Welcome to Brazos Matters.

I'm Jay Socol, along with my co-host, Texas A&M journalism major and KAMU content contributor Avery Foster.

Well, every now and then, I'll ask friends who represent a variety of professions what's new in their world, some kind of noticeable change or shift or a fresh challenge that our KAMU audience might find intriguing?

And so that's what led to today's topic.

All of us will experience struggles and burdens of some kind, but hopefully each of us has a strong support group and access to professional support when it's necessary.

But that's not always the case, especially in the rural areas of our community and our state.

Behind so many family farms and ranches that we pass without thinking about it on our highways or our farm to market roads, are people silently suffering with burdens that most of us never even think about.

And we ran across a shocking statistic.

Or at least Avery did that.

According to a CDC study that male farmers, ranchers and agricultural managers have a suicide rate of more than 50% higher than the national average for men across all occupations.

So with us today are two psychologists and researchers who are working to extend easy to use telehealth options to these farmers and ranchers in order to bridge that health care gap and maybe break the stigma that surrounds mental health care needs in these rural areas.

That's a long wind up.

But joining us are Doctor Carly McCord, a licensed psychologist and founding executive director at Texas A&M Telehealth Institute.

And doctor Mikaela Spooner, also a psychologist with the Telehealth Institute and lead provider for the FarmHope project, which we'll learn more about in just a bit.

Thank you very much to both of you for being here.

Absolutely.

Howdy.

Howdy.

All right.

Take it away, Avery.

Thank you guys for being here.

So I'm going to start with you, doctor McCord.

So can you tell us a little bit about yourself and what the Texas A&M Telehealth Institute is about?

Sure.

So, yes, I'm a licensed psychologist and clinical associate professor and medicine and education here at Texas A&M.

And have the privilege of being the captain of the Telehealth Institute, where we focus on clinical care, research and educational opportunities to equip the next generation of learners and knowledge about telehealth for underserved communities.

All right.

I'm going to throw the same question to you.

Can you tell us a little bit about yourself and then what the FarmHope project is.

Yeah definitely.

So the FarmHope project is a little bit of a passion project.

I think for both doctor McCord and myself.

I grew up in, in town, but oftentimes was spending my time outside of town with horses, and, I continued to have horses.

Author.

My life and be involved in 4-H and FFA, and that's been something that I've kind of kept in my pocket throughout grad school and all of my training.

And so on my postdoc year.

Doctor McCord mentioned FarmHope and I already had this passion for serving, rural communities and reaching out to those who didn't have access to quality mental health care.

And so FarmHope bridges, both my professional interests, in counseling and mental health, as well as my personal interest in kind of the rural and ag populations.

Cool.

Well, obviously, I think mental health is such a, relevant thing today, especially, you know, as we progress as a society.

But I still think there are some groups that tend to suffer.

So could you talk to us about, you know, the stigma, the tough it out mentality and maybe some barriers that the experience.

Yeah.

So I'll kind of touch on the ag side of things.

There's obviously some overlap between rural communities and these ag communities.

But talking specifically about ag communities, you're looking at areas where people are not necessarily close together.

You don't have that immediate support.

They might be miles from each other, miles from town, miles from access to, both mental and physical health care.

So that's that's one barrier.

You also have the barrier of mental health stigma.

And that ties into the tough it out mentality.

The tough it out mentality has a really great foundation and has a lot of positive attributes, really just meaning, perseverance and being adaptable and resilient in whatever you're doing.

And we see this a lot in the ag population because they are so passionate about the farming and ranching that they do when it becomes a barrier.

Is when you pair that tough it out mentality with, well, I got to do this alone because I'm weak.

If I ask for help and I'm weak if I ask for support.

And so now we're really trying to say, well, both things can be true.

You can be this resilient.

Tough it out kind of person.

And you don't have to do it alone.

And you can reach out for support when things get a little out of hand, because they face stressors that you and I don't think about on a day to day basis, oftentimes out of their control.

And so those are kind of some of the barriers that we've been seeing, as well as that positive, protective, resilient side of this population.

Would you talk a little bit more about some of those stressors that we probably don't consider, those of us who don't live in rural communities or work on farms and ranches, things that I would guess, or financial uncertainty.

Climate change, just the isolation of living out in in these areas.

And what I would guess also is just the pressure of being the generation where this could potentially fall apart.

Talk more about those sorts of things.

Yeah, you hit the nail on the head.

There's a lot of external stressors and internal stressors that we're seeing in this population.

External stressors.

You're right.

The weather, we might say, oh yeah, we're getting a lot of rain.

This is so great.

Well, is that farmland getting flooded?

And are all those crops now no longer growing?

Or what?

Same with a wildfire.

And it's not just.

Oh, yeah, a wildfire knocked out some of my livestock, and now I'm.

Now I'm good.

Now I'm done for the year.

There could be another disaster.

There could be another weather event that these farmers and ranchers.

You can't prepare for.

So that's a stressor.

The economy, not knowing how much money you're going to get, selling those crops or selling your livestock.

Another huge stressor, you have the physical stress as well, which I don't want to overlook.

There are risks in their line of work that we also don't have to worry about.

We aren't operating heavy machinery on a day to day basis or working with large animals, where you can get seriously injured.

And if you don't have insurance, you might let an injury go and then face all sorts of repercussions from that.

And then internally, you have the pressure of, gosh, I don't want to lose this third or fourth generation farm, but my kids might not want it.

So what do I do?

Or, you know, we used to be able to make ends meet.

And now with the economy, we're not sure if we're going to make it.

How do you make more time for a second job?

Whenever you're working longer than full time, often is what we're seeing with ag communities.

These are crazy factors that you're talking about because, you know, somebody who lives here in the heart of this community.

Okay, I'm going to worry about my my four minute commute to campus from the house.

Or am I going to have to, you know, park a little farther away like, those are our first world.

Yeah, those are first world problems.

You're talking about things that are pretty existential.

Absolutely, absolutely.

You're talking about folks that might have a 25 or 30 minute drive into town.

Are they going to make time away from their land and their livestock to go to the doctor or to go see a therapist?

How do you prioritize that when your commute is so long, or when you have life or death situations, when your machinery breaks down or when you get run over by your cows?

Yeah, things like that.

Okay, so for you, doctor McCord, what are some of the things that you're seeing in our area in the Brazos Valley, some of these stressors that come to your attention, some of these challenges that come to your attention that you're trying to turn.

Yeah.

I think the commute times are real that the, the majority of our health care providers are here in Brazos County.

But I certainly have, heartbeat and understanding of the Brazos Valley and that those, those 35 to 60 minute commute times from our neighboring counties to any type of care means.

You you often go without there you you're not just sacrificing the the 45 minutes for an hour each way.

It's then the the time spent in the waiting room just at the.

If you live in a city and the way that you interact with your health care system, kind of like you were talking about with your parking, is is different.

Like we all sacrifice for a couple hours.

If you live in town to get what you need.

And then when we're talking rural, we're we're talking half a day or a whole day away.

And I think that, you know, for adults, we were in charge of our own destinies a little bit.

And then with our our kiddos, we've it takes both taking the kid out of their school time and, the parents being away from work or other responsibilities to give them the care that they need.

And so that's why I love telehealth.

Yeah, because whether you whether these folks intend to or not, it's it's resulting in neglect just because they can't overcome some of these barriers it ends up being self neglect.

Yeah.

Right.

Yeah.

And yeah I'm, I was talking mostly about access and I'd already mentioned stigma.

I think all those things just compound upon each other where yeah, we just sometimes go without.

But there's been some great programs built not just for Telehealth Institute, but others that the state has invested in to try and get telehealth care to families that need it.

And I want the community here in the Brazos Valley and beyond, to know what those resources are.

So Doctor Spooner this question is going towards you.

But if you have anything to add please do so with tele therapy, changing the landscape and breaking down these traditional barriers like what do you see in rural communities.

Like how is this helping.

It's helping a lot.

And it's it's still growing in a lot of ways.

But making, making services accessible for those who don't have insurance or to those who don't have the money to pay out of pocket.

We hear all the time.

Well, we wouldn't have gotten services.

I wouldn't have reached out for therapy had y'all not been here.

And so we're we're seeing this most with most of, the clients that come into the Telehealth Institute virtually.

And so it makes me wonder how many more folks are out there that maybe don't know about the services that are going without because of financial barriers or, access barriers.

Yeah.

Anything else that I'm missing on that?

I, I've just seen time and time again, I mean, there's the, tchat program, Texas Child Health Access through telemedicine program and, and the schools, that the, the parents don't have to leave work or leave home.

The kid doesn't have to leave school.

They don't miss instructional time.

They just get care when and where they need it.

Within the schools, it's one of the best things the state of Texas has invested into, children's mental health care access.

And, that's, that's in the schools.

And then I think for our farm and ag communities, our farm help program that creates access to care outside of, hours and just trying to flexibly meet people when and where they are.

Is wonderful.

And we we've got access points and our resource centers and some of our clinical care settings throughout the rural regions.

And there are multiple ways to get care.

If people reach out, if you just tuned in, I'm Jay Socol you're listening to Brazos Matters and Avery Foster and I are visiting with doctors Carly McCord and Mikaela Spooner of the Texas A&M Telehealth Institute about mental health and well-being challenges within agricultural communities and their, efforts to provide support through telehealth initiatives.

So for you, Doctor Spooner, how how do these rural workers in need even find out about FarmHope and then get connected to it?

Absolutely, absolutely.

So FarmHope.

I'll I'll kind of give the the overview and then get more specific.

Sure.

So FarmHope is a collaboration between the Texas A&M Telehealth Institute as well as, Agrilife extension.

So we offer this two pronged approach where there's educational workshops, usually ranch succession planning events.

Those are really popular.

As, farmers and ranchers get older, they need to figure out how to get their files in order.

And so we paired those with some education around mental health and then plug it in with these therapy services.

So folks that have attended these workshops get the information about how to get in contact with us.

So if anyone is interested in us hosting one of those workshops, that's something that we can discuss.

But beyond that we have our website, as well as fliers and little pocket cards, that fit right in, the pocket on the front of your shirt that give you access to our phone number, our website, as well as our intake paperwork by just scanning a QR code.

So our website is telehealth Stanford.edu.

Nice.

Thanks for the recovery, doctor.

McCord And so all of our information is on there.

And to qualify for these services, you just have to answer yes to two questions.

If you are in Texas and if you are or are related to an ag producer.

So you could be the cousin, the aunt, the uncle, the kid of someone in an ag related field and you would qualify.

And so on our intake forms, you just say, hey, are you a farm hope person?

And if you say yes, then you get automatically directed to me and I give them a call and we set up a session where I answer questions that they might have.

There's no insurance, there's no vouchers, there's no referral.

It's totally free of charge for those folks in Texas.

Interesting.

So I watched a podcast two days ago that you were on Doctor Spooner, and, you mentioned something about farm Hope not being a hotline.

It's an access or passage or, passage or access point for tele behavioral services.

Why is that distinction important?

Yeah.

That's correct.

So we also have some relationships with the agri stress hotline and hotlines in kind of the the way I'm using it is more for crisis, more for I need someone to talk to right now.

Maybe it's after hours.

Maybe it's the middle of the night.

I need someone to talk to for some immediate support.

And what we do at farm Hope is a little bit different.

We are offering these services as, more of an ongoing, like, hey, now that you're not in crisis, or maybe you haven't been in crisis, but you're wanting to work on some things in your life stress, communication, relationships, managing, managing your agriculture business, whatever it might be, and really set up maybe weekly sessions to get to know each other and really dig into some of this work.

So it's not an immediate fix.

I guess you could say it's not this immediate support that you get from a hotline, but our role is just different.

It's going to be that ongoing work where you dig in to some of these things and learn what changes you really want to make in your life or within yourself.

To address some current stressors.

So this question really is for either one of you or for both of you.

But you mentioned Doctor Spooner a little earlier.

You use the word perseverance.

And so I'm wondering if either of you are seeing any kind of perseverance or enduring strength or resolve or resiliency in these rural populations.

And see things to feel hopeful about.

Can I start?

Yeah, I, I've known Doctor Spooner for a while, but I don't know if she knows this about me.

I came to Texas A&M to study positive psychology with Doctor Tim Elliott, and my dissertation was on folks who've, experienced spinal cord injuries and other traumatic, physical losses.

And I the the universe.

God brought me to my very first assistantship, which is our very first telehealth pilot project back in 2009.

And so I came to study positive psychology because I wanted to know as much about what was right with people as to how to help them.

And psychology hasn't always been about the what's right with people.

And then I got plugged in with our first telehealth pilot, and I learned that about our communities and all of the strength and resilience and capacity they have to solve problems together as a community or even the individual or community members and their resilience.

Time after time after time.

News.

We've touched 47 counties, so each community has shown resilience.

We've touched thousands of people and cases.

I've supervised so many of them.

And time after time after time, it's people that show that resilience and strength.

We were all our bodies and our minds were created to heal and to grow.

Are there specific examples that come to mind right now that that you just hang on to, because they were so extraordinary?

That's a great question.

Honestly, I, I would I wish I could I could give you I, I yeah, I don't know I, I am thinking of one person in particular that.

But it is so many of the stories that all combine just time after time.

Yeah.

It's it it's going through significant loss of tragic losses of, a spouse and reuniting and reconnecting to a family that they felt like they didn't have any energy to get out of bed in the morning.

And just spending that time week after week where, little by little, started to make those changes and they had a commitment to wanting to feel better.

And I guess the other thing I we've we've been spending a lot of time in flood response and spending time in Kerrville and Hunt and our, our whole team and just watching those families as people who are rebuilding, from losing everything.

And we're supporting the frontera health clinic.

And it took a while to say that they needed some help.

But wait, there's plenty of people on staff that lost everything had, you know, one pair of clothes and no towels or anything, and they showed up to serve at the front desk or to be a nurse, and they just keep showing up.

And so then we, we try on our side to keep showing up for them to, to support in whatever way we can.

That's amazing.

Yeah.

So something that I think people take into account is in rural communities, they often, you know, maybe lack internet connection or access to devices.

So do y'all provide any technology or services to help with that?

And can you walk us through the process of what that looks like?

Absolutely.

So we do have partnerships with some of our resource centers in the Brazos Valley, and they are equipped, with our technology to have folks come in, and get set up in their office.

So we have some of those options for those that can get to, resource clinic in their county.

We also offer just telephone sessions.

If there's not enough bandwidth for the video aspect, we can call on the phone and we can be flexible in that way.

If folks don't have any way in any technology to get in touch with us, we can mail them a tablet, free of charge for them to use that is equipped with, all of the software that they need to get in contact with us.

All the options.

Got a physical place you can show up to.

You can do audio only, or we will loan you a device.

Don't let it be a barrier.

That's excellent.

And I'm trying to be efficient with the.

With our time.

We've only got a few minutes left.

But you mentioned that you're doing work right now in 40 something counties.

Was that right?

Are there particular areas of the state that you haven't quite been able to get into, that you're really trying to be intentional about?

So yeah, my heart beats been in the Brazos Valley.

We started in Leon County and and grew from there.

And so I did hit all of the Brazos Valley counties with an access point and with sustainable care.

And we're on 15 years going strong there.

And then, we've also, been investing, I think, our biggest growth area in South Texas.

But that's not our only growth area.

We've got, some sites and far west Texas, East Texas is pretty uncovered.

I don't know.

We've touched 47 counties.

There's 254, but I won't stop until they all turn maroon and everybody has access to care.

I'm on East Texas.

Let's get this thing together.

Well, it's I'm.

I'm partial because I come from an area that's a little bit west of Fort, where it's kind of between Abilene and Fort Worth.

Stephens County.

It's a little Breckenridge, Texas go, buckaroos.

And, and so that's my frame of reference, but it's also stuck in the 1980s when I left there.

And so I'm sure Stevens County and other counties up there have evolved, in terms of reducing some stigma, I hope, having access to some of these services, I hope, but that's my frame of reference.

Well, and I would say we we could have gone the route of being a Teladoc.

And, you know, you you pay X amount each time you log in to a session and we're charging insurance.

And so I think I've gone a little bit of a nontraditional route of grants and contracts and donors and trying to just make access to care, available to those that are most in need.

And our ag communities have been, areas of our recent focus to get them plugged in.

Yeah.

And so, yeah, it's challenging getting to all 254, but we won't stop till we're done I guess.

So in our last couple of minutes, either one or both of you want to give, a last pitch for farm Hope and for the Telehealth Institute and who it's for and how to get in touch.

Go, doctor Spooner and elevator pitch.

My plug for farm Hope is that there's so often a belief that you might talk to someone that's not going to get it, that's going to say, take a vacation, take some self-care.

And I think we're really unique because I have a little bit more understanding and training in what the needs of that, population is.

And so the services are tailored a little bit different.

We really want to show up and be different and be, something really unique for the AG folks.

So even if people have questions, give us a call.

I'm in the office and available to answer any questions and put folks at ease.

And I'm proud of Doctor Spooner.

I'm proud of farm Hope.

I would love for folks who are questioning to, reach out, connect to see what's out there and see how it might help throw me a website one more time.

Telehealth.tamu.edu.

Perfect and check the box for farm help.

Doctor Carly McCord.

Doctor Mikaela Spooner, thank you so much for being with us on Brazos Matters.

Thank you for having us.

Yes.

Thank you.

Brazos matters is a production of Aggielands Public Radio 90.9 Kamu FM, a member of Texas A&M Division of Community Engagement.

Our show was engineered and edited by Matt Dittman You can find us on YouTube and all podcast platforms.

We thank you very much for listening or for watching.

And for Avery Foster I'm Jay, Socol.

Hope you have a great day.