APRN Rural Scholar student project by Marlene Pereira, RN, BSN East Carolina University

1. Farmer
Suicides
SCOPE AND PREVENTION
OF THE PROBLEM
MARLENE PEREIRA, RN, BSN

2. Causative Factors for Suicide in NC Farmers
COMPOUNDING
CRISES
Worsening financial
stressors
Other countries producing
crops for less
Damaging international
agricultural tariffs
Increased domestic input
costs
Nuisance hog lawsuits
Major hurricanes, wet
winters, dry springs
Farming: Way of life, no
family time, less leisure
activity
Isolated lifestyle
RISING
FARMER
SUICIDE RATE
(Spahr, 2019)

3. FARMER SUICIDE STATISTICS
 Higher than normal suicide rate among farmers,
loggers and fishermen, when compared to general
population
National Farmers Union (NFU) reports suicide rate
is almost double in farmers
 2012: Farmers as an occupational group lead in
suicide.
2015: Third highest occupation for suicides.
Suicide rate: 84.5 / 100,000
 (Farm Journal, 2019; Spahr, 2019)

4. Recognition and Prevention
What can providers do better?

5. RECOGNITION
Good baseline occupational history.
Identify risk factors for suicide in individuals.
PHQ Depression screen (PHQ-9) to assess risk.
Ask directly if the farmer has thoughts of committing suicide. (If
yes, do not leave the person alone).
Build a rapport.
Watch for mood/behavioral changes as personality changes,
alcohol/drug use, insomnia, recklessness.
Enquire about support systems (family, friends, church lifelines,
neighbors)
Ask about access to means used in suicides (firearms, pesticide
consumption, or medications).
Encourage farmers to discuss thoughts and feelings of depression
and anxiety, and more so, if psychiatric history present.
Discuss financial stressors that can lead to suicidal ideation,
referral to Farm Aid’s Advocates and NY Farm Net for financial
crises.
Talk to farmer/ families and help the spouses/ children understand
the risk and mitigation factors.
(Dickrell, 2018; Donham & Thelin, 2016; Spahr, 2019)

6. FARMER SUICIDE PREVENTION
Discuss mental health, keep lines of communication open
Encourage social worker visits to the homes
Refer to psychologist, psychiatry
Limit access to means of suicide (firearms, vehicles, narcotic or sedating medications)
Educate about calling the National Crisis line 1800.273.8255 when
suicidal thoughts prevail
Encourage them to ask for a Crisis Intervention Team member
Continue follow up’s
(Donham & Thelin, 2016; Mead, 2019; Smith et al., 2019)

7. Crisis
Resource
Lifelines
Farm Aid Hotline 800-FARM-AID (327-6243), Monday to Friday 9
am-5 pm Eastern (Suicide hotline).
National Suicide Prevention Lifeline 800-273-TALK (8255), 24/7
(Suicide hotline). 2-1-1, A comprehensive hotline that connects
callers with local resources.
AgrAbility is a resource for farmers with disabilities, and this
does list mental health resources as helplines, and national
mental health organizations.
Farm Aid’s Farm Advocates work with farmers to address
financial crises on a one-on-one basis.
NY Farm Net 1800-547-3276 nyfarmnet.org has a financial
consultant that can help with making a budget or estate planning
and a personal consultant that can help with social work or
clinical counseling, counsellors usually with agricultural
background.
The National Farmers Union’s Farm Crisis Center has hotlines,
mediation, and disaster assistance resources.
The National Suicide Prevention Lifeline (1800.273.8255) is
available for everyone, regardless of occupation.
 (Dickrell, 2018; Mead, 2019; Smith et al., 2019)

8. REFERENCES
Dickrell, J. (2018). You can help prevent farmer suicides. AG Web Farm Journal. Retrieved from
https://www.agweb.com/article/you-can-help-prevent-farmer-suicides
Donham, K. J. & Thelin, A. (2016). Agriculture medicine: Rural occupational and environmental
health, safety, and prevention (2nd ed.). John Wiley & Sone, Inc.
Farm Journal. (2019). Suicide Prevention Project aims to help distressed farmers. AG WEB. Retrieved
from https://www.agweb.com/article/suicide-prevention-project-aims-to-help-distressed-
farmers (Links to an external site.)
Mead, A. (2019). Preventing Farmer Suicides through Help Lines and Farm Visits. Rural health
Information Hub. Retrieved from https://www.ruralhealthinfo.org/rural-monitor/preventing-
farmer-suicides/
Smith, M., Segal, J., & Robinson, L. (2019). Suicide Prevention. Help Guide. Retrieved from
https://www.helpguide.org/articles/suicide-prevention/suicide-prevention.htm (Links to an
external site.)
Spahr, R. (2019). Farm Stress: N.C. Institute working to help farmers facing mental health crisis. ECU
News Services. Retrieved from https://www.northcarolina.edu/news/farm-stress-n-c-institute-
working-to-help-farmers-facing-mental-health-crisis/
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