Three decades later, a call to 1-800-FARM-AID rings the cellphone of Joe Schroeder. Callers are in such dire straits that the father of two toddlers answers day and night. “I talk to suicidal farmers regularly,” he says. “Almost all of them are facing foreclosure.” Call volume is on the rise: Schroeder averaged 38 calls a month in 2016, and 56 calls a month in 2017; so far, the average this year is more than 70 calls a month. His job is to connect farmers with mental health services and low-cost financial and legal advice — anything that can help. “It’s about just being there for them,” says Schroeder, “and warming them up to the idea of filing for bankruptcy, which is often the only option left by the time they call me.”

The average farm income dropped 45 percent between 2013 and 2016 and continues to fall — a trend precipitated by a global glut in agricultural commodities. Meanwhile, the costs of land and supplies are growing, pushing farmer debt far above 1980s levels. Farmer bankruptcies are indeed rising, though agricultural economists say that today’s low interest rates are staving off a crisis on the scale seen in Reagan’s day, when rates climbed as high as 20 percent. The authors of a January report from CoBank, a major ag lender, saw no cause for mass hysteria just yet, but they did sound an early alarm bell: Economic indicators, they say, are “creeping closer to the concerning levels of the 1980s.”

The days when farm foreclosures top the headlines again may not be far off. But there is no question that something is deeply askew in rural America, as evidenced by a different set of stats. Part of what garnered public attention about the plight of farmers in the 1980s was a wave of suicides sparked by financial stress, yet the farmer suicide rate is now 50 percent higher. Farmers today have the highest suicide rate of any occupation in America — about five times higher than the general population and twice that of veterans, according to a 2016 report from the Centers for Disease Control and Prevention. That same year, the National Institute for Occupational Safety and Health found that farmers also have the highest rate of death due to stress-related conditions, ranging from heart disease and hypertension to ulcers and nervous disorders.

Unlike bankruptcies and foreclosures, these trends can’t be pegged to downward swings in the bushel prices of corn and wheat. In the course of speaking with farmers and farmer advocacy groups for this article, it became clear that systemic, generational issues are coming to a head in agricultural communities. It’s as if the stress and instability of the 1980s never disappeared but rather became the norm in agriculture.

Late last year, another disturbing report made it clear that the situation in farm country is worse than initially feared. Three in four farmers surveyed said that someone they know has been affected by opioid addiction, and one in four admitted that someone was them. That’s compared to about five to 10 percent of the rural population at large, and it’s a far cry from the estimated one percent of all Americans who are thought to suffer from opioid addiction.

The opioid epidemic, characterized by users who first get hooked on prescription painkillers and then move on to street drugs like heroin, fentanyl and the mind-bogglingly fatal carfentanyl (a dose the size of a grain of sand can kill you), has made drug overdoses the number one cause of death among Americans under the age of 50, having surpassed homicides, heart disease and car crashes last year. The epidemic is well known in the hinterlands — the per capita overdose rate is highest in rural counties and increasing three times faster than in urban areas — but the outsized role of farmers in that picture has come as a shock to many.

“It’s an explosive issue,” says Roger Johnson, president of the National Farmers Union (NFU), one of the organizations that commissioned the survey. “There has been a lot of surprise about it, but when you talk to farmers, they’re like, ‘Yeah, I know some people.’”

Farmers may recognize that drug addiction is a problem in their communities, but the survey found that they think the bigger opioid problem resides in cities. Johnson believes that this gap between perception and reality reinforces the stigma of drug addiction in rural areas. People feel like it’s a case of a few bad apples, he says, not something that three in four of their neighbors are dealing with, which subverts any effort to do something about it. “The families affected often don’t realize that the family down the road is affected, too,” says Johnson. “We need to make it OK to talk about this.”

In January, the NFU and American Farm Bureau Federation (which co-sponsored the survey) rolled out Farm Town Strong, a joint campaign to raise awareness of how opioid addiction is eating away at the folks who feed this country. So far, it has largely amounted to a media blitz — the hope is to reduce shame and denial by reframing the choice to enter drug treatment as an act of courage rather than a sign of moral failure.

But there’s also a political bent. The left-leaning NFU represents the interests of its 200,000 members in Washington, alongside the larger, right-wing Farm Bureau. They often disagree on agricultural policy, but one would hope this topic rises above partisan politics, says Johnson. “This town could use some better examples of folks working together,” he says.

Dairyman Jay Simeral counts himself among the 75 percent of farmers affected by the opioid epidemic. He doesn’t use drugs, but members of his family do, and gossip in his hometown of Adena, Ohio (population 712), is replete with heartbreaking tales of overdoses. He says only a handful of farmers remain in the area — a poverty-stricken part of the state along the border of West Virginia. Most have already sold out to coal companies, whose strip-mining practices have decimated the rolling landscape.

When I spoke to Simeral in March, the 52-year-old was still milking his 28 cows, but he knew he’d have to sell the herd soon, if not his land. After two years of steadily declining prices, U.S. dairy farmers currently earn about $14 per hundredweight (about 12 gallons) of milk, roughly $8 below the break-even point once expenses are taken into account. Simeral says that he is about $3,000 in the red every month. “I’m behind on all my bills,” he says. “I have huge loans I can’t pay, and my credit is maxed out. I’m cutting corners everywhere I can, but I don’t see how I’m going to make it.”

Financial problems are nothing new for the Simeral family. He and his dad both suffered work-related injuries about six years ago, and a downswing in the market around the same time forced them to sell off their herd.

He has a history of anger issues, which nearly destroyed his family life in the past. “I wanted to hurt people,” he says. “If someone said something negative about farming, I wanted to tear their head off.” Through therapy, Simeral realized that anxiety and depression were at the roots of his rage. Things got better — until recently. The prospect of losing his herd is not only a matter of financial ruin but also a loss of the one thing that provides a measure of respite. “Some people go to the bar to drink,” he says. “For me, going to the barn to milk is my release.”

Simeral’s ancestors first settled the 114 acres he calls home in 1778 — the family still possesses the original land grant deed, with Thomas Jefferson’s signature on it. That 240-year lineage may end with him, though. The feeling of loss is visceral.

“A lot of people probably can’t understand this, but when a cow leaves the farm, part of you goes with her,” he says. “I cried like a baby every time my dad loaded a trailer of cows that had been sold.” Tears flowed in the supermarket aisle, too. “After we quit milking, I went grocery shopping with my wife,” he says. “She picked up a gallon of milk and I just broke down and bawled right there in the store.”

In 2015, milk prices swung back up and Simeral decided to give farming another go. The good prices lasted only a year. Late this winter, Simeral dialed Schroeder at Farm Aid, seeking a lifeline. “I don’t know if I’ll be able to pick myself up this time,” he told me a few weeks later, his voice cracking. “When worry kicks in, it doesn’t keep me awake; it just makes me not want to wake up.”

Apart from persistent economic duress, experts point to an array of other factors behind the growing mental health crisis among farmers.

Exposure to certain agrichemicals is known to wreak havoc on the nervous system, and some studies suggest that mental illness is a frequent result. During planting and harvesting seasons, farmers routinely work almost around the clock atop heavy machinery — a lifestyle that makes agriculture one of the most injurious professions. Painkillers prescribed for injuries are a well-worn gateway to opioid addiction, and anecdotal evidence suggests that self-medicating with drugs and alcohol to get through the long shifts is widespread in agriculture. Some experts speculate that many farmer suicides are disguised as machinery accidents.

A rich social life — one of the keys to preventing small personal challenges from snowballing into unbearable depression — can be harder to come by in the country. Isolation is part of the job for many farmers in an age when one person on a giant tractor can commandeer a thousand acres on his own. “Farmers have a lot of head time,” says Jolene Lichty, a therapist in O’Neill, Nebraska, who has counseled farmers for a quarter of a century. She, too, has seen an uptick in severe cases of depression and suicidal tendencies. “Between their guns and machinery, most farmers have plenty of tools to make that happen.”

Tight-knit faith-based communities can form a powerful safety net when times are tough. But the conservative norms of rural America may form a roadblock when dealing with mental health issues — stoic, aging farmers aren’t the type that easily adapt to changing times.

Most farmer suicides are men, as are most of Lichty’s clients, many of whom have lost both their livelihoods and their marriages. She believes that, after financial stress, the second biggest factor in her clients’ misery is the entrenched notion that men must swallow their pain and carry on. She urges them to swallow their pride instead. “Farmers feel like they should be able to pull up their bootstraps and handle it, but they need to understand that depression isn’t a character flaw,” says Lichty. “I tell them it takes more balls to come to counseling than not to.”

Finding a path forward as a farmer, rather than calling it quits and taking a minimum-wage job at the nearest Walmart, also takes balls. There’s a tendency among affluent urbanites to suggest that struggling farmers are simply a casualty of modern times and that they should get over it and change careers. Simeral finds the notion unrealistic and insulting: “What kind of job is a 52-year-old farmer going to get in a depressed area?” He has tried, working on and off as a car mechanic in town over the years, but he keeps getting laid off. “I believe farmers have a right to make a living,” he says.

I asked him why he doesn’t transition to organic production, which is generally more profitable, but I immediately regretted it (apparently, he has heard that one before, too). Cattle feed is, by far, his biggest expense and costs at least twice as much when it’s certified organic. Before you’re eligible for certification — and the price premium that goes along with it — you have to use organic feed for three years, he grumbled. I could feel him seething under his breath, thinking, You do the math, asshole.

What are realistic solutions? A wholesale restructuring of the agricultural economy will take a generation or more. The 1980s crisis created the political will for a handful of modest legislative reforms, most notably the Agricultural Credit Act of 1987. Hopefully, this go-around will see more progress.

Meanwhile, the dearth of mental health resources and drug treatment facilities in rural areas isn’t helping. Farm Aid offers the only national hotline for farmers in crisis, and Schroeder is its sole, overworked staffer.* Most farm-heavy states had hotlines in the 1980s, but only a handful of them remain today. In March, Agri-Mark, a large dairy processor in the U.S. Northeast, included the number for the one in New York on a flyer tucked into envelopes with the monthly milk checks to farmers. A spokesman said the company will soon set up its own mental health assistance program.

Nebraska is the rare state with not only a hotline but also free vouchers for farmers to receive counseling (this is how most of Lichty’s clients come to her). These aren’t administered by the state government but by a religious charity, the Interchurch Ministries of Nebraska. In the first six months of 2018, the organization fielded an average of 58 calls per month from people requesting counseling services, up 240 percent from the same period in 2016. But this is only a fraction of hotline callers — many call ostensibly for financial and legal help, but end up accepting counseling services, and the organization currently mails about 200 vouchers per month.

Politicians are slowly catching up to the crisis. This spring, legislators in Washington passed a bill that will fund a network of mental health services for farmers. In Washington, D.C., members of the House of Representatives hope to revive the STRESS Act, which is part of the 2008 Farm Bill that would have created a similar network on a national scale if it had received funding.

President Donald Trump is a wild card in this scenario. He has pledged billions of dollars to address the opioid epidemic, but he has also pledged to execute drug dealers in the manner of some of the authoritarian leaders he admires. Neither of these has come to pass. But Trump’s recent trade spats are undercutting the bottom line of many American farmers who face insolvency.

China retaliated against Trump’s tariffs on steel and more than 1,000 other goods this spring with tariffs on scores of agricultural products, including a crippling 25 percent tax on imported American pork and soybeans. Soybean farmers were already struggling to make a living, with the price per bushel hovering at or below the cost of production in recent years. China typically buys 60 percent of the U.S. soybean harvest, meaning that America’s 300,000 soybean farmers may see catastrophic losses come harvest season.

Dairy farmers, who currently face an even more dire economic situation than soy and grain farmers, are anxiously awaiting the outcome of the North American Free Trade Agreement (NAFTA) negotiations. Dairy exports to Mexico have grown 885 percent since Bill Clinton signed the trade pact nearly a quarter of a century ago, much of which would be wiped out overnight if Trump follows through on his recently renewed pledge to “rip it up.”

The President’s apparent disregard for farmers is ironic, given that most of them voted for him. Much lip service has been given to the narrative that laid-off factory workers in the Rust Belt sparked the populist revolt that brought him to power, but it was fueled just as much by disgruntled farmers.

“If we lose our trading partners, it will be the nail in the coffin for many people in agriculture,” says Michelle Specht, director of a regional Farm Bureau chapter in eastern Ohio, which includes the county where Simeral lives. She and her husband both grew up on dairy farms in the area and maintained a herd of their own until, like the Simerals, the downswing six years ago forced them to sell out. “I just couldn’t take watching my husband kill himself trying to make it work and having nothing to show for it,” says 62-year-old Specht.

It’s hard not to take her morbid metaphors literally. Specht’s husband still grows corn and hay, but she considers herself lucky to have a job at the Farm Bureau. Her role is to advocate for whatever cause will be most helpful to local farmers, which has meant trying to do something about the opioid problem for the past two years. Ohio has one of the highest rates of overdose per capita in the country. “We all know a family that has been affected,” she says. That includes hers: “My 83-year old mother has a prescription-drug problem,” she says. “We feel like we have it under control now, but it’s an addiction that she’ll probably have for the rest of her life.”

Instead of trying to help farmers and their families get off drugs, Specht has turned her focus to keeping kids from ever getting on them with a massive campaign run through local 4-H clubs and Future Farmers of America chapters. Her parallel concern is whether those kids will have any interest in agriculture when they grow up. “Farmers here have to feed their cows before they feed themselves,” she says. “I don’t see how the next generation will be willing to work as hard as their parents and never make a dime.”

I ask what she and her neighbors — about two-thirds of whom voted for Trump — think of the President at this point. Specht says she’d prefer that our conversation not get political. “I can’t speak for others,” she offers, lowering her voice, “but I know how I feel about him.” (Wink, wink.)

Simeral is much more frank when I pose the question: “He doesn’t give a shit about us. A lot of people around here are like, Boy, what a mistake.”

*Recognizing the increased need, in July Farm Aid added another in-house farm advocate, Annie Heuscher.