LAUSR

Background Farmers in Australia, in general, have poorer health outcomes, including higher rates of suicide. Aims To investigate risk and protective factors and attitudes towards suicide and help-seeking among farmers living and working in New South Wales and Queensland in Australia. Methods A qualitative study in which three farming sites were selected in each state to represent an area with a suicide rate equal to, below and above the state average. Focus groups were conducted with men and women separately. Results Focus groups involved 30 men and 33 women. Inductive thematic analysis showed three broad themes characterized responses: environment and society; community and relationships; and individual factors. There was considerable overlap and dynamic interaction between themes. A combination of individual factors, as well as social and environmental stressors, was described as most likely to increase risk of suicide death and reduce help-seeking. The vast majority of known farmer suicides described involved men and many of the issues discussed pertained specifically to male farmers. Participants found suicide as an act complex, intertwined with many factors, and hard to fathom. A common belief was that an individual must feel a complete lack of hope and perceive their situation vastly differently from others to contemplate suicide. Conclusions Future suicide prevention efforts for farmers should take a biopsycho-ecological approach. Physical, psychological and cultural isolation could be addressed with education and training programmes and public campaigns. These could also improve people's ability to recognize possible suicidality.