Aching from a string of farmer suicides and other mental health challenges, neighbors in rural eastern Colorado are learning how to check in on one another. But as the drought drags on, is talking enough?
Ms. Rosenblum is a journalist from West Virginia and the 2022-23 New York Times Opinion editing fellow. Ms. Bottoms is a photographer from Oklahoma and a former New York Times photography fellow.
LA JUNTA, Colo. — Before Freud and before the pharmaceutical industry came to define what we understand as mental illness, doctors used to prescribe wealthy men suffering nervous breakdowns “the West Cure.” Building on the theories of George Miller Beard, who blamed modern life for frayed nerves, they recommended elites like Teddy Roosevelt trade reading their newspapers for a regimen of riding and roping beneath the cavernous skies. More than a century later, modern life has only gotten faster, and from Bozeman, Mont., to Denver, the West remains a popular place to retreat from it all. But the West Cure was never meant for the people who actually live there.
Today, the region is the epicenter of the country’s mental health crisis: It includes nine of the 10 states with the highest per capita suicide rate. (The tenth state, West Virginia, is where I’m from.) The Western states are where many Native Americans, farmers and veterans live — three groups who die by suicide more often than almost any other. These states also tend to have a greater share of rural counties, which have nearly twice the rate of suicide as urban ones — what we lack in access to mental health resources, we tend to make up for in stigma and firearms. It takes a special type of therapist to want to settle in a tiny town where, depending on that person’s constitution, the silence of the plains can be either peaceful or deafening; it can be even harder to park your truck at said therapist’s office, where everyone can see.
But there is a paradox when it comes to mental health in rural places: While rural communities might be tight-lipped, they are also, typically, tight-knit. In 2014, a group of people concerned about rising rates of suicide and anxiety in their towns reached out to the High Plains Research Network, a public health group affiliated with the University of Colorado School of Medicine, hoping to design a mental health tool that would address both the challenges and strengths of eastern Colorado. Eventually, they landed on the idea that while people in places like Yuma, population 3,500, may balk at the mention of a therapist, they probably already treat their local bartender like one. What if that bartender was trained, even a little, to recognize symptoms of emotional distress and intervene? What if everyone in town was?
While the idea of informal mental health support is far from new (programs like The Confess Project have been spreading a similar concept geared toward Black men and the barbershop, for example), the need in eastern Colorado was pressing. In Kiowa County, a rural area of about 1,500 people just west of Kansas, four men with ties to the county died by suicide in 2018, three of them in a two-week period. Their deaths shook a region used to hardship. Priscilla Waggoner, a reporter with The Kiowa County Independent at the time, pressed Dr. J.C. Carrica, president and C.E.O. of Southeast Health Group, on what he was going to do about it. “Her question hit me hard,” he said. “At the time, I didn’t have an answer.”
Eventually, he decided to use the model the researchers and concerned citizens had been collaborating on. Called COMET, for Changing Our Mental and Emotional Trajectory, it teaches community members to pay attention if a neighbor seems off and ask a question that might probe a little deeper than he or she normally would. For example: “Hey, I haven’t seen you at church lately. How’s everything at home?” If the person engages, the neighbor can suggest talking over coffee. If the conversation gets too heavy, the person should be directed to a professional.
It’s a simple idea — almost too simple. “Aren’t they just reinventing friendship?” our photographer, September Dawn Bottoms, asked aloud one day as we zoomed past crunchy fields of sage brush and lush fields of corn. But when we raised this point to Sergio Sanchez, a community adviser on the project in Yuma, he beamed. That’s exactly what they were doing, he said.
Can friendship really serve as mental health care? Perhaps more than we might suspect. “Mental health” as a term can feel so sanitized, so broad and abstract, that it ends up concealing some basic facts about our society. For example, according to the Survey Center on American Life, a project of the American Enterprise Institute, friendship in America has been rapidly declining, especially male friendship. Three decades ago, most men reported having at least six friends; in 2021, only half reported having four or more close friends. Fifteen percent of men reported having no close friends, a fivefold increase since 1990.
In his book “Lost Connections: Why You’re Depressed and How to Find Hope,” the journalist Johann Hari points to the loss of friendship — and family bonds and community groups — as one of the main reasons we may be depressed. Given that “grief and depression have identical symptoms,” he writes, what if depression is really “a form of grief — for our own lives not being as they should” or “a form of grief for the connections we’ve lost, yet still need?” If Mr. Hari is right, then tools like COMET are deceptive in their simplicity — perhaps even radical — in the sense that they address a root cause of depression: disconnection. Perhaps in a world of such increasing isolation, it helps to formalize care and compassion with an acronym.
When he brought the COMET program into southeast Colorado, Dr. Carrica, a fourth-generation landowner in Otero County, added some extra infrastructure and a motto: “Do you look after your neighbors as close as your crop or herd?” Today, his team calls the concept The Coffee Break Project and keeps a brick-and-mortar location by the same name in downtown Rocky Ford, a small town along the Arkansas River that produces some of the pumpkins we’ll soon carve.
The goal of the headquarters in Rocky Ford, said Jennifer Pollmiller, who oversees communications for Southeast Health Group, was to create a drop-in center for farmers and anyone else to grab a coffee and connect — sometimes about mental health, sometimes about how to train good dogs. On the walls hang wooden boards seared with the brands of local ranches. The boards send a message: This space is for them.
We met several farmers and ranchers there. Nancy Lucero is a Mississippi Choctaw tribal member who used to work as a mental health counselor with Native populations before she started farming alfalfa. She described the constant “background anxiety” farmers like she and her husband, Ron, feel.
“I think sometimes we think of mental health challenges as either mental illness or it’s some catastrophic life thing that’s happened that suddenly blows everything up,” she said. But what if anxiety and depression never go away because of the conditions farmers, and other people, are living in? she wondered. “What if it’s just become the way of life?”
Jace Honey knows about that constant hum of stress. Mr. Honey, the president of the local livestock exchange in La Junta, said he was already using many of COMET’s principles in his roles as an auctioneer “and a marriage counselor, and a weatherman, and a financial adviser.”
Sometimes people bend his ear about standard gripes: Talk about auctions becomes talk about money; talk about money becomes talk about strained relationships. On other occasions, the conversations are more intense. Mr. Honey recalled he was able to help an employee whose son was seeing things on the farm that weren’t there. Mr. Honey directed him to Dr. Carrica, who helped the family with managing what turned out to be schizophrenia. “Everything’s not good,” Mr. Honey said, “but it’s better.”
Are efforts like COMET and The Coffee Break Project “working”? It’s difficult to say. High Plains’s research suggests people report feeling more comfortable asking slightly nosy questions after the training. But informal therapy is just that — informal — and many of these check-ins happen far from view, like in the aisles of the hardware store, we heard, or in private meetings at the bank. No one has yet conducted anything like a formal study on its effects.
What nagged at me the most, though, driving through the state, was how flimsy the question “How are you, really?” seems, given the conditions the West is up against. Farming has always been an unpredictable business, vulnerable to forces that feel beyond any one person’s control. Many of the farmers we spoke with described the anxiety of watching a hailstorm destroy four months of labor, or the war in Ukraine drive up the price of fertilizer. The hours are grueling; some ranchers told us they don’t take vacations, or if they do, they take them separately from their spouses.
But there was one stressor that loomed larger than all the rest in our conversations: the drought. For the past 20 years, depending on how you count, there has been a particularly difficult dry spell in eastern Colorado, as in much of the West.
When we visited, the evidence was everywhere: the young cattle we saw being sold at auction several months early because there’s no more grass for them to eat; the furrowed brows of the ranchers doing the selling. Some even said they were planning to finally do what they’d always threatened: pack up and move to Nebraska or South Dakota, where the rain is supposedly better.
Very few of the farmers and ranchers we met believe in climate change, but some used the term “desertification” and spoke about the impact the drought has had on their mental health. Erik Tucker, a soft-spoken cattleman who is open about his own struggles with anxiety and depression, drew a direct line between the two.
Soil health is mental health, he told us from his kitchen table. Poor soil health, poor grass. Poor grass, poor cows. Poor cows, poor people. Poor people, poor mental health.
Mr. Tucker says he is not an environmentalist. He does not like solar farms, for example. He learned about the concept of soil health one day about a decade ago, when he was waiting out “a nasty wind storm.” It reminded him, he said, of “the 1930s, the great Dust Bowl era.”
“It was slowly driving me insane,” he said. Refusing to believe God intended for farming to feel so futile, he started researching what ranchers are trying in other parts of the world, in “brittle climates” like Australia, South Africa and Mexico, where he says people are “doing an outstanding good job” with rainfall levels similar to what they receive in eastern Colorado. As he spoke with real admiration, part of me wondered whether another virtue of something like The Coffee Break Project is that it has the potential to bring a community together around its problems, instead of keeping its members apart, in separate therapy rooms.
I ask him, hopefully, how many ranchers in the area he’s been able to share his newfound knowledge with. “Four or five,” he replies. He is unsatisfied. Cowboys are stubborn, he says. They don’t like to change.
And yet, slowly, they are.
If you are having thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.
Cassady Rosenblum (@cassadyariel) is a writer from West Virginia. She is the 2022-23 New York Times Opinion editing fellow. September Dawn Bottoms (@septemberdawnbo) is a photographer from Oklahoma. She was a New York Times photography fellow in 2020.