COLUMBIA, Mo. – Amid mounting pressures — floods, bankruptcies, consolidation and a credit squeeze — rural Missourians struggle to access mental health services.

Mental health challenges are a growing public health concern in rural Missouri, according to a new report from the Missouri Hospital Association, Missouri Department of Mental Health, Missouri Coalition for Community Behavioral Healthcare, Missouri Farm Bureau and University of Missouri Extension.

The report, “Growing Stress on the Farm: The Expanding Economic and Mental Health Disparities in Rural Missouri,” presents policy opportunities designed to expand access to mental health services, reduce stigma and improve mental health outcomes for rural Missourians. Download the report at A printable one-page summary with infographics is also available.

Missouri’s farmers and ranchers have faced numerous economic challenges. Missouri also faces the largest shortage of behavioral health care providers in the U.S. Each of Missouri’s 99 rural counties is a designated Mental Health Professional Shortage Area. And even when these resources can be found, the stigma of mental health treatment can discourage care.

“Farmers, because of their strong and independent nature, often are reluctant to talk about these issues,” says MU Extension safety and health specialist Karen Funkenbusch, who is one of the authors of the report.

Farmers and ranchers have reported to agricultural MU Extension specialists that they are experiencing unusually high levels of stress. In response, field specialists have worked with campus faculty to coordinate efforts and launch several new initiatives. Professional development events in the spring of 2020 will provide behavioral health providers around the state opportunities to build the unique skills needed to serve individuals and families from agricultural backgrounds. MU Extension is working with extension services in several other Midwestern states on developing a catalog of resources and programs to help farmers and ranchers in crisis know where to turn, and to provide a more robust network of stress assistance programs, including a stress hotline and prescription drug misuse education.


  • 988 Suicide & Crisis Lifeline provides free and confidential emotional support 24/7. Call 988.
  • Missouri AgrAbility Project helps farmers with disabilities and their families succeed through on-site assessments, recommendations, peer networking, educational resources and referrals to potential service providers.
  • Taking Care of You is a research-based MU Extension program that focuses on positive psychology and mindfulness to provide practical strategies for dealing with life’s challenges.
  • Signs and Symptoms of Stress (PDF). Downloadable infographic from MU Extension, Missouri Department of Agriculture and Upper Midwest Agricultural Safety and Health Center.
  • Suicide Prevention Facts and Resources in Missouri. Downloadable infographic from the Missouri Department of Mental Health.