A study by the University of Cambridge at the time of the crisis found just 1.5 per cent of farmers affected sought help from a mental health professional, choosing instead to rely on family and friendship networks, although diagnoses of anxiety and depression went up.

There were outbreaks of foot-and-mouth on 133 North US farms in 2001, but many more saw losses of stock after exclusion zones were set up requiring mandatory culls for animals within range of confirmed cases.

The trauma of giving up stock and watching it burn on the pyres that became a regular sight in the countryside is still affecting farmers many years on from the crisis, say staff from the Royal Agricultural Benevolent Institution (RABI).

Sally Connor, the regional manager at RABI, said: “A lot of farmers said the thing they couldn’t bear was the farm being so quiet. They went outside and there wasn’t a single sound.

“You’ve got a farmer who has been busy every single day, and then suddenly he’s got nothing to do. An empty farm. No livestock to look after, and no job to do himself.”

But while mental health support was available at the time through RABI and other organisations including the Farming Community Network, many working on farms did not actively seek it.

Ms Connor said: “I met a man who came up to me 10 years after the crisis and said he was one of the drivers who took the dead stock away.

“It traumatised him so much that he had to give up driving. When I asked him if he’d sought help from his doctor, he said ‘no, you don’t do that, do you?

“And some years later I was at an agricultural show and a farmer bought £20 worth of raffle tickets from me. He sat on a tractor wheel and tears just ran down his cheeks. This big, burly farmer, and he started talking about the impact of foot and mouth.”

For many farmers, the stigma of disclosing that they were struggling was a problem.

John Basnett, who was the regional welfare officer for the North-East at RABI during the crisis, said: “The phone was ringing off the hook, and the calls were endless. The problems people were facing were horrendous.

“But they weren’t discussing mental health, although a lot of people were quite desperate.

“Nobody mentioned mental health in those days. It was a little bit taboo.

“But some of them were broken, there was so much love and care for their animals and they were just devastated and crying down the phone.

“It was just a sense of desolation and hopelessness.”

Mr Basnett said that while mental support provision has improved for farmers since the crisis, he did not regard foot and mouth to be a turning point for farmers who were previously worried about disclosing mental health problems.

He said: “It’s still very difficult to get farmers and farmworkers to open up, even nowadays.

“They’re very stoical and don’t want to talk about it in the main, which is unfortunate.”

RABI now offers online support for farmers struggling with mental health problems, but Mr Basnett said the charity has experienced issues with rural workers without broadband trying to access help.

Emma Mamo, the head of workplace wellbeing at Mind, said: “There are a number of unique pressures associated with the industry, such as the often-isolating nature of daily work, long and anti-social working hours; and the difficult economic climate, with income often dependent on factors outside their control.

“Specific agricultural crises – such as the foot and mouth epidemic 20 years ago – can amplify many of these pressures and stress-inducing circumstances, and can have a lasting impact on the mental health of farming communities.”