Farmers' suicide in India: implications for public mental health

Investigating the conceptual model of the formation of psychological resilience in farmers affected by droughts in Iran using structural equation modeling

INTRODUCTION

Drought has had a significant impact on farmers, resulting in a substantial increase in mental health disorders among them. This study aimed to test the model of forming psychological resilience among farmers in drought-affected regions in Iran using a valid and reliable tool designed during the research.

METHOD

A quantitative cross-sectional study was conducted in 2024 in two stages. Firstly, the tool for measuring the model components was designed. Its psychometric properties were evaluated using the content and face validity as well as Cronbach's alpha and test-retest methods. Secondly, the model was tested using structural equation modeling (SEM). The sample size was estimated as 400 farmers being selected by the cluster-random sampling method. Descriptive statistics were performed using SPSS version 22.0 and SEM was conducted using Mplus version 7.

RESULTS

Out of 400 distributed questionnaires, 387 were returned to the researchers. The psychometric results showed acceptable validity and reliability (CVI = 0.86, CVR = 0.92, and Cronbach's alpha = 0.88). The SEM results indicated that the initial model needed modifications to improve fit indices (χ²/df = 2.30, CFI = 0.67, TLI = 0.77, RMSEA = 0.042, SRMR = 0.031). The valid model for psychological resilience was achieved after conducting the modifications (χ²/df = 2.90, CFI = 0.98, TLI = 0.97, RMSEA = 0.031, SRMR = 0.021).

CONCLUSION

This study showed that the model is appropriate for the context of Iran. Utilizing the model and its components, targeted interventions can be implemented to improve the psychological resilience of farmers both in practice and in the field. Furthermore, the tool designed in this study allows for the analysis of the model's applicability in other provinces affected by drought in Iran. Based on the findings, informed decisions and interventions can be effectively formulated.

Psychological autopsy study of suicides in farmers: Study from Kerala

Background

Though agricultural farming is considered a peaceful and healthy industry it has a high rate of mortality especially suicide. In India, 11.2% of suicides are reported in the farming sector.

Aim

To identify the role of psychosocial factors leading to farmer's suicide in a farmer's dominant district of Kerala.

Material and Method

One hundred and sixty-six successive suicides in Wayanad district and age, sex, marital status, and financial status matched normal controls residing in the same locality were evaluated and compared on psycho-social demographic variables, life events, and details of suicide.

Results

Significantly a greater number of victims were living separately, living in rented homes, had no own land for cultivation, migrated, had marital discord, and strained relationships with relatives. They had loans from private financial enterprises and single money persons, had past attempts, a family history of alcoholism, and highly stressful life events. The most frequent psychiatric diagnosis was alcohol dependence/abuse followed by depression. The majority committed suicide by hanging followed by insecticide poisoning. Intention to commit suicide was expressed by 38.5% and 30.2% were intoxicated at the time of attempt. The venue for the attempt was the own house in 75.7% of cases.

Conclusion

This study suggests the following remedial measures to prevent farmers' suicides. Expert advice to manage financial constraints like availing loans, crop insurance, etc. Guidance from the agricultural department for cost-effective cultivation. Early identification and treatment of psychiatric disorders.

The wellbeing paradox in Hungarian local sustainable agriculture: a health psychology approach

BACKGROUND

The literature suggests that farmers' work involves a number of operational difficulties. Although alternative food networks address the majority of their problems, they can potentially generate new hardships. The aim of this study is to examine the situational and engagement-related work difficulties associated with the everyday world of Community Supported Agriculture (CSA) farmers.

METHODS

This study used the health psychology approach, namely interpretive phenomenology, to understand the social determinants of farmers' working lives in CSA and to explore mental health challenges within the practices of local sustainable farming. To collect data, semi-structured, in-person interviews were conducted with CSA farmers in Hungary.

RESULTS

Our study shows that new modes of consumer-producer connectivity create novel situations and issues which farmers are forced to address. Three personal experiential themes emerge from the data to describe CSA farmers' work difficulties: (1) Conflicted autonomy; (2) The pressure of boxes; (3) Social overload. The difficulties for CSA farmers seem to be rooted in the economic characteristics of alternative agriculture where farmers organize food production for the satisfaction of consumer needs. In addition, structural conditions require several different CSA farmer roles, which could even be conflicting.

CONCLUSION

This study provides participants' perspectives on the health and wellbeing costs of sustainable farming. Newer producer-consumer connections require both time and experience and involve extra effort or skills, but farmers often lack these abilities. The results show how perceptions of work processes relate to the general framework of CSA, which necessitates a distinct strategy for farm management.

Health in Food Systems Policies in India: A Document Review

BACKGROUND

Food systems affect nutritional and other health outcomes. Recent literature from India has described policy aspects addressing nutritional implications of specific foods (eg, fruits, vegetables, and trans-fats), and identified opportunities to tackle the double burden of malnutrition. This paper attempts to deepen the understanding on how health concerns and the role of the health sector are addressed across food systems policies in India.

METHODS

This qualitative study used two approaches; namely (i) the framework method and (ii) manifest content analysis, to investigate national-level policy documents from relevant sectors (ie, food security, agriculture, biodiversity, food processing, trade, and waste management, besides health and nutrition). The documents were selected purposively. The textual data were coded and compared, from which themes were identified, described, and interpreted. Additionally, mentions of various health concerns and of the health ministry in the included documents were recorded and collated.

RESULTS

A total of 35 policy documents were included in the analysis. A variety of health concerns spanning nutritional, communicable and non-communicable diseases (NCDs) were mentioned. Undernutrition received specific attention even beyond nutrition policies. Only few policies mentioned NCDs, infectious diseases, and injuries. Governing and advisory bodies were instituted by 17 of the analysed policies (eg, food safety, agriculture, and food processing), and often included representation from the health ministry (9 of the 17 identified inter-ministerial bodies).

CONCLUSION

We found some evidence of concern for health, and inclusion of health ministry in food policy documents in India. The ongoing and planned intersectoral coordination to tackle undernutrition could inform actions to address other relevant but currently underappreciated concerns such as NCDs. Our study demonstrated a method for analysis of health consideration and intersectoral coordination in food policy documents, which could be applied to studies in other settings and policy domains.

'All that Followed a Death. . .': An Alleged Celebrity Suicide, Media Discourse and Mental Health

Mortality and morbidity due to suicides have been an ever-growing burden in India. The public response to the understanding of suicidal deaths and popular perceptions are heavily dependent on media discourse and reporting of such cases. Recently, the alleged death of a young Indian celebrity due to suicide in India led to a media debacle that quickly spurred into endless speculations and sensational reporting of the associated details. Incidents of high-profile suicide often cause varied perceptions, attitudes and beliefs related to the 'act' that can get further compounded by misinformation and media-portrayal of the same. Recent cross-sectional research by Raj et al. (2020) explores the adherence of Indian media reporting of suicides for a month after the celebrity-death. It reveals that more than 80% of the news articles deviate from the prevalent Press Council of India (PCI) and the World Health Organization (WHO) guidelines for media-reporting of suicides. With this study in the background, the commentary contextualizes its findings in the Indian socio-cultural scenario, reviews the influence of media on public attitudes toward suicide, and highlights the need for active media-public health collaboration as a part of a national suicide prevention strategy. Suicides need to be viewed beyond just the 'medical or psychological health' model through a more holistic biopsychosocial framework.

Key Risk Factors Affecting Farmers' Mental Health: A Systematic Review

Recently, concern has increased globally over farmers' mental health issues. We present a systematic review of the outcomes, locations, study designs, and methods of current studies on farmers' mental health. In particular, this review aims to fill an important gap in understanding of the potential key risk factors affecting farmers' mental health around the world. 167 articles on farmer mental health were included in a final systematic review using a standardized electronic literature search strategy and PRISMA guidelines. The four most-cited influences on farmers' mental health in the reviewed literature respectively were pesticide exposure, financial difficulties, climate variabilities/drought, and poor physical health/past injuries. The majority of studies were from developed countries, most specifically from the United States, Australia, and the United Kingdom. Comparative studies on the mental health of farmers and other occupational workers showed mixed results, with a larger portion identifying that psychological health disturbances were more common in farmers and farm-workers. Knowledge of farmer psychological disorder risk factors and its impacts are essential for reducing the burden of mental illness. Further research will be required on climate change impacts, developing country farmers' mental health, and information on how to reduce help-seeking barriers amongst farmers.

Healthier land, healthier farmers: considering the potential of natural resource management as a place-focused farmer health intervention

Farmers have particular wellbeing-related vulnerabilities that conventional health interventions struggle to address. We consider the potential of natural resource management (NRM) programs, which reach large numbers of farmers, as non-conventional place-focused wellbeing interventions. Although designed to address environmental degradation, NRM can influence the wellbeing of farmers. We used qualitative meta-synthesis to reanalyse studies examining social dimensions of NRM in Australia and generate a theoretical framework identifying potential pathways between NRM and wellbeing, intended to inform subsequent empirical work. Our results suggest NRM programs influence several important determinants of farmer wellbeing, in particular social capital, self-efficacy, social identity, material wellbeing, and health itself. The pathways by which NRM influences these determinants are mediated by distal factors such as changes in land conditions, farmer skills and knowledge and resources accessible to farmers. These, in turn, are moderated by the design and delivery of NRM programs, suggesting potential to enhance the health benefits of NRM through specific attention to program design.

Psychological morbidity of farmers and non-farming population: results from a UK survey

The relatively high rate of suicide among UK farmers suggests that they may suffer greater mental health problems than the general population. This paper provides a comparison of the psychological morbidity of farmers and their partners/spouses with non-farmers. The General Health Questionnaire (GHQ-12) was administered using face-to-face interviews with 784 attendees of agricultural shows in the UK. Results show that GHQ-12 scores for farmers and their partners/spouses were significantly higher (P < 0.001) than those for the non-farming population, indicating higher psychological morbidity among farmer families. Approximately 35% of farmers had scores 12 and higher (recommended cut-off for psychiatric disorders), compared to 27% of non-farmers. Within the farmers group, male respondents, those aged from 45 to 64, self-employed or not in paid employment, having a non-supervisory position and living in a rural area were characterized by higher mean GHQ-12 scores compared to correspondent subgroups from the non-farming population.

Suicide in a Poor Rural Community in the Western Cape, South Africa: Experiences of Five Suicide Attempters and Their Families

International studies have documented the association between poverty, low education levels and poor mental health, including suicide attempts. Many farm worker communities in the Western Cape, South Africa, are exposed to poor living and working conditions throughout their lives. They also tend to suffer from chronic illness such as tuberculosis as well as widespread alcohol abuse. Many farm workers are also exposed to pesticides, which have been associated with affective disorders. Through in-depth, semi-structured interviews this qualitative study explored the life experiences of five suicide survivors and their carers to examine the factors that, according to them, predisposed them to and precipitated the suicide attempt. The impact of the suicide attempt on the family was also explored as well as shortcomings in terms of psychological support networks in the community. Contextual factors identified by the study participants that affected them included abject poverty as a result of unemployment and low education levels, childhood within dysfunctional family environments, early alcohol use and current alcohol dependence, previous and current interpersonal conflict and violence, a sense of hopelessness and the absence of coping mechanisms. Easy access to pesticides as a means for self-harm was also a common factor. Further research on the determinants of suicide attempts in this community is needed, as well as on effective and affordable interventions in remote and vulnerable communities such as these. Addressing structural problems would deal with the underlying reasons for suicidal feelings. In the meantime, shorter-term multi-sectoral interventions are needed by stakeholders such as government, civil society and faith-based organizations. These could include effective legislation and policies that regulate working and living conditions of farm workers, appropriate mental health care interventions, educational workshops, and nutrition schemes that address the unique needs of rural farming communities.