In this powerful and deeply compassionate episode, Dr. Sally Spencer-Thomas talks with Monica Kramer McConkey, one of the nation’s leading voices on rural and agricultural mental health, about the silent crisis facing farm families across America.
Monica brings both clinical expertise and lived experience—she grew up on a farm in northwestern Minnesota and has spent over 30 years supporting agricultural communities through depression, addiction, and suicide loss. Together, Sally and Monica explore the intersection of isolation, economic pressure, and cultural stoicism—and how resilience, connection, and tailored interventions are changing lives across rural America.
Listeners will gain insight into how we can bridge the urban-rural divide in mental health, build suicide-safe communities, and sow hope where it’s needed most.
Key Themes & Questions We Explore
The Story: Roots in Rural Life
What was it like growing up on a Minnesota farm, and how did that shape Monica’s approach to behavioral health?
What pivotal experiences led her to dedicate her life to supporting farmers and ranchers?
How do generational values, work ethic, and pride impact conversations about mental health in farm families?
The Science: Understanding the Farm Mental Health Crisis
What do we know about suicide rates among farmers and other agricultural workers?
How do chronic uncertainty and economic volatility impact psychological wellbeing?
How does stigma show up differently in rural communities—and what can we learn from that?
What are the connections between substance use, stress, and suicide risk in rural America?
How does farm stress ripple through families, and what role can clinicians play in supporting these systems?
The Strategy: What’s Working
What does Monica’s work as an Ag Mental Health Specialist look like day-to-day?
Which strategies—peer networks, faith-based programs, storytelling—are breaking through stigma and saving lives?
What is Eyes on the Horizon Consulting doing to train, equip, and inspire communities across the country?
If we could wave a magic wand, what three changes would make rural America more mentally healthy and suicide-safe?
The Call to Action: Sowing Seeds of Hope
How can behavioral health professionals adapt care to rural realities?
What can employers, policymakers, and communities do to expand access and trust?
What message does Monica most want every farmer and rancher to hear about mental health and hope?
About Monica Kramer McConkey, LPC
With 30 years of experience in behavioral health, Monica Kramer McConkey has served as a counselor, program supervisor, and administrator. Holding a Master’s in Counseling and licensure as a Professional Counselor, she focuses her career on increasing access to mental health care and reducing stigma in rural, underserved communities.
Growing up on a farm in northwestern Minnesota, Monica has a firsthand understanding of how weather, debt, and isolation intersect with identity and family legacy. Today, she works as an Agricultural Mental Health Specialist, supporting farmers and ranchers throughout Minnesota, and travels nationally through her company, Eyes on the Horizon Consulting, LLC, to deliver training and keynotes on resilience, stress management, and suicide prevention.
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Learn more about Eyes on the Horizon Consulting
https://www.eyesonthehorizon.org/
References & Resources
Farm State of Mind – American Farm Bureau Federation
Rural Health Info Hub – Farmer Mental Health
Psychology Today – “Agricultural Behavioral Health Crisis”
Eyes on the Horizon Consulting, LLC – Official Website
The Agrarian Imperative – PubMed Abstract
University of Illinois Research – “Move Forward: A Marginalia Analysis of Farmers’ Mental Health Management Strategies”
Rural Resilience Online Course – Managing Farm Stress
Supporting Farmers’ Mental Health: Understanding Farm Culture Course – Blackthorn Events Platform