LOUISVILLE, Miss. -- Jim McAdory wears many hats. On any given day, the Mississippi State University Extension Service agent fields calls from local cattle farmers, teaches kids about the importance of daily nutrition, and tests soil to diagnose front yard and garden harvest problems -- all before lunch.

Based in Winston County, McAdory recently gained an additional role: Mental Health First Aid instructor.

MSU Extension’s PROMISE initiative -- short for “PReventing Opioid Misuse In the SouthEast” -- trains Extension agents in Mental Health First Aid so they can recognize signs of mental health crisis or substance use disorder in their communities.

Since the program started in 2017, nearly every Extension agent in all 82 counties has been trained in Mental Health First Aid. According to program data, three out of four agents reported increased confidence in helping connect people with mental health support. Fifteen percent of agents reported using their training in a mental health crisis, including incidents of community members confiding to them that they had thoughts of harming themselves or others.

The new role does not change McAdory’s daily routine. It does give him new tools to recognize and help if a community member is in distress when he’s out on the job. As with his agricultural agent activities, the new role leverages his relationships with the community. Like farming, mental health maintenance is not one-size-fits-all, McAdory said. Winston County’s diverse agricultural landscape means both his ag and community knowledge must run a wide gamut.

“Our watermelon growers are different from our poultry producers, who are different from our sweet potato farmers,” McAdory said, adding that he not only has to be able to contribute technical knowledge to assist with each type of farming, but he also must be able to relate to the diverse farmers, too.

For McAdory, that process means listening and using new Mental Health First Aid training to recognize signs of distress, whether that includes grief, financial troubles or substance use disorders.

“PROMISE opened up a whole new ballgame for me,” he said. “Mental health is something Extension agents need to be aware of. We work with hundreds of people in a month, and this training helps us recognize trauma and cues us when to listen differently than before.”

In recent years, rural overdoses outpaced urban rates, particularly among rural residents with opioid use disorder. During the pandemic, opioid overdose deaths exploded. Across the U.S., the total number of overdose deaths increased by 33% during the first eight months of 2020, compared to the same period of 2019. Mississippi saw an even higher jump -- 37% -- according to data from the Commonwealth Fund.

Three in four farmers say opioids are easily attainable, but only a third say the same of mental health or substance use treatment.

As community members themselves, agents like McAdory are a vital in recognizing mental health needs and connecting farmers with mental health resources that are often scarce in rural communities. Experts point out that the services are there, but it often takes a trusted community member to guide those who need them.

“Because Extension agents work with farmers across the state every day, they are well-positioned to build on those relationships to normalize conversations about mental health and to connect those who are struggling to find resources that can help,” said MSU Extension health specialist David Buys, adding that the newly trained Extension agents create a mental health support network across Mississippi.

Extension agents have long understood the constant difficulties farmers face, but the PROMISE initiative has enabled them to fully appreciate the deeper toll on farmers’ mental health. Buys said that naming and destigmatizing the psychological toll of farming is a first step, and Extension agents are equipped and ready to help.

“Stigma around mental health is one of the biggest barriers to getting folks to care, and by training agents on the background related to mental health and why farmers struggle sometimes, we are chipping away at the stigma,” Buys said. “Always keeping in view that while we are not the end of the care continuum, we serve as an important connector to care.”

McAdory and his Extension colleagues have taken Mental Health First Aid further into their communities by training local officials, police officers and school staff members to help local leaders understand signs of mental health issues, which can manifest as disruptive behavior.

Being an Extension agent means being in the community, no matter the different needs, McAdory said. 

“Not everybody has a yard, but everyone has health,” he added.

To access the Crisis Text Line 24/7, text TALK to 741-741, and find more resources from the Farm Bureau at https://msfb.org/mental-health/.

To learn more about MSU PROMISE, visit: http://extension.msstate.edu/the-promise-initiative.