Most of the main street in Dexter, Iowa, is closed for good. Fourth-generation farmer Barb Kalbach keeps track on her drive to her husband Jim's workshop.
"The emptying out of rural Iowa is this, square mile by square mile," she told CBS News.
Part of what she's seeing is a major decline in small farms. Around 90% of small farms in the area have shuttered, unable to survive shrinking profits, climate change and corporate farming, the Kalbachs told CBS News.
And it's not just Iowa — in the last two decades, more than 100,000 small farms have disappeared in America.
The Kalbachs have one of the few family farms left in Dexter.
"The last 20 years have been terrible," Jim Kalbach told CBS News. "You gotta be great big or you just as well forget it. Five hundred acres won't do it anymore — you need 5,000."
Those who remain are barely holding on. According to the Centers for Disease Control and Prevention, farmer suicide rates have spiked 40% in less than two decades.
That's why the Minnesota Department of Agriculture has launched a hotline to help.
A worker at the Minnesota Farm and Rural Helpline, Cre Larsen, told CBS News their team fields about 30,000 calls a year.
"Some of the farmers call in the middle of the night," Larsen added. "Two in the morning on their tractor, trying to get the tilling, because they know seeding has to happen — 'Can you just talk to me? Can you help keep me awake?'"
The most urgent calls are answered by Ted Matthews, who once led the Federal Emergency Management Agency's mental health response.
"The first call, they're very timid," Matthews told CBS News. "They're not sure whether they should have called."
Matthews also said "It's overwhelming how difficult things are in farming," adding, "There's not a minute where a farmer doesn't feel stressed. There's something always going on that could go wrong."
Matthews said the number of farmer suicides in Minnesota has started to drop as more farmers call and connect.
"This idea that you have to get so bad in order to see a therapist is a foolish one," Matthews said. "Why wouldn't you want to be healthier?"
If you or someone you know is in emotional distress or suicidal crisis, call the National Suicide Prevention Hotline at 1-800-273-TALK (8255).
For more information about mental health care resources and support, The National Alliance on Mental Illness (NAMI) HelpLine can be reached Monday through Friday, 10 a.m.-6 p.m. ET, at 1-800-950-NAMI (6264) or email firstname.lastname@example.org.
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