A Checklist and Guide for Making Referrals
By: Robert J. Fetsch, Human Development & Family Studies
Colorado State University

and

Roger T. Williams, Professional Development & Applied Studies
University of Wisconsin-Madison

SIGNS OF FARM AND RANCH STRESS

The last few years have been difficult for farm and ranch families. Many are experiencing financial and emotional stress as a result. There are several signs or symptoms when a farm family may be in need of help. These are signs that can be observed by friends, extended family members, neighbors, milk haulers, veterinarians, clergy persons, school personnel or health and human service workers. These signs include:

• Change in routines. The rancher or ranch family stops attending church, drops out of 4-H, Home makers or other groups, or no longer stops in at the local coffee shop or feed mill.
• Care of livestock declines. Cattle may not be cared for in the usual way; they may lose condition, appear gaunt or show signs of neglect or physical abuse.
• Increase in illness. Farmers or farm family members may experience more upper respiratory illnesses (colds, flu) or other chronic conditions (aches, pains, persistent cough).
• Increase in farm or ranch accidents. The risk of farm accidents increases due to fatigue or loss of ability to concentrate; children may be at risk if there isn’t adequate childcare.
• Appearance of farmstead declines. The farm family no longer takes pride in the way farm buildings and grounds appear, or no longer has the time to do maintenance work.
• Children show signs of stress. Farm and ranch children may act out, decline in
  academic performance or be increasingly absent from school; they may
  also show signs of physical abuse or neglect.

SIGNS OF CHRONIC, PROLONGED STRESS

When farm and ranch families are stressed out for long periods of time – chronic, prolonged stress – they may experience a number of signs and symptoms. Watch for the following effects in farm families you see on a day-to-day basis:

SIGNS OF DEPRESSION OR SUICIDAL INTENT

The greater the number of signs or symptoms a ranch or farm family is experiencing, the greater your concern should be. In addition, if family members are exhibiting the following signs of depression or suicidal intent, it is important that you connect them with professional help as soon as possible. All cries for help should be taken seriously.

Signs of Depression

• Appearance: Sad face, slow movements, unkempt look.
• Unhappy feelings: Feeling sad, hopeless, discouraged, listless.
• Negative thoughts: “I’m a failure,” “I’m no good,” “No one cares.”
• Reduced activity and pleasure in usual activities: “Doing anything is just too much of an effort.”
• People problems: “I don’t want anyone to see me,” “I feel so lonely.”
• Physical problems: Sleeping problems, decreased sexual interest, headaches.
• Guilt and low self esteem: “It’s all my fault,” “I should be punished.”

Signs of Suicidal Intent

• Anxiety or depression:  Severe, intense feelings of anxiety or depression.
• Withdrawal or isolation: Withdrawn, alone, lack of friends and supports.
• Helpless and hopeless: Sense of complete powerlessness, a hopeless feeling.
• Alcohol abuse: There is often a link between alcoholism and suicide.
• Previous suicidal attempts: May have been previous attempts of low to high lethality.
• Suicidal plan: Frequent or constant thoughts with a specific plan in mind.
• Cries for help: Making a will, giving possessions away, making statements
  such as “I’m calling it quits,” or “Maybe my family would be better off
  without me.”

HOW TO REFER A PERSON FOR HELP

1. Be aware of the agencies and resources available
   inyour community – what services they offer and what their limitations
   are.
2. Listen for signs and symptoms that the person or
   family needs help which you can’t provide, i.e., financial, legal or
   personal counseling.
3. Assess what agency or community resource would be
   most appropriate to address the person’s (or family’s) problems.
4. Discuss the referral with the person or family
   (“It sounds/looks like you are feeling _____. I think _____ could help
   you deal with your situation.”)
5. Explore the individual’s or family’s willingness
   to initiate contact with the community resource (“How do you feel about
   seeking help from this person/agency?”)
6. Where the person or family is unwilling to take
   the initiative or where ther is some danger if action is not taken, you
   should take the initiative:

• Call the agency and ask to speak to the intake
  worker (if there is one).
• Identify yourself and your relationship with
  the person or family.
• State what you think the person’s or family’s
  needs are (needs immediate protection from suicidal acts, needs an
  appointment for counseling, needs financial or legal advice).
• State what you think the person’s or family’s
  needs are (needs immediate protection from suicidal acts, needs an
  appointment for counseling, needs financial or legal advice).
• Provide the agency with background information
  (name, address and phone; age and gender; nature of current problem or
  crisis; any past history you’re aware of; further information as
  called for).
• Ask the agency what follow-up action they will
  take:

• When will they act on the referral?
• Who will be the person for you to contact
  later if necessary?
• What will be the cost of the service (flat
  fee/sliding scale)?
• Do you need to do anything else to complete the referral?

7. Make sure the person or family and referral agency connect and get together. Make one or more follow-up contacts with the agency if called for by the situation.