JUANA SUMMERS, HOST:

Coping with stress, grief and even suicide have been prominent concerns during the COVID-19 pandemic, and farmers are among those most affected in this country. Two-thirds of farmers surveyed nationwide said the pandemic affected their mental health. That's according to a poll by the American Farm Bureau. Now, some Midwestern states, with the help of grants from the U.S. Department of Agriculture, are helping people who interact with farmers become a line of defense against stress. Iowa Public Radio's Kendall Crawford reports.

KENDALL CRAWFORD, BYLINE: Doug Fuller has farmed land in central Iowa about 20 miles from the state capital, Des Moines, for most of his life. He's 65, slim, energetic and wears a blue baseball cap while he tends to the brightly colored flowers that line his backyard.

DOUG FULLER: OK. And then I got impatiens and more vinca, and then this is just a hodgepodge.

CRAWFORD: This time last year, this same garden was bare. Fuller was in the middle of a yearlong battle with severe depression and suicidal thoughts.

FULLER: Hopelessness, you know, is probably the biggest thing you think of, because, you know, when this goes on for month after month after month, you know, you just feel like, is this ever going to improve?

CRAWFORD: He doesn't know what triggered it. Maybe it was a windstorm that flattened some of his crops, maybe the isolation of COVID. But he does know he only got better after he asked for help.

FULLER: I just don't see any reason to have kept all this to myself. It was as real as, you know, we are sitting here today.

CRAWFORD: The Centers for Disease Control and Prevention says farmers and ranchers are nearly two times more likely to die by suicide in the U.S. compared to other occupations. Many hesitate to tell someone their troubles.

MICHAEL ROSMANN: They're reluctant to reveal what they perceive as weaknesses when admitting that we need help is a strength, not a weakness.

CRAWFORD: That's Michael Rosmann, a farmer and clinical psychologist who specializes in agricultural behavioral health. He says farmers face a lot of factors out of their control - commodity prices, global markets - and that can lead to a lot of stress.

ROSMANN: They often show the signs of distress to people who they work with regularly. They will tell people who are perceived to be on their side about what they're going through.

CRAWFORD: The USDA has distributed half-a-million-dollar grants to states throughout the country to bolster programs that combat stress for those in agriculture. The Iowa Department of Agriculture is using that money to take its mental health outreach beyond the farm to banks, to veterinarian offices, to pesticide safety trainings. It's an effort to teach people who interact with farmers how to identify distress.

DONNA MILLS: So that's a bit different.

CRAWFORD: At the annual Monona County Farm Bureau meeting in Ute, a small town in western Iowa, Donna Mills steps up to the microphone.

MILLS: So if you open to the first page, I just want to point out a few pages with some valuable resources.

CRAWFORD: She directs the crowd to the pamphlets sitting in front of them. They're packed full with suicide warning signs and hotline numbers. The outreach coordinator says sometimes this presentation is met with awkward laughter. Other times, she sees its impact.

MILLS: There were a few sessions that I had where someone would come up after me and say, you know, there was a guy that was sitting in this training. He attempted to take his own life several times already. So thank you.

CRAWFORD: Back at his farm, Doug Fuller says his doctor and his family did ask him about suicide and then assured him.

FULLER: You know, you're going to be OK. You're going to be fine. It's hard to believe at the time, but it is true.

CRAWFORD: And he's grateful that his family and friends never stopped fighting for him. For NPR News, I'm Kendall Crawford.

SUMMERS: This story was commissioned by Harvest Public Media, a collaboration of public radio newsrooms focusing on rural issues in the Midwest and the Great Plains. If you or someone you know is in crisis, call or text 988 to reach the suicide and crisis lifeline. Just those three digits - 988. Transcript provided by NPR, Copyright NPR.