"Let me call my psychologist," said no farmer, ever.

Ted Matthews knows that. He's spent the better part of two decades as the lone state-funded psychologist for Minnesota's ag families, based out of Hutchinson, Minn.

Matthews, who, at 75, resembles a trim Santa Claus in jeans and a golf shirt, has cultivated a reputation as something of a farmer whisperer, traveling to homesteads from Roseau to Wanamingo. He knows that his taciturn, independent-minded clientele is among the most reluctant to access mental health care. And among those who might most benefit from it.

National suicide rates have been rising for most of the past two decades, with older white men in rural areas among those most at risk. Farmers, who largely square with that demographic, have one of the highest rates of suicide, by occupation, at nearly double the average.

Growing crops and raising animals is among the most stressful professions, subject to the whims of fickle weather and fluctuating markets. The work has only become more mentally taxing as small family farmers face increasing competition from corporate operators, devastating diseases, soaring production costs, and more. The start of each new year brings high-stakes financial decisions, as farmers apply for operating loans, buy seed and equipment.

Matthews notes that, just a few decades ago, 400 acres was considered a nice size family farm. But keeping up with modern economies of scale can require working thousands of acres. Farm debt is at an all-time high as farmers contend with volatile global commodity prices. "Everything looks different," Matthews said. "The issues are more complex."

The number of farms in the United States has dwindled from a high of nearly 7 million in the 1930s to roughly 2 million today. Some see the country's largest farming crisis since the 1980s looming on the horizon.

Minnesota has been a leader in supporting farmers' mental health, by providing Matthews' services at no cost, without the hassle of appointments or insurance, since the late 1990s.

Most other agricultural states simply issue vouchers for counseling sessions at a traditional clinic, which isn't as effective, said Monica McConkey, 51, a Detroit Lakes-based therapist who joined Matthews three years ago to help keep up with demand.

"Those counselors aren't necessarily what I like to call 'agriculturally competent,' and often don't have a good understanding of the really unique pressures and dynamics of farming and ranching," said the former 4-H-er, who listed several such factors, including the isolating nature of ag work, the stigma associated with seeking help, and the weight of upholding a family legacy.

"We are the envy of many, many states for the services we provide."

Focused on farmers

For most of Matthews' and McConkey's clients, farming is not just a job, but an all-encompassing lifestyle. It's an identity steeped in self-sufficiency and allergic to formality.

Which is why visitors to Matthews' downtown Hutchinson office can enter through a discreet side door. And why he replaced his fancy furniture with pieces that make his visitors feel more at home. "I had these awesome leather recliner chairs, and nobody would sit in them," Matthews explained.

Instead, there's an old kitchen table. And a faded, lumpy armchair that sees even more use, evidenced by two boot prints worn into the carpet. And Matthews, offering a fresh cup of coffee and a listening ear. "Tons of people come in nervous, but I've never had people leave nervous," he said.

After four years as an Air Force medic, Matthews decided to become a psychologist. (His father's response — "Why? I never hit your mother" — typified that generation's perception of the profession.) Matthews felt it could play to his strengths: In applying for a part-time job selling cars to put himself through school, he'd taken a personality test and received the highest empathy score the dealership had ever seen.

He worked as a hospital counselor and then became the director of a burgeoning mental health team at the Federal Emergency Management Agency in Minnesota. One day, an instructor with one of the state's farm business management programs asked Matthews if he had ever worked with farmers. Matthews assured the man they did — but after looking through his records, he realized no farmers had ever called.

Even now, in his current role with the Minnesota Department of Agriculture, farmers rarely reach out directly. Instead, they're referred by their business adviser, or banker, or their spouse, who know better than to label Matthews a psychologist, or therapist, or, heaven forbid, a shrink.

"They just say, 'Let's call Ted,' " Matthews explained.

Matthews' down-to-earth style makes clients comfortable opening up, explains his longtime friend Doug Backman, a retired farmer near Morris, Minn. "It ain't Mr. Matthews, it ain't nothing, it's just Ted — that's the way us farmers work, I guess. We're not interested in some white-collar guy to come out and tell us how to run our business. We want somebody that will talk with us."

And Matthews is willing to talk, anytime.

He takes calls on holidays. On vacations. Five minutes after coming home from the office. Even — yes — during Vikings games. "You might as well say he works 24/7, because he has that phone with him at all times," Backman said.

"There is not a phone call that he does not answer: morning, noon or night — or middle of the night," his wife, Cathy Matthews, agreed. "I'm first in his heart, but his work is his life. He devotes 100% to his clients."

So many stressors

If Matthews is always working, so are his clients. Farming is a life of long hours and infinite tasks. If something breaks, you fix it. There's no clocking out at 5. Or PTO for sickness, injury or medical appointments. You miss a lot of ball games and weddings.

Weather and finances are primary sources of farmers' anxiety. Climate change has led to more extreme rainfall and drought. Trade wars and inflation have wreaked havoc, too. Between 2013 and 2019, Minnesota's median farm profits averaged $35,000. COVID shutdowns and avian flu outbreaks have forced farmers to dump milk and euthanize animals.

Both Matthews and McConkey also cite family dynamics as one of the biggest stressors. In recent decades, wives have taken a larger role in farm operations, and want more input on decisions. And the average age of a Minnesota farmer is nearly 60, which means many are working into their 70s and 80s, often beside their middle-aged children and young adult grandchildren, without a transition plan.

Farmers often feel compelled hold onto their land at all costs, even if it means sacrificing their relationships or physical and financial health, McConkey said. When they pass their land to the next generation, or become physically incapable of farming, or face losing their family's farm for financial reasons, it can trigger suicide attempts. "It basically throws them into an existential crisis, like, 'I don't even know who I am apart from this farm,'" McConkey said. "There's a lot of grief and loss attached to the farm."

She encourages those who interact with farmers — lenders, veterinarians, community members — to watch for warning signs that someone is struggling. "There are so many farmers who live on a long gravel road surrounded by a grove of trees, and nobody's going to see them," she said.

While the typical worker can simply seek new employment after a firing or layoff, it's nearly impossible for farmers who go belly-up to start a new operation, due to the high cost of land and equipment. "The super-scary thing for farmers is that when you're out, you're out," Matthews said. "And what else are you if you're not a farmer?"

As he considers retirement himself, Matthews faces the same question. He's found great fulfillment being part of a network of people supporting family farmers — a group with a lifestyle we don't want to disappear, despite all the struggles inherent to agricultural work, McConkey noted.

"Farm kids are some of the most resilient, common-sense people that exist," she said. "And when you're living and working with family, those family ties are very strong. It provides you with life experiences that you won't get somewhere else."