Analysis & Comment

Opinion | ‘Do You Look After Your Neighbors as Close as Your Crop or Herd?’

Supported by

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?

Send any friend a story

As a subscriber, you have 10 gift articles to give each month. Anyone can read what you share.

By Cassady Rosenblum

Photographs by September Dawn Bottoms

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.

Source: Read Full Article