“Cowboy up.”

It’s a phrase uttered often in the wide opens of Colorado.

“Walk it off.” “Tough it out.” “Strap your boots back on and get ‘er done.”

It’s the Cowboy Code, and out in mountain towns like Durango, that code still hangs in the air like an old ghost from the wild West.

Ranchers and farmers live it, mountain bikers and extreme skiers embody it, even shopkeepers trying to hang on for dear life embrace it.

“I grew up on a ranch and I knew that culture well,” La Plata County Commissioner Marsha Porter-Norton said recently.

“It’s like, ‘Get your proverbial stuff together and just go get it done. If you get bucked off … you can just get up.’”

I’ve spent some time in a number of mountain towns this year — Durango, Telluride, Breckenridge, Ouray, Del Norte — and I’m starting to see that our stoic Cowboy up culture isn’t working very well for us right now. In fact, it’s killing people.

“It doesn’t always work,” Porter-Norton said at a recent townhall on the raging mental health crisis in Durango. Porter-Norton, a longtime social worker and advocate for healthy communities, was the keynote speaker at the forum focused on mental health solutions and sponsored by The Gazette and Writers on the Range. “It doesn’t always work to get the kind of help and support that you need.”

Keep your emotions in check. Talk less and say more. Treasure your independence and self-reliance. All the qualities that define a good Westerner are working against our good mental health. Turns out those great, empty lands can leave you feeling pretty empty. All that wide-open space often isolates Westerners from each other. And those hard winters can make a person a little too hard.

We may revere cowboys, but they can be pretty unhappy campers emotionally. 

“How did we get to a place where people with severe emotional crises are literally lying in the streets?” Porter-Norton asked the crowd in Durango recently.

According to a survey from the county’s public health department, the suicide rate in La Plata County is 30% higher than the Colorado average, which is 36% higher than the national average.

That makes La Plata County one of the worst incubators of suicide in the country.

But when I visited Durango, I saw a town that is fighting back, just like Vail, Summit County, Telluride and other mountain towns. Those high suicide rates have been a wake-up call that is echoing off mountain walls like a blaring siren right now.

All around the Mountain West, I’ve seen towns itching to Cowboy Down a bit if it means getting their residents healthier.

On May 5, for example, Vail opened its first-ever psychiatric hospital after a $60 million fundraising effort.

“These are the only psychiatric beds in all of western Colorado, actually, between here and Salt Lake City. This is it,” Chris Lindley, executive director of Vail Health Behavioral Health, told our reporter David O. Williams.

Durango is soon to follow suit, with plans in the works for a recovery campus to treat mental illness and substance abuse.

“The more we talk about this as a community, the more important it is,” Porter-Norton said at that town hall.

Porter-Norton is a founding member of the SouthWEST Opioid Response District (SWORD) board of directors, which is deploying $7.7 million in opioid settlement funds to support substance abuse and behavioral health programs in La Plata County.

A state-funded program in La Plata and Montezuma counties already trains local community members in mental health prevention. 

La Plata County Public Health now has a harm reduction coordinator, Sierra Roe, to help those with substance abuse challenges.

The La Plata County Suicide Prevention Coalition is a collective of community members working directly to reduce suicide attempts and deaths. 

‘When I was growing up, there were like two choices,” if you faced a mental health challenge, Porter-Norton said. “And now it’s just a whole range. There’s young people in recovery, there’s family recovery. There’s a lot less shade on the fact people in recovery may choose different life paths to get there. And I think that’s really exciting.”

She mentioned that Axis Health is one of the best at providing counseling services, psychiatric care and crisis interventions in Durango.

Southwest Colorado now has five mental health co-responder programs in five counties, in which sheriff’s deputies and police officers are paired with mental health workers to go out on calls that involve mental health crises rather than crimes.

“The legal system is the worst place for people with mental illness,” said Porter-Norton. Co-responder programs like Durango’s CORE team have had huge success in keeping mentally ill people out of jail.

“The people at our jail with mental illness, it doesn’t help them, and often exacerbates their mental health issues. So that’s why all these other solutions … are so important,” added Porter-Norton.

The Colorado Behavioral Health Administration now funds more than 30 such initiatives in rural areas around the state.

Durango also has launched several mental health programs for youth, including La Plata Youth Services, Four Corners Rainbow Youth Center and The Hub.

Farther south, the Southern Ute Indian Tribe Health Center has started seeing success at addressing Native American mental health issues.

“So there’s a lot going on in the community,” said Porter-Norton. “We’ve come long way. But we have a long way to go.”

Now she’s worried about cuts to Medicaid being pushed by the U.S. House of Representatives, which she said would strain mental health services just as they are starting to gain a foothold.

“One-fourth of the people in La Plata County are on Medicaid, and it funds mental health and behavioral health services,” Porter-Norton said at the town hall.

The current budget plan lawmakers are trying to pass through Congress would cut $625 billion from Medicaid.

What happens if those cuts are passed?

We’ll probably see backsliding on mental health in our mountain towns rather than continued forward progress. The residents with the fewest resources around the West will likely revert to their default response, put their heads down, and Cowboy Up once again.