Rural Stress is a term coined for those working in the agriculture industry, facing a unique set of stress factors others may not even consider. Increased fertilizer costs, drought, vulnerability of commodity prices, and the looming fear of failing to keep a family’s multi-generational legacy alive are just a few of those stressors. While counseling clearly cannot change some of those factors, what a counselor can do is be a non-judgmental supporter and help turn on a light of appreciation for those great things in the farmer or rancher’s life that is often overshadowed by stress and anxiety. This was the message shared by Dr. Joseph (JC) Carrica, CEO of a rural Community Mental Health Center, delivered to Congress at a recent hearing of the US Senate Committee on Agriculture, Forestry, and Nutrition. “We can’t forget the needs of rural Americans. They feed America. They deserve our support.”
When people think about Colorado, they often think about Denver, the Front Range, and Boulder. They think of beautiful mountain towns. They think of snowy mountain peaks and ski resorts. Unfortunately, the more than 700,000 Coloradans living in rural areas of our state are often forgotten. They are the ones who have been in their communities for generations raising livestock, tilling fields, doing back-breaking labor under Colorado’s 300 days of sunshine, while trying to keep enough water on their farm or ranch during what seems like a never-ending drought. When we think about their strength, it is easy to forget they too need help and support to face life’s challenges.
These communities are not forgotten when it comes to the Colorado’s Community Mental Health Centers (CMHCs), who have made it their mission to support their communities. As Dr. JC Carrica, head of Southeast Health Group, said in his testimony to Congress, in his CMHC’s area, “the cattle outnumber the residents 7 to 1.” And often the focus isn’t on mental health; the conversations aren’t about feelings. So, they get creative. His CMHC, which serves Crowley, Kiowa, Baca, Prowers, Bent and Otero counties has created solutions tailored specifically to meet the needs of rural communities. “We can’t let stigma or the rural and frontier lifestyle become a barrier to care,” said Dr. Carrica.
When barriers to seeking help include, as Dr. Carrica puts it, “transportation, profound remoteness, or simply the fear of having your car, or pickup seen in our parking lot,” Southeast offers help with innovative options such as tele-health. And Southeast can’t do it alone. They frequently call on their partners and have strong ties throughout the community. They work together with the Department of Agriculture, the Farm Bureau, the Colorado State University Extension Office, and groups like the National Council on Mental Wellbeing and the Mountain Plains Mental Health Technology Transfer Center, to name just a few.
It’s that understanding of what connects a population and that strong bond to the community that makes a mental health center special and different than your average behavioral healthcare provider. It’s that closeness and teamwork, that makes them unique.
That bond includes community partners, but it also includes a system of mental health centers. Each of these centers have a mission to service, one that crosses county lines. As a group, they collaborate, problem solve, and work together. Even though Otero County may be hundreds of miles from Sedgwick or Weld County, they have something in common- their rich agricultural history and the issues that face rural Coloradans today.
Southeast Health Group found success in their Coffee Break Project. With the promise of free coffee and doughnuts, ranchers gather just to shoot the breeze. According to Dr. Carrica, “During conversations on weather, commodities, the increased price of fertilizer and diesel, bank loan payments, and how to deal with the end of legacy ranches and farms as children are not returning to take the operations over, mental health check-ins covertly happen.” With the catchphrase “Do you look after your neighbors as close as your crop or herd?” before long The Coffee Break Project became a safe space for deeper conversation.
In Weld County, North Range Behavioral Health found a similar issue with very serious consequences. One specific area of Weld County had seen several suicides in a row, with no acknowledgment of the cause of death or discussion of the pain that led up to it. North Range, which has its own Suicide Education and Support Services tailored to their rural community, became invested in drawing awareness to the stigma and shame and to encouraging others to open up and seek help before it was too late.
When Southeast presented a session at the Colorado Behavioral Healthcare Council annual conference, an event that celebrates the power of community behavioral health in Colorado, North Range learned of the Coffee Break Project and connected the strategies to their own corner of the state.
The two CMHCs, offering tailored rural mental health services to their very different communities have been working together since. North Range began spreading the Coffee Break Project in Weld County and the COMET (Changing Our Mental and Emotional Trajectory) training it implements. Then, Centennial Mental Health, covering Morgan, Logan, Sedgwick, Phillips, Yuma, Washington, Kit Carson, Cheyenne, Lincoln, and Elbert counties, saw a connection as well. They too became involved in the COMET training.
In a community that doesn’t want to make a fuss or talk about sensitive topics- it takes a special group, a special kind of place to create a change. It takes a place that understands its community, that has connections and ties to that community, that has ties to other resources across the state, and that is dedicated to making sure every nook and cranny of every county they represent has access to the same services. For many rural and frontier communities of Colorado- a mental health center is the only place that fits that description. It takes decades of care and coordination to achieve such insight. And it takes a special level of understanding, to create that kind of change. For now, rural Coloradans can rely on this system of care to meet their needs.