Across the West, drought conditions are the worst they've been in nearly two decades. The dry weather is hitting farmers and ranchers particularly hard, who need water for their crops and livestock. But it's not just their bottom line that's being threatened. The effect of drought and climate change on agriculture workers' mental health is increasingly concerning health care providers.

Mindy Perkovich has been a farmer for about 12 years.

"Every time I seed or plant a crop," she says. "There's like a certain amount of hope that goes with it."

Perkovich typically grows things like turnips, squash and tomatoes for the local market on seven acres. This season, though, she's had to cut her crops down to less than a single acre.

"We don't know if we're gonna have water to keep that alive," she says. "Financially, I can't really even express how dramatic it's changed in the last couple years, water-wise, because without water, we can't grow crops without crops, we have nothing to sell to our consumers."

It doesn't typically rain much in Southwest Colorado's Mancos Valley, where Perkovich farms, and last week her irrigation water was officially cut off for the season. Sacrifices like that can be really hard on farmers' mental health.

"When I walk outside of my house, and I look to the west, and most of our property is crispy and brown and dry, it makes me want to cry," she says. "You can feel it deep inside of you because when you put your heart and soul into this work, and you go outside and it feels hopeless, I don't really have the words to explain it further. I don't know. It's really sad."

Farming is risky business

Farmers and agriculture workers have the second highest rate of suicides in the county where Perkovich farms, according to a state suicide prevention group called Celebrating Healthy Communities. And, when that group looked at drought and suicide data together, they found the two spike in tandem. That tracks with research from Australia and India linking climate change to significantly higher suicide risk for farmers.

Researchers also found that farmers and agriculture workers are the second-highest at-risk population in the county where Perkovich farms. That means they're more likely to die by suicide than almost any other occupational group.

JC Carrica, a rural behavioral health specialist in Colorado, isn't surprised by the findings here. He says that, in farming there are peaks of anxiety and peaks of depression that come with the ups and downs of weather and the agriculture market.

The Centers for Disease Control and Prevention says that rural communities already have nearly double the suicide rate as urban areas. And drought is especially devastating for farmers, according to Carrica.

"When you see the wind come through and shear off whatever little bit of grass you had from a quarter inch of rain a couple of days prior," he says. "It's kind of the carrot and the stick, and sometimes there's just not enough carrot to keep people's hopes high."

Rural areas have fewer mental health and suicide prevention resources, and Carrica says more effort needs to be made to get mental health care to farmers, on their level.

Few counsellors, lots of guns

Richard McKeon, who oversees the National Suicide Prevention Resource Center, says it's not just a lack of services that's behind America's high rural suicide rate.

"People in rural communities and farming communities may be much more familiar with firearms," he says. "And perhaps, that's really a crisis that could lead to a tragic event, while there are other methods of suicide attempts that are not nearly as lethal."

But McKeon also says that it's important to understand that deaths by suicide are more complex than just one triggering event. Support from family and friends, for example, is just as important as professional mental health care.

Back on Mindy Perkovich's farm, she's had to lay off all of her employees for the first time ever, because there's no water. And also for the first time, she sought out therapy.

"I was always really resistant to reaching out to a therapist," she says. "I was like, No, I can handle this. I don't need to have somebody else help me figure out my stuff. But I will say it was incredibly helpful."

She says that she's still holding onto hope for some rain and, until it comes, all she can do is keep planting and caring for whatever crops she can.

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255