit more, Andrea, first off for you, relative to how do you have or have seen this application towards actual ranches or farms and ranches and farms and ranchers? And I'll allow you, Andrea, to have that lead and then I'll let Becky follow up. Thank you. Well, I think it's just as Lila said, you know, that stress can affect our concentration. And so when we think of the effect that stress has on our farms and ranches, it's big. And we have to remember that, you know, we're constant as producers, they're constantly looking at the resources we have available and how we can manage them. And one of the most important resources we have, if not the most important resources are on health. And so how we manage that is very important to the operations. And we're constantly looking at how things can be effective and efficient. And that means how people can be effective and efficient managers or employees, whatever your role is in the operation. I think producers have an extreme keen sense of knowing when something is wrong with an animal and things aren't right. Just like some of the symptoms they talked about early on of stress, producers can identify those in an animal, you know, from a great distance and very quickly in the automatically go into how can we fix it? How can we make it better? But sometimes we forget to look in the mirror and analyze our own symptoms. You know, we get caught up in monitoring symptoms of the animals we're taking care of. But sometimes maybe we forget to think about the humans that we're taking care of also in looking at what those symptoms are. Because we know that healthy, happy animals are more productive and more efficient in the same goals for ourselves. Sure. And just paying more attention to our own as individuals and realizing that just self-awareness is something that can be important. Becky, in terms of some of the interactions that you've had with some farmers and ranchers, how do you see that affecting first off our agricultural industry and more importantly our best resource of people? I think some different things. I think that people are becoming more aware of resources. I think there's some work that remains to be done on accepting those resources and accessing those resources. And very often we come in with a mindset of we can handle this or I should just be able to handle this. What's the matter with me that I can't handle this? And we fall into the comparing our insides, our inside feelings to other people's outsides. And they look like they're able to handle it. They look fine. What's the matter with me that I can't? And so some of it is not comparing our inside feelings to their outsides. And being open to accessing those services, as others have said, we are our greatest resource. And why wouldn't we take the time to prioritize ourselves? And I think I'm going to sound ancient when I say this, but I think we can really learn from some of the younger generations. I think there's some progress that's been made and they're being more open to talking about mental health and be more open to accessing resources. And I think this might be a time where we can maybe learn from our younger counterparts and how to be more accepting of some support services. Thank you. I'm going to continue this transition and point it back to Dr. Charlie Stoltenau. And Charlie, with some of the resources that are available, are there things that you think that we can highlight? And at least from a little bit of the background, as you said, of application of being there. And of course, in the 80s was a little bit more challenging. And of course, there's always differences and challenges within the agricultural world. I just wanted to give you the opportunity to kind of draw the connection of how farm and agriculture can be impacted on stress. And then if there's any particular resources that are available. And for those of you that are on live as well, Dr. Miranda Meehan put a link to some of the resources that we have on our website. Charlie? Well, thanks, Travis. And I'm not going to repeat the resources out there. I just want to say, you know, I'm a fifth generation. The abstract on my land goes all the way back to the Homestead Act of 1862. And so there is this whole sense of, you know, belonging or sense of responsibility. But I've done this actually unofficially. We had a bad drought about 10 years ago, and I was introduced. And I was very open with people. And so it's about raising awareness, but being genuine in the empathy. And I got in front of a group of ranchers. And I said, you know, everybody struggles. You may not look at me and understand that my life has been filled with dealing with things of depression and anxiety. Everybody has struggles. And I want to tell you I'm here. I'm here to listen because life is hard. And sometimes it gets really hard. And so Travis, as you talked about resources, but one of the biggest resources you mean me being open and being honest with people that, you know, we understand being empathetic, listening, non-judgmental. I'm not here to try and solve your problems, but I will listen to you and let you talk. And that's probably one of the biggest things, especially for men. Because as men, we're going to be the rugged individuals. We're going to internalize all this. And no one can see it because if it is, I might look weak. And that's not being weak. That's, it's tough and sharing with each other and understanding that these are the things going on in your life. The other thing I thought about was I'm named after my great, great grandfather who came straight from Germany. And I thought, what if I could talk to him? And I told him that I'm feeling really bad about all this. And I might lose the farm of things. And I'm pretty sure he would say, oh, Charlie, my child, it doesn't matter. This is just a thing. You are much more, you're much more valuable to me as a great, great grandchild than this place ever would mean to me. And so we throw a lot of things on ourselves that we suppose that our ancestors thought, and I don't think that's correct. I really think we need to put this in perspective because if I turned around and said, what would I want to say to my grandchild 140 years from now? And I'd say, don't worry about this. This is small. I really care about you. And so to start dealing with these mental health issues, we have to let people understand that we do care and we need to help them put it in perspective. And that starts with just listening. Thank you. Thank you, Dr. Charlie. Sean, I'm gonna allow you to kind of follow up on that one, just to, and I think we'll move on relative to some of the topics that we're going to discuss. But do you have anything that you would like to add there of just kind of how it relates to agriculture and some of the things that we can keep top of mind here as we just frame the discussion before we move on on how we can kind of make some of those improvements? I really like what Andrea had to say earlier about, you know, when you work with livestock, for example, that you really pay attention to the health of your animals. And I can't count the number of times that I've, you know, sat on the back of a horse and gone through a herd of cows and calves. And I learned this from when I was a kid and you're watching for signs of illness, is something wrong? Is their head down? Are they lame, things like that? And I learned if you have a cow or a calf in that situation, you know, pull your rope out, find a pan, isolate them and find out what's wrong and get them some support and some treatment, that's really important. And so Andrea mentioned, our health is really our most important resource when we're functioning in a farmer ranch operation. It allows us to function every day, but especially in times of stress, it allows us to be resilient. Stress actually takes a huge toll on physical and mental health. And there's a, there's a much higher incidence of stress-related physical and mental health illnesses for those who work in agriculture. And that's why it's important to pay attention to this issue and the quality of our health because it's the quality of our health that allows us to be resilient when those stresses occur. And related a little bit to what Charlie was talking about, when you work in agriculture, especially if you have a historical tie, like he's talked a little bit about Lila and Andrea talked a little bit about, hey, we've been on this operation for quite a long time, people develop a deep attachment to being in agriculture as a way of life. And so when you feel things are threatening your way of life, that can be very stressful. And that's why we kind of carry this stress with us sometimes. So much of our identity is often wrapped up in being, I'm a farmer, I'm a rancher. And as Charlie points out, that's part of who we are, but we're a lot more than that. We're sons and daughters, we're husbands and wives, we're grandparents, we're adult siblings, we're community members and leaders. There's a lot of things about who we are that are more than what's happening on our farmer ranch operation. And so being able to understand that who we are doesn't boil down to how successful we feel right now in our farmer ranch operation. But there's much more to it than that and that paying attention to our health and helping others around us have good health as they're working in agriculture needs to be a really important priority. Okay, thank you. Thank you very much on kind of describing that. We've got a couple questions that have came up into our question and answer section. And so I thank those, the individuals and for keeping us on base with that. And I think that way it allows our participants to help join us on getting out what they want from an infrastructure too. And I think that we can evaluate stress relative to just short term, but I'm going to punch this next question to Philip first off. And then if there's anyone, I'll then I'll open it up to anyone if they wish to ask or to provide any information. But I'm going to the first question and our question and answer portion is talk about chronic stress. And so, you know, that that at least is brought up there of, you know, it's not just the the one thing that was the challenge this week, or that, you know, maybe it's adding up just a little bit more. And so Philip, maybe you can kind of provide some guidance there and keep that discussion motoring. Yeah, chronic stress is a lot sneakier than the short term stress. You know, when there are short term stressors, they're usually, you know, very obvious and in your face. And you feel that heightened stress in the moment. But, you know, we're working with a with a farmer or ranch operation that stress may be more chronic where you have season after season, you're after your of difficulties, you know, in both your business, your personal life, and that can add up. And I think it's useful to think of it as other chronic diseases or issues like heart issues where if left untreated, even though it's kind of always in the background, it can lead to major issues down the road. So, you know, as mentioned in previous videos in this series on, you know, preparing for drought, you know, taking action early is key to avoiding major issues down the road. And so the same is true for managing stress, both in the short term and the long term. So knowing what your stress signals are, and having a plan for how to manage them is going to be important to avoid the serious consequences later on. Great. Now I'll open it up to the rest of our panelists in response to the question of kind of just of how it's all adding up in terms of just that problems and challenges and obstacles that we may see in agriculture. I was just going to speak to that a little bit. I think a lot of people, not just farmers and ranchers, but a lot of people have the belief that if you're a good person, you work hard, good things come to you. And so when that isn't happening, right, when weather conditions we can't control, market factors we can't control, government influences, all those things that are out of our control can cause you to perhaps cause your operation to be in jeopardy. And then it challenges that worldview that I'm a good person, so good things are going to happen. And I think stress and leading into depression is exceptionally challenging when a worldview has been challenged such as that, such as it isn't a matter of you haven't worked hard enough, it's outside of your control. And sometimes realizing that that it's outside of your control is part of what can help open the door to accessing services, because if you believe it's all your fault and you just haven't worked hard enough or you're not a good person or you're a failure or whatever, it kind of closes the door to being open to those services where when you can when you can relieve some of that responsibility from yourself and acknowledge there's a lot of influences working against farmers and ranchers a lot of the time, I think it sometimes can relieve a bit of that stress and pressure. Great, thank you. Anybody else wish to talk on that? Laila wants to go ahead. One thing that we have to keep in mind, farmers and ranchers are very independent and self-reliant, they're not going to ask for help, so and and they're, they feel that they've failed, so they don't want anybody to know that they're having problems. So the last thing they're going to do is actually ask for help. So you have to be very observant and know when, like with cattle, when there is a problem, you have to know that. It's a very good point in fact of keeping the privacy of and and and pride, truthfully, right? Laila is that, you know, from an agricultural standpoint you take pride in what you do, which is certainly is similar in several other occupations, but I know that the, as an agriculturalist, it's something that we enjoy and like you said there, of not wanting to say, well, I'm a failure today or what the potential cause kind of of that. We have another question in our Q&A portion and in fact we're getting a large reach. Oh, Sean, do you want to step in? Yeah, I just wanted to follow up on that point a little bit related to chronic stress. A couple of things are really important to remember and the foundation of this being that it's true that often one of the challenges for being able to access services that can be helpful to you if you're kind of in a rural context is that sense of stoicism or that sense of stigma. I can be self-reliant, I can take care of this myself, but just like you wouldn't expect, you know, your prize bull in the corral to get up and wander over to you and say, hey, I need your help. The difference is, as human beings, as we have self-awareness and we're able to recognize what we can do specifically for our health. And in terms of chronic stress, two important things to consider. One is healthy living practices of all the things that may cost in a farm or ranch operation. There's a lots of things that we spend money on, but one thing that you don't have to spend so much money, but you just invest time and effort is in your health. Regular exercise, for example, is really important. Getting a good night's sleep, having a healthy diet. So any healthy living practices that you can pursue to be able to improve your health, that's a high value effort that you can make in terms of being able to diminish the chronic stress you're going to experience when you're working in agriculture. The other one is having good social support. And so whether that is you're connected to your faith community, you are connected to your family in meaningful ways and give each other support, whether you talk with a counselor professionally, any of those you can reach out to. And we talk often about, well, sometimes being in farming and ranching, we're not so willing to volunteer that we might need some help. We're willing to help others if there's a problem, but we might not raise our hand and say, hey, I could use some support here, but cultivating that social support network and staying connected with others, those two things are very helpful to managing the chronic ups and downs of stress in agriculture. Thank you, Sean, very much. And in fact, I think that there's just one more that we're going to pull together and then shift some of the transitions here. But I think that as we talk about causes or leading impacts that we can potentially that can change our life, if that's the case, I'm going to grab in this question is that we actually have a participant that's joining us from California. And the question becomes of, what about media? You know, and maybe this is larger than media, maybe it's societal as well. And like we said, from an agriculture standpoint, we take pride, but commonly we get told that it's the cows that cause greenhouse gases or, of course, Colorado's making the news for not having meat or meatless Mondays that had taken those trends. And so I guess even as it describes of the climate change and how that might affect it, or just the media of saying, hey, you know, agriculture, maybe it's we don't respect you as much as maybe we certainly feel as though we should for feeding our families and feeding the world and I'll open that up to to any of our panelists on, you know, what is what can be done or what do you see relative to societal pressures that are past paying the bills? Well, Travis, one thing, even though we use it a continuous diet of social media is not healthy. And part of this is what we do in extension, you know, if you boil extension down to its bare essence, there are two things that we really do. And one of those are critical thinking skills. And then the two is second is leadership. And so when when we think about these things, we can worry about almost anything. What we really need to do is step back and where we help each other is, you know, critically think about what's really going on. And what is the, you know, we deal in science, we deal in science based evidence. And so I saw that on the screen, it's a little difficult for us to see all the questions and things. But but the point is, you really have to start developing your own sense of what makes sense? What are what are the critical issues? And what are the things a speaker panels before talked about? You there's so many things beyond our control. What can we control in our lives? What do we take responsibility for? And those are actually very few. And the rest we have to we have to learn to let it go, because we have to think about what can I affect? How can I do it? And I'm going to do my best. And that's the most anybody can ask of us. And and social media starts putting on so many unrealistic expectations on anybody who views you have to have the right clothing, you have to have the right body image, you have to have the right house, you have to have the right political persuasion and the list goes on. And really, it's it's stepping back and saying, you know, what what does really matter to me? And then what are the things that I can control? And what can I adapt to? And the rest of it, we have to learn to let go. Thank you. Anybody else want to add on that one? Travis, I would just note that I'm a friend from New Zealand who we met through the topic of learning about farm stress and being resilient. And it was interesting to visit with him. He was up here and toured quite a bit of the United States looking at conditions in agriculture all across the United States from the Eastern Seaboard to California, where I think this question comes from. And as we visited about it, he was in the dairy industry in New Zealand. And he he mentioned a very similar point that as dairy producers down in New Zealand, they felt a lot of quote, external or societal pressure to kind of make adaptations to how how eco friendly they are in agriculture and some of the things like that. And and just recognizing that agriculture is a constantly changing industry. And one of the things I love about agriculture is the innovation that you see in agriculture. People seeing these different challenges that come up and then finding ways to adapt and successfully work together to meet those challenges. And we do live in a changing world. And sometimes the mindsets of society are maybe feel more friendly to agriculture and typical operations. And sometimes they challenge us. I look at the work of groups like the North Dakota Beef Commission that that Lila is involved with, where you have groups of folks who come together in agriculture, and they look at these particular challenges. And they say, how can we work together to craft messages and help educate the public about what we do, about many of our practices that are that maybe are misunderstood. And and as you work together with people, that can really help in terms of lowering the stress and make you feel like you're making progress when they're those external factors that at first seem beyond your control. And so one of the really empowering things for individuals working in agriculture is to feel connected to others who understand what they are experiencing, and then working together with them on solutions. And so as I see folks who are connected like to some of the farm advocacy groups, whether that be Farm Bureau, Farmers Union, or particular agricultural commodity groups, things like that, that can be very helpful because you're talking to people who understand and see some of the similar things that you do, but they can work together with you and finding solutions. When we're under stress, sometimes we tend to withdraw, but actually the opposite approach is most useful. Find people that you can connect with who understand what you're experiencing or what maybe the specific stress concern is, and then how can you collaborate to find solutions? That's really helpful in being able to feel like you're not at the mercy of things that are beyond your control. Thank you, Sean. And I think that we've broadened the discussion here and have a 40-minute introduction. And so let's dig into making some more solutions, or at least evaluating that we've identified a challenge. And again, we saw that. And first off, and we touched on the self-care there and the health and wellness, and we'll come back to that as we get to our solutions. But what I'd like to move forward with, in fact, is with first Becky and then also with Philip, and we can discuss. But one of the things is that we have access to the mental health counseling. And so we have that ability. And even if it's me, or if it's my family, or if it's my friend, realizing that there's somebody now that we feel is seeing challenges in their life. And we've said, okay, from a pride and an agricultural approach, this isn't something that certainly, I believe, as Lila said, doesn't come first of mine of saying, I could use some help. And I could use some discussion. And so, Becky, I'm going to allow you to discuss of, how has that been a positive thing for people that you've been involved with? How can people take that step and say, I'm not okay today? Right. Well, and I think I get a little feisty with that. We're just not going to access those services because that's what's contributed to that 57% increase in our suicide rate in our site. And so it's time to not just accept that as a truth, as that this is the way it's going to be. It's time to challenge that. And I think we're in a great position to do so. We have a variety of people across the state ready and willing to mobilize to support our farmers and ranchers in rural mental health. That's a significant portion of who I see in my practice. I do, I call it farm to farm therapy, I'm at my farm, and I see people on their farm. I adjust my hours to meet them. We do it via telemedicine so they don't have to leave the farm. There's no getting cleaned up to go to town, right? You can just, you come as you are. And so I think there are so many things that are reducing that barrier. And one of the things that I see is the greatest hindrance right now is our mindset. And so I really challenge all of us to think differently as we just don't, farmers and ranchers just don't, we just don't access help. Really, how's that working for us? We're at a 57% increase, how's it going? Not very well. And so we need to challenge ourselves and those around us and be willing to have those difficult conversations to say, you know what, this isn't working. We need to do things differently. And if we can't do it for ourselves, what about for our children and our grandchildren who are learning coping skills from us or lack thereof? Because that next statistic, when it comes out, that's who it's going to be, is our children and grandchildren. And it's not okay with me to have a 57% jump in suicide rate when it comes to my children and grandchildren. And so I'm willing to do something different, if not for myself, for sure for them. Thank you, Becky, for changing the dialogue here and giving us a charge to move forward. No doubt of saying that. And Phillip, next. Yeah, I'd say it's important to be comfortable having discussions about mental health and behavioral health for you as an individual and being prepared to have those discussions with friends and family. So people will often kind of make bids for help, you know, in subtle ways, you know, they'll kind of drop that they're having a difficult time with something or that they're just not feeling well. And, you know, they usually talk about their physical health. But most people can, you know, kind of intuitively know that there's more going on there. And so being aware of those bids for help and responding to them appropriately is something that people in the community can do. I think a big thing is those not to-dos, you know, so don't change the topic when you have this bid for help. Be able to say comfortably and discuss with that person what the problem is. And I think a very helpful strategy is to be direct, ask, you know, are you having issues, you know, is there something that can help you with, you know, how's your mental and behavioral health? Asking those specific questions. And, you know, in my past experience, asking those questions and being direct with, you know, both clients and friends, you get very little kickback from that. People are often relieved to be asked the question that's on their mind, you know, how can I help you or what's going on or tell me more about it? So I think the biggest tip or biggest piece of advice there is to not be afraid to ask those questions. Be comfortable with it. Well, super. Thank you, Phillip. And being the moderator today, I get to ask the questions. And so you grabbed the behavioral health and the mental health and said, okay, let's talk about the discussions from that. Now, I'm going to even take that one off your shoulders, because I'm going to point that one to Lila and say, please help me to learn a little bit of the differences of behavioral health and mental health and kind of how we can be able to kind of pull that together. Lila, would you like to take that discussion and that Phillip set up for us? Behavioral health is more the lifestyle factors that impact the overall physical and wellness, mental wellness. Whereas mental health is more the psychological and emotional, the social well being, anorexia for one would be one of the more dangerous mental health disorders. Behavioral orders or disorders would be alcohol, drugs, just mood swings in general would be with the behavioral disorders. Okay, and I think that we should discuss that if our panel is interested relative to just behavioral changes. And that can be, again, as we talked about things that we can try to improve, but let's before we go to things that we can try to improve, let's talk just a little bit about falling down the hill, if that's what I was to describe, relative to substance abuse or things that changes into our life that we can realize, well, now even things have not only been impactful on my mental health, but changing the behavioral. And I'm going to open that up to each of you and you can choose who feel and wants to talk about kind of how do we get past some of that substance abuse or changes on our behavioral health. Travis, I'll start and just more in the behavior. I actually don't feel qualified on a substance abuse and those things, but I will tell you that in my personal life, when you hit a wall or you have a very stressful and you need to change, right? You make the decision, man, I gotta change some things. My advice is start small. Oftentimes people want to change their whole entire life and it goes along for a little while and then all of a sudden, as you said, down the hill it all caves in. And so a simple thing that I did was every morning when I get up, first thing is swinging my legs out of bed, turn the light on because I might hit something. But the first thing I do is I say a prayer of gratitude out loud. And that's it. I said, I can do this. I can change this part of my behavior. And even if it's just for 30 seconds or a minute, but starting out with gratitude, and for me, this is my personal, but yet that has had a profound effect on the rest of my journey of behavioral change. And what I do is I got this, this part becomes part of my routine. This is a very positive thing. What's the next thing? What's the next thing? And so we all, especially Americans, we all want instant change. We want it now and we want it permanent. And it was, it probably took us a while to get into the place where we are, where we're not really need help. It's going to take us a while to get out. And we have to understand it and we have to let those that are hurting or we see is you start, you know, we're going to start small because everybody needs a victory. And we're going to build on those victories. And so I just want to share on the behavioral side is, is a person moves through this and it's a whole lot easier if you got somebody that will walk along with you and neck and those people can come from almost anywhere. We just have to be willing to be those people or willing to allow those people to come into our lives because they're there. Are we going to be one of them? Okay, super. So I'll open that up to anybody else, just kind of as we discuss just in generalities there of behavioral health, substance abuse, addictions as we, as I said, move of rolling down the hill of whatever that may be. But does anybody else have any things that that can be added on our discussion and dialogue? Philip? Yeah. So, you know, when having conversations about stress and mental health, substance abuse and addiction comes up pretty frequently, as if those two, you know, are really, you know, strongly related. And it's because it's a very common way of coping with stressors. It's not a healthy way of coping with stressors. But it's one way that people do it. And so, you know, when we talk about substance use, you know, a bunch of different terms get thrown out, substance use, substance abuse, addiction, and it can be kind of difficult to distinguish between those. But in general, you know, substance use is, you know, the use of a prescribed substance under the direction of a physician or a pharmacist. And there's not necessarily anything wrong with that. We take medications for all kinds of health conditions. And there are many available for mental and behavioral conditions as well. But under times of stress, especially extreme stress, you can begin to abuse those substances. So taking more of a prescribed substance than necessary, mixing it with other substances. And that can be kind of a recipe for disaster down the road. And I see that as one of those warning signals, like Sean mentioned, that comes on on the dashboard of a car. You know, you have this warning signal, like the check engine light, and abusing substances or using them more than you typically do, is one of those things that needs to be checked out and looked at early on to avoid, you know, a serious problem down the road. So just to clarify, there are those terms and what we mean by them. You know, an addiction is something, you know, entirely separate from or something entirely other, you know, this here is a chronic disease and a problem that requires professional help. But it can be scary for some people to talk about substance use and substance abuse, because they lump it in with the term addiction. And many people still consider that, you know, a moral problem or a self control or willpower problem. And that's simply not true. You know, these are medical issues that need professional help. Hey, thank you. Does anybody else have anything to particularly add on dependence, chemical dependence problems that may or may not arise? I guess this is not so specific to chemical dependence, but anytime that you're dealing with high levels of stress, one of the things that you might want to do is, and it is useful, is to kind of do an inventory. And there's actually, if you see your healthcare provider, I mean, that's doing an inventory of your health. They'll take you through your physical health and they'll ask you questions about how are you sleeping? What kind of symptoms do you have? There's brief screening inventories called depression screenings that you can take, just a few questions that help get a sense of where you are. But one of the things you can do is just ask yourself, as you think about the stresses in your life, what changes has this cost or what changes am I experiencing in my life, perhaps as a result of this stress? Are there any changes in my physical well-being? Am I having sleep difficulties? Or am I eating differently? Are there any changes with the way I'm thinking about things? Like, am I having thoughts of harming myself? That's not normal for me. Or am I finding it really hard to get out of the bed, get out of bed and be motivated to attack the day? That's not normal for me. Do you feel changes in terms of your relationships? How am I relating to a spouse or a child? Am I being more irritable with them or getting in more arguments or just avoiding activities with them, whereas normally I wouldn't do that? And all of those are, and stress often causes us to change. And we try to cope. And as Philip just pointed out, issues of chemical dependence often arise simply because we're trying to cope in ways that are unhealthy strategies for coping. And self-care is all about finding healthy strategies for coping. And health care are the little things that you can do going back exactly to what Charlie mentioned. And he mentioned a couple of things, right? And actually research shows that it's those simple steps with health care that are actually the most impactful and make the biggest difference. And it's actually doing these small positive things that are really impactful for our health. So exactly what he talked about, even taking a few minutes every day to cultivate a sense of gratitude. And he mentioned for him the practice of prayer is helpful for that. For other people, it might be something else to count their blessings in the midst of feeling stressed out. But these type of small practices, self-care practices can be really important, whether it's mindfulness, whether it's daily exercise, whether it's having top time every day with a friend or a family member. Those sorts of things are really important to find these positive self-care strategies to be able to cope with our stress rather than unhealthy strategies. And unhealthy strategies, you can kind of unintentionally fall into like, okay, do I have a prescription medication or an over-the-counter medication? And I'm taking it much more often than I used to. Or am I starting to misuse a substance like alcohol or something else because I am not finding another effective way to cope. So those are really important things to think about, what are those changes I'm experiencing? And then what are some more healthy strategies that I can pursue? And I would add one thing, having someone to hold you accountable to pursue those healthy strategies is really important. And that's why you see a health care provider or a counselor, because they can help you with that process of being accountable for pursuing healthy strategies in your coping. Thank you, Sean. And in relation to North Dakota State University of, again, finding some of that work-life balance in an in an agricultural setting, you know, the sun comes up early, hopefully earlier now, you know, as we move through the summer and goes down later. And so I know that even, again, growing up in the agricultural world that you feel is so that, and we say this, again, maybe with some pride of, hey, the sun's up, we got work to do. But when you do that, it's sometimes common to not be able to disconnect. And, you know, and that's where at least your guys' descriptions of the self-care and, you know, providing yourself a healthy lifestyle, and in fact, you know, and in a place that you can kind of call your own, that you do enjoy, and that's about you, and that's about the betterment of your world. Andrea, I'm going to open it up to you there, and you can describe kind of some of the things that you've seen that have worked for you or worked for others, and in fact, allowing us to stay on, you know, sleep schedules that don't put us backwards, and then while we are up and working in our world, what can we do to just kind of disconnect or to make sure that we're looking at our own behaviors? Thank you. So when Sean asked me to be part of this call, it was a little reluctant at first. And then yesterday, I was thought, I need to prepare for this, I need to think about this. So I enjoy the sunshine. It was a nice sunny day yesterday. So I took my notes and went out to the deck to sit in the sunshine and just kind of reflect. And in the meantime, my husband came home from a parts run and said, you know, I got a bunch of wheel bearings, we're working on a piece of equipment. And he said, well, you know, the question we always ask in air culture, how much did that cost? How much do we have into this piece of equipment? He said, well, I learned my lesson with the last thing we fixed. He said, it's more important to, it's better to change the wheel bearing before it goes out, because if you wait till it goes out, then it breaks a lot more things. And it was kind of a light bulb moment for me, because it's preventative maintenance. And that's the same thing that that we're talking about here when we're talking about a management stress and positive healthy habits and behaviors. You know, it's really about preventing some of those negative behaviors. And there's a lot of ways you can do that. And sleep is important. Just breathing, I think is important. Sometimes it just to take a deep breath. Some of you have maybe seen the animated movie Ferdinand. And there's a calming goat in Ferdinand. And he takes these obnoxious large calming breaths. But I've actually bought a calming goat, a little stuffed goat for one of my friends, like when we were going through a difficult situation. And we look at that calming goat and kind of laugh now. But that's kind of our reminder that sometimes we just need to take a deep breath and reflect on what's important to us and work on those habits. And like Dr. Charlie said, start small with just one thing. I write in a gratitude journal every day. That's my reminder. I actually have a certain amount of lines I have to fill in. Every morning. And for me, I get up early in the morning before everybody else does to do that. And a few years ago when I would have heard someone say, I get up really early to do this before the day starts, I thought they were crazy. And so it took me a while to implement that habit into my life. I think just little things I'm reflecting on on what it makes us happy. And for me, it's walks, it's being outside, drinking lots of water are all different things that I've tried to implement into my life. And like Becky said, I have three kids and we are modeling the way to them for how we handle this. And I heard a lot from professionals when we were going through COVID last spring and everybody was at home. How do you want them to remember this time? And I think about that to every day, like how do I want to look back and reflect on this day? And hopefully, we have more positives than negatives. And you mentioned sleep too, and how that's important. And I think in my extension work, I've been working with remote workers and helping people build their skills to work remotely. Well, in agriculture, we've been working remotely the whole time. And one of the things we do encourage in remote work is having people have signals to shut down for the day, like when your day is really over. And for some people, it's closing the computer, turning the screen off. That's kind of the end of my work day is when I close that computer, I shift to another focus. My husband, it's kind of the opposite. He spends most of his day outside doing farm ranch things all day long. So when he comes in, his downtime is turning the screen on. And that's when he reads the news. And so it's not the same for everybody. And I think it's important to note that and that that's okay. But just to have some habits and some signals to ourselves that that we're shifting to to another time. And maybe that is sleep. Thank you. Thank you, Andrea. And in fact, I'm well aware, at least now, as we potentially make it through a pandemic, but I know where my happy place is. And in fact, my happy place is in my kitchen, because I know that I get to cook for my lovely wife as well and provide evening meals, hopefully. But that's what one of the things that allows me. And I like where this discussion is going. And so I'm going to open it up to to the rest of the individuals. But I'd like to maybe grab Lila's opinions there on and we're talking about the positives of, you know, how do we dig out of this? What are we doing? What can we do right? And Lila, go ahead. Okay, one of the things if you're depressed, a lot of times you want to sleep. You know, if you're not depressed, it can lead to depression if you can't sleep. And some of the things as far as sleeping, the one thing they many people do is take their phone to bed. That definitely does not help the sleep habits. You know, that should stay out in the other room when you go to bed that that's the end of the phone for the day. And many people will have a drink of alcohol or or take a pill to help them sleep. That would all be fine and dandy except for the fact that especially alcohol really messes up your sleep quality. I mean, it might make you or help you fall asleep, but it messes your your quality of sleep up. So you wake up the next morning and you're probably more tired than when you went to bed. So those are just some of the things that one has to keep keep an eye on basically. Does anybody else have anything to add of saying, Hey, what are those? What are those good things that we can focus on to kind of kind of dig out? So Travis, I just like to make comments so early in my career, just out of professional school in debt, started a new practice and realized, Oh my gosh, what have I done? And one of the things was it got really depressed. And, you know, you look at me and I say, you know, I burst out crying in the middle of the day because I was so stressed out and so depressed. And so I went to see a counselor in Des Moines and gave me some really, really good advice. And they said, you know, it's okay to be sad. It's even okay to be depressed. Everybody goes through that. But here was the key. He said, but you control the depression. If you want to be depressed for three hours, then be depressed. But then it that's enough. And now we go back to doing our routine and get back into the routine of things. And I'm not saying that will help anyone else, but see a counselor and gave me all I had to do is go once. And that is like the little switch in my brain flipped. And now I was still sad, but I control the sadness and rather than it controlling me. And that allowed me to make other changes in my life that I could change the path of where it went. But it's those little things, but get an outside perspective. And that's some of the best advice I've ever gotten is because everyone gets sad. Everyone does. And it's okay to even get depressed. It is. It's okay. It's part of our defense mechanism. But we can't let it control us. We control it. And so when you give people the idea that they can actually control something or what's going on, it's a really freeing moment that there is something I can do. And Travis, I would follow up with that on the topic of depression. I think it's important to recognize that depression is not an unusual development or condition that happens in response to stress. And, you know, my dad was a big guy. He was 6'2 and he looked like the Marlboro man. Seriously. And mustache, cowboy boots. And I mean, he looked like he just walked out of the pasture every day. And I remember it was mid-1980s and I was in high school when I had my first experience with major depression. And I didn't know what was going on. And I started talking to my parents. And I remember sitting down with my dad and him saying to me, hey, it's okay to experience depression. I've done it. And here I am looking at this big cowboy and I'm thinking, dad, you've gone through depression. He said, yeah, I've done counseling for it. I've gotten help for it. It's not a sign that you're weak. It's not a sign that something that you've made some kind of mistake. It's just a health thing just like any other health condition. And that's when I started my own journey of trying to understand depression. It's kind of endemic in my family. Both my parents experienced it. Five out of six siblings in my family have experienced it. And I started to understand depression is a health condition, just like diabetes is a health condition. And it's very subject to treatment and management. You may have to do certain things, but you can do certain things like Charlie was mentioning that are very helpful, but you have to get educated about it. But strategies like exercise, talk therapy with a counselor, good medication, and a variety of other positive practices can really help you when depression is something that you're experiencing. And you want to find strategies to help with depression because depression takes a toll on your physical health. It takes a toll on your mental well-being and has potentially very harmful effects. To the point of what Becky mentioned earlier that we see, I mean, there's research over the past 20 years in North Dakota that we had a 58% increase in the suicide rate that is directly tied to the experience of depression because suicidality is very often a manifestation of people who are in extreme state of depression. And so it's very important to recognize it as a health condition, something that is caused by stress. But also to recognize it doesn't mean that it can't be treated. It doesn't mean that you can't be helped. It doesn't mean that you're weak. It means that you have a physical health condition, just like any other type of health issue. And you need to see a professional and get assistance for that. And it's very treatable. And millions of people have experienced it. The National Institutes of Mental Health has this great little video series you can access online. It's called Real Man, Real Depression. And there's firefighters and lumberjacks and ranchers on there talking about their experience with depression. It's not something to be ashamed of. It's something to just acknowledge and then get help for. Thank you, Sean. And I appreciate the dialogue that we've had. And in fact, I know that I'm surrounded by talented people. And we're going to kind of, again, transition that just a little bit. Because even as we were discussing about depression, is that it almost felt first person. There, as you were describing it, I'm saying, hey, it's mine of, hey, this is why I'm not feeling well. But one of the things that I think that we also needed keeping in consideration in today's webinar is that we can, as you said, be mentors and friends to come along with it. And so let's just shift the transition of where that challenge is. And let's say we're the leader now. And we went through it if it was a depression for us. And so what if we're the leader? And we've identified a neighbor or a friend that has some of those stresses or depressions. And in fact, this follows with one of the questions that was in our chat boxes. If you notice someone exhibiting a lot of stress and perhaps depression that's impacting them, what steps can you do? And in fact, kind of just how can you provide empathy to start that discussion? How do you provide the support to know that they're struggling? And I'm going to start it off with Phillip. And then we can move and talk about that of saying, okay, so now we've discussed it of, hey, now we're the leader, what can we help to help our colleague or mentors? Phillip? Yeah, I think there are a couple of key things. One of them is to be aware of the resources in your community. So resources available in the particular town you work, whether they're counseling agencies, it could be in the form of a doctor's office. Many of the doctors who work in rural areas are trained in managing behavioral mental health issues or at least they know the correct referrals. So if you're not confident in your ability to provide advice on their specific issue, being aware of people in your community who can address those issues is going to be important. A second thing to really keep in mind though too is how you approach someone who you suspect or who you know is struggling with issues and the word empathy comes up. And empathy is kind of one of those ambiguous words. People might get confused with empathy. Is it sympathy? What is it? And really it's just being present with that person, listening to what they have to say. And again, this is where I like to bring up the things not to do. But which I see very often in day-to-day life is it's tempting to change the topic when something uncomfortable comes up. So that's the first what not to do. So don't change the topic. The second thing is don't compare your problems to their problems because then it just becomes a volleyball match of who has it worse and that doesn't necessarily help always either. Or a third thing is trying to find a silver lining. And usually those remarks start out with well at least it isn't this or it isn't that. Or you have so many other things going on. Why are you worried about this one? So knowing your resources in your community and just being a good listener and an ear for them to talk to or to affect the strategies. Thank you, Phillip. Becky, in this discussion, what comes to mind for you? Again, as we've shaped this discussion today, now we've promoted you to mentor because now you're serving in that responsibility of saying, how can my colleague get better? Right. I think there's a great gift in meeting someone where they're at and helping someone feel heard. And so if someone would come to me and say, I just I have just so stressed and be like, yeah, I can tell what's going on and just meeting them where they're at. And like everyone has already said, not problem solving and all of those things and just holding space for them to feel what they're feeling. But then how do we transition past that? Right. So staying engaged, staying engaged, staying engaged. And sometimes at least I'll speak from the cultural group I'm a part of talking can sometimes be hard when we're talking about feelings or emotions or things like that. So if if a phone call or face to face feels like too much following up with the text message, there's a lot of things I don't like texting for. But sometimes that can feel like a non threatening way to follow up offering to go with someone to either drive together to their primary care doctor or if there's a therapist that you're connecting them with providing them information being with them when they make the phone call and just staying engaged and staying supportive. And you know, for a lot of the rural people, if you're going to meet with someone in person, take that drive with them, find something else to do while they have their appointment, but you're there with them providing that support. And it just helps people feel less alone. And it increases follow through because they know that you're there with them. And haven't we all been in a position where we're doing something scary, but someone's with us. And it's like, oh, I was so glad you were with me. That would that would have really been awful to do on my own. So it's just staying engaged, helping them access services, providing resources and following up, following up, following up, not being a pest, right? Like we're not bullying people into this. It's just that support of regard. Thank you very much. Andrea, your input. Yeah, I think this is something that I struggled with the most as an extension agent, and it wasn't prepared for is the people coming into my office and just sitting down in and just opening up about a lot of things. And so it took me a little while to learn to just sit and listen, and that that's what they were there for that time was just they wanted someone to listen to them. Sometimes it was a phone call. Sometimes it was sitting down in the office. And at that time, they weren't there for me to answer a question. They weren't there for the information I could give them. Just typically what I felt my role was in the extension office. It's just there to listen to them and they still still deal with that. Now I have shifted my responsibilities a little bit more to working with organizations, but still it's just listening to people. They just want to be heard. And so just like Becky said, that active listening, I always say, you know, you have two years and one month. Sometimes it's hard for me to remember that because I like to talk a lot, but just that that being there to listen to people. And absolutely go ahead. Yeah, if I could add to that, the listening part is important. The follow up is important. But also when working with men, there are some slight differences too. So a lot of times guys want you to do something with them, you know, not just listen to them. So for someone who's not a great communicator or doesn't have the words to express themselves, doing something with them, going fishing, going for a walk, watching a game, doing something active and spending time together is often, you know, as effective as the talking that many other people prefer. So just to keep in mind when you're working with someone or helping someone who, you know, isn't that great of a communicator. Thank you, Phillip and Lila. I think again, where this is a as exciting a question is that we've had is again, now you get the opportunity to be the mentor and kind of provide some guidance. So what comes first of mind for you on being that active listener? And I think that's great as Andrea discussed it. And in fact, to me, it becomes so intentional, if that's the right word there of that, you really, really have to want to be a part of the discussion and make sure that you're present in those discussions as well of being there and being helpful for them and not just putting it as a to-do list. But go ahead, Lila, in terms of your guidance kind of of help and build somebody up. I think the one thing that we all have or all enjoy is going for a walk. And so you go for a walk with someone and just let them talk. You listen. That makes a world of difference. If I could just jump in for a second. I just, I think sometimes people literally struggle like with literally what words to use with someone, like literally what words do we use to start a conversation or to approach the topic. And I think everyone had great ideas of finding an activity to do because that then the conversation feels a bit more natural. I've had a lot of success with I wonder if statements, you know, I see what you're going through. I wonder if you're having a tough time. I wonder how you're feeling about that. I wonder if you're having thoughts of hurting yourself. I wonder if and it seems to soften it a little bit and and I don't ever want people to feel discouraged if they broach that topic, right? And it's not well received. That doesn't mean that was unsuccessful. You've planted that seed and then you can come back to it because now they know you're a safe person to talk about it with. And I think one of the things that is different about talking to a therapist versus a neighbor or a friend, which are all good. This is not a criticism, but therapists and counselors are trained to hear the hard stuff. And they do have hopefully the words, right, to be able to handle that. And so it's a beautiful thing when there's extension agents and friends and families and pastors and priests and all those people for people to reach out to and they're all important. It's part of our community. But there's also times where a therapist or a counselor is is an appropriate fit to add in to all those other support people that are involved with a person's life. And people I've had say, I don't know what I'm going to say to you. It's okay. I do. I do know. I do know what what where we're going to go with this. I do know how to get you to talk and people will leave and you can just see the way to the world just drops off of their shoulders just literally dropped. They're like, Oh, I feel so much better. Beautiful. And so using I wonder if statements but also knowing when it's appropriate to refer to someone else. Super. And I just want to follow up with you with you on that one, Becky, in terms of the referral of, you know, how do I do that? You know, I'm now I'm transitioning back. I'm just the friend that's helping to make that happen. And I know that you discussed that, you know, that's an option that we do have. But, you know, whether it becomes a initially a depression or a substance abuse problem or or even if it becomes that there's there's potential in terms of a suicidal thoughts that we need to discuss. What what is the correct steps? I mean, and what are those places that we found that can be that resource? Sure. So there's some individuality in what the next step is, right? And so depending on where a person's at, it's engaging the support people already in their world, right? So I would start there. I always like to get people in with their primary care physician. As Sean spoke about earlier, there can be a lot of physical health conditions that can contribute to depression and anxiety. I talk about people what they're consuming. So a lot of times when we're anxious, we're drinking a lot of caffeine, which actually increases our anxiety and can make that worse can make us have a rapid heart rate. And so talking about some of those things and so start where the person is at in the community that they're in. And then knowing though that there are therapists such as myself that I can meet with anyone across the state of North Dakota or Minnesota for that matter. And so it isn't the barriers to service that we used to have in place aren't there the way they used to be some limitations with internet access and things like that. But I mean, my mom is 75 and has a smartphone and knows how to FaceTime. And that's essentially what therapy is over what we call telemedicine or telehealth. And I think that realizing that the previous barriers to service that we have really aren't there anymore. And what did this pandemic teach us? How many of us have zoomed more than we've ever zoomed prior to a pandemic, right? Like so many things were done over Zoom. And so I really think in some ways it normalized that as an access point for service, whether it being for mental health care or even I've had primary care visits over Zoom. And so meeting the person where they're at but also realizing that they're not stuck to their physical location as far as who is they have available to them for service providers and then walking with them to access those services. So providing the information, offering to call with them offering to go with them. You don't have to sit in the office if that feels too intrusive, but just being with them joining with them in that journey. Thank you very much. And I'm going to pass it next back to we kindly appreciated those thoughts and that input to Dr. Charlie. So Dr. Charlie, relative to there was a question of kind of why veterinary medicine is one of the challenges on that we have to face suicidal rates at a larger level, but from an agricultural approach as well. Is there some thoughts of how we can continue and I know that you get the opportunity and have had for your career of working with a tremendous number and breadth of farmers and ranchers and agriculturalists in general. How do we pull people out of that hole? How do you pull them out of that hole? That's a good way and you know it's kind of descriptive you talk about in the hole because that's certainly what feels like you're in the hole alone. One of the notes I've put to myself here is we have to do what we say we're going to do. And I'm going to tell a story of in my late 20s I was living in Detroit and I had a really close friend that was in living in Los Angeles and that's a four times, three time zones apart and I remember that they had a really, really tough time. I mean really and they called me at 11 o'clock their time so that's two in the morning my time in Detroit and he is depressed and we get to the discussion I'm going to do is how I got there but I said are you thinking of hurting yourself and he goes yeah I am I said I'll be there in a couple hours he says what do you mean I said I'm getting up I'm going to drive to the airport I'm going to come and get you and he says stop I said what he says you would do that for me I said well absolutely he says that's all I needed to hear and so how we pull people out you know if they're in the hole or the pit or whatever one of the big things for them is actually to realize someone will come and get them and so when we hear these conversations I really appreciate Andrea because I'm amazed in my office how many people come just to visit with me or call on the phone or do a Zoom because they just want to talk and I am humbled that they would actually consider me worthy to listen to them but that's what we need to do so if you really you really want to have an impact in this area in people's lives they have to know that it's not just words that you're willing to do what it takes to help them or to get them where they need to go and that's one of the biggest things right there that they know someone cares that's the really big thing how do we let them know that we care because then that's the start of the process of helping them get out of whatever they got themselves into it most likely and they're going to have to they're the ones that have to do the work to pull themselves out and these are all positive and we talked about other things you know techniques medications all those things but really it's still not that individual but what they want to know is they're not alone it's it's I'm not alone doing this and so when I talk to ranchers and and farmers out there someone comes to me and says you know this or whatever I have to make that commitment I will get them referred I will walk with them I will do what it takes because they're they're precious in my sight and I would hate to have it that I didn't do my best and so I'm not trying to put pressure on the individuals here the panels or whatever but you know we when we think about this this is this is like somebody having a heart attack out there are you going to do CPR you know this is this is how serious this is are we going to do it and and I think everyone on this call would but it's you have to have that what am I going to do because if I open this door it would be worse that I got halfway through the door and said oh no I'm out of here if you're going to open the door you have to be willing to to walk through that door and do what you need to do because you make a difference. Travis can I follow up on that? Please. This will relate to what Charlie said as well as something that Becky mentioned a couple of minutes ago but not long ago Mary Keena who's on this call had asked me to do a little training and I said well you know what the group what is the group that you'd like me to visit with for about 15 or 20 minutes and she said well it's the manure haulers group that I work with and and I said well what do you want me to address and she said just when they encounter someone who may be struggling what can their role be and I thought it was really important to help them understand they didn't need to worry about being a mental health specialist that's not their job and that's um Phillips job or Becky Cobb Dunham's job they have that specific training but what they could do is they can be the bridge to that resource that's going to help them with their specific stress related or health related concern and so one of the things that any of us can do is we can be that bridge and that's where being informed about useful resources that are helpful in terms of managing stress or improving health um that awareness and being educated about those things and being willing to share those be that bridge is I think a really important role that you can play and when you have that listening ear and that empathy for someone then they may be saying okay I've had a chance to kind of express how I'm feeling now what's the next step you can say hey let me connect you let me help be that bridge and as Becky mentioned it's kind of individualized everybody's circumstances a little bit different the severity of the depression they may be dealing with or the particular concerns that are affecting them for one person that may be hey I'm having trouble communicating in my marriage but for another person that may be I'm having some real challenging sleep difficulties well there's different solutions and different resources that you're going to connect someone to based on those particular concerns in the state of North Dakota if someone is having a challenge connecting with resources or particularly if there's more of a crisis situation where there are thoughts of self-harm or suicide then you're going to want to connect them with the crisis line in the state of North Dakota and the group called first link handles crisis line intervention crisis line calls and that type of intervention you can call 211 and they will respond but they will they're also a referral service and they will connect you with a wide range of available community resources as has been mentioned telehealth counseling is very much an option these days and Becky's group together counseling she hasn't like waved her arms in the air and advertised herself but that's is a great resource that provides telehealth counseling for farm and ranch populations across our region that's a really good resource and then there's lots of other things out there just google ndsu farm and ranch stress or ndsu farm stress and we have a website that has a wealth of publications and videos and all sorts of other resources that you can access so there's actually a wide range of resources out there these days I work a little bit with a group called agro wellness and it's a coalition of folks from around the region who are all working on farm stress issues that includes folks from the Iowa concern hotline it includes folks from from the state of Kansas and so I would just encourage you to take a little time to familiarize yourself with some of those resources and get people connected up the red river farm network has been doing a podcast series called the transformation podcast series where they interview folks who have been dealing with mental health and other health concerns in agriculture they tell their stories and share what are things that have worked for me podcasting is a is a really popular way for people to access information now it's very simple for you to send them a link to that transformation podcast so I would encourage people to really think about being that bridge to the variety of useful resources that are out there for dealing with any kind of mental or other type of health concerns that folks in agriculture may be dealing with absolutely thank you Dr. Broderson and you getting touched on the ndsu farm and ranch stress website that is available and and also some of those other resources and and helpful opportunities and again that's the dependent just kind of pull things together is that even from an agricultural standpoint if if we do get rain or the crop prices go up or the the bearing didn't go out on our our tractor or whatever and so some of the days that there are some good things and in fact we always need to keep that into consideration but you know some of if we if we push or if we change our mental health and if we change our behavioral health even when things get better it seems like it's it's tougher to grab and and to keep moving and progressing and so we've had a great discussion on that but I think that even if you know our life feels better or realizing that something can be impactful and not as close in terms of depression we can dig in and that is an important part what I'm going to do here is we're going to we're going to be finishing up but we have the quiz up there but I'm going to allow each one of our presenters to just provide a quick follow-up and here's your elevator speech and I'm going to allow Lila to to be our first person and so thank you so much before we close things up to our presenters as our participants have noticed and those that will get to watch this is that I got the opportunity to moderate and be surrounded by a lot of talented individuals and we thank you very very much for your input here at North Dakota State University as part of our extension program and part of our drought seminars and so to come full circle of of whether it rains or whether it doesn't and how we have an impact on agricultural operations this is an important part on on mental health and and dealing with some of those stresses or maybe it's transition plans and succession from one generation to another and and that's certainly a topic on its own Lila we're going to give each one of you guys just an opportunity to close us up for our webinar today go ahead there was one thing that someone had told me once that having anxiety and having depression is like being scared and tired at the same time and I think that kind of sums the whole thing up that's what depression is all about and and I think we were given a lot of of information as far as what we can do to help with the depression whether it's ourselves whether it's someone else how to to look for it and where to go if if we actually are depressed and and not to feel bad about the fact that that we might need some outside help okay thank you Andrea yeah well just thank you for asking me to be a part of this today and thank you for everyone joining us I think as I reflect on our discussion in some of the the questions we talked about communication is so important whether it is talking about mental and behavioral health or from transfer communicate communicate it seems really simple to do but it is it's difficult and it's difficult to take those steps and start those discussions early on and don't ever assume anything and I always tell my kids I don't like surprises especially the day before parent teachers conferences is there anything you need to tell me I don't like surprises but I think the more we communicate with each other the more the more we communicate with other people and the more informed we are we're all better together and so I think we're we're all a team whether we be an extension team or a team of food producers we're all working for the same goal and so whenever we can communicate and support each other I think that's important great thank you Andrea for joining us Philip and I just say there are some there are a lot of parallels between preparing your your pharma ranch operation for drought and and taking care of your mental health intervening early consulting with professionals having a plan in place on steps that you can take now it goes a long way in mitigating issues down the road so I think recognizing those warning signs and talking with the leaders and professionals in your community regarding mental health issues the prevention you know goes a long ways on that. Thank you Philip for joining us as well and Becky your turn. Okay I just wanted to mention a few things as Sean mentioned I work with Together Counseling you can find our website at Together Counseling Group.com on that website is a download link for this brochure called worrying out your bootstraps it's been done in collaboration with Sean and Farmer's Union and and things like that but it is information that you can give out or leave at the grocery store court board or in the gas station or places to to have something to give people if you're looking for that. I do therapy with farmers and ranchers it would be my greatest honor to work with any of of those people in need please know that I do my best to get people resources and services within a week so there aren't long waiting lists and just I'm just so proud of everybody for being willing to talk about this and for all the attendees to just changing changing the message out there that farmers and ranchers don't do it differently they do they are and they will. Thank you so much and we'll pass it to my colleagues here that are actually on campus hanging out behind their green screen and Dr. Charlie go ahead. Thanks I was thinking one of the messages you know mental health is just like physical health right you have to work out you have to take care of the aches and pains you sprain your ankle you're going to take care of it you if you sprain something in your mental health really need to take care of it then the other note I took was we're all into physical fun right well part of this is also what do you what's your mental fun what do you like to do right and we have these in they're applicable to both parts of us and so you know we've got to step back and think what do I like to do what's the mental fun because this go around around in circles of stress this is not that much fun what can I do to have fun. All right thank you and Dr. Sean Brotherson he helped to to guide some of this discussion and and pull together a talented talented group of people here Sean you get the opportunity to to provide your insight here and we'll summarize this up. I would build off a little bit what Charlie just said and think a little bit about in in my life are there things that I might need to do a little bit differently that would contribute to my health to contribute to my sense of happiness and there's a lot of research that shows when we focus on the negative things in our life we don't tend to see a lot of improvement but when we tend to focus on positive things things that help us be resilient things that bring us happiness and hope then we see more improvement in our mental health and in our overall functioning and so I'd encourage you to think about that and there's a famous quote from a farmer down in Australia who was being interviewed about mental health and he said here's what I can tell you about us farmers and ranchers in Australia we take care of our livestock we take care of our equipment but we don't do a very good job of taking care of ourselves and I would just encourage people to remember that you can have a have a listing of all the assets on your farm or ranch operation you can talk about seed you can talk about livestock you can talk about buildings you can talk about equipment all these different assets and yet none of those are as important or as valuable as you are and your health your health really is the most important asset on any farm or ranch operation and it's important for you and your well-being and your happiness on a daily basis and the quality of the relationships with people you care about and so I'd encourage you to think about as you think about preparing your farm or ranch operation for drought stress or any other kind of stress you know as a family life specialist I cannot make it rain on your farm ranch operation but there is something you can exercise a lot of control over and that is the choices you make relative to your own health and the health of those around you so I'd encourage you to make health a priority it's going to be the best investment that you ever made on your farm or ranch operation. Thank you Dr. Brotherson and in fact it's been touched on a couple times that the NDSU does have a farm and ranch stress website in relation to this is our final of our webinar series for this drought portion and those are are and will be available at www.ag.ndsu.edu slash drought and so thank you to our participants thank you for our attendees and I'm certain that we will gladly appreciate this as a resource and will be archived for others to to visit and to use so for all of those individuals out there that have stayed with us for nearly two hours we kindly appreciate you and hopefully that it's a glorious sunshiny day in your world and so as I certainly feel and try to live as well as we say it on be healthy and and be happy is that be optimistic and I think that that's part of it as well as that that's kind of where home base is and realize that we can be optimistic and and be a part of our agricultural world and so thanks for all of those that work so hard every day to to feed and clothe our our individuals across the world and more power to you and charge on thank you