Lance Wheeler, in front of dozens of hay bales shipped in from South Dakota, looks out on his pastures on his family ranch, Rafter W, near Simla, Colorado. Due to the drought impeding hay production in Colorado, he's has had to buy hay far from the state. Lance feels the drought has been a bigger stressor for him than the pandemic.

Mental Health in the High Plains

Pitched, co-reported and photographed for Kaiser Health News with Vignesh Ramachandran.

Agricultural workers in rural communities endure a lot every day to supply food to the world. As one official put it, they're "absorbing a lot of the shocks to the system for us: hailstorms, pest outbreaks, drought, markets - they're adjusting for all that to keep food production moving."

Their extremely hard and financially difficult work in an severe drought, a pride in self-sufficiency that has stigmatized mental health, little access to health providers in rural areas and slashed public health budgets have led to a mental health crisis in rural communities, all compounded by the pandemic. And the trouble is, this isn't new.

Lance shares a moment with one of his cattle on the ranch. “I guess my cows are my therapists,” he said. Connection with the animals and land helps him get through stressful times on the ranch.

Surrounded by ranching decor, Roberta Kusma, left, laughs with her old friend Betty Hood at Patty Ann’s Cafe in Kiowa, Colorado. The cafe has always been a meeting place for ranchers to talk shop about their shared experiences. In a county with very few mental health resources, Patty Ann's is essential to the community.

Different services, like counseling, are advertised at a healthcare office building in Elizabeth, Colorado on the far western edge of Elbert County. The county has no hospitals and few physical and mental healthcare resources. Those that are available are concentrated in the western part of the county closer to the Denver metro area.

The Elbert County Department of Health and Human Services sits at the edge of the town of Kiowa, butting up against the prairie.

Ranch gloves are seen on a mental health awareness poster as Dwayne Smith, Elbert County's public health director, works in his office at the Department of Health and Human Services in Kiowa, Colorado. “Time cards and schedules have had no meaning for the past year,” said Smith, one of three full-time employees at the department. “It’s just been never-ending.” The health department, which had at least six nurses 15 years ago, has no nurses and no clinical services available after being cut to the bone. Often, all Dwayne can do is try to destigmatize mental health through daily pandemic newsletters.

The National Suicide Prevention Lifeline phone number is taped with other notes onto Dwayne’s office cabinet.

Signs meant to destigmatize mental health struggles during the COVID-19 pandemic sit inside Dwayne’s office.

The old medical clinic room inside the Elbert County Department of Health and Human Services building has turned into a storage closet. A Halloween pumpkin candy bucket and out-of-date medical equipment clutter the room, among other things.

Farmer and rancher Laura Negley walks by a water tank, not in use at the time, filled with tumbleweeds on her family’s native grass pasture in Eads, Colorado. Unpredictable weather, a volatile commodity market and a 700-acre grass fire cost her a lot of income around 2012, leading to anxiety and some depression.

Bills sit on the counter in Laura’s family home in Eads. The financial stresses of farming and ranching are significant factors leading to mental health struggles in agricultural workers.

A prayer is framed next to photos of Laura’s son, Jayce, in her home. She was devastated after the 2012 financial losses, followed by Jayce’s departure for college. “That’s kind of when the wheels fell off for me. And then I kind of spiraled down,” Laura said.

Laura and her husband, John, say a prayer before dinner in their home. She says her Christian faith has helped her through anxiety and depression.

Laura looks out on her family’s native grass pasture. Severe drought over the last decade has degraded this pasture and many others. They're likely to not have cattle this year due to the drought impeding grass growth.

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