The Centre for Suicide Research was commissioned by the Department of Health to carry out research into suicide in farmers. This work included a psychological autopsy study, and studies of the geographical distribution of farming suicides, methods used for suicide by farmers and stress in farmers. We also investigated seasonality in farming suicides.
Psychological autopsy study
We carried out a psychological autopsy study of 84 farmers who died by suicide in England and Wales between October 1991 and December 1993. This involved an in-depth investigation of the circumstances of the deaths, personal and family history, social circumstances, physical and mental health, personality factors, treatments received, and problems at home and work in the year before death, using interviews with relatives or friends of the deceased together with information from coroners' records, general practitioner records and psychiatric casenotes. We used a random sample of 500 living farmers who responded to a questionnaire (see below) for comparison. Psychiatric disorder, especially depressive disorder, occupational, relationship and financial problems and physical illness were common and important factors in the suicide deaths. Running a small farm, having no confiding relationship, single status and attending a general practitioner in the last 3 months were significantly more frequent in the farmers who had died than in the living comparison group. The key explanatory variables in this study (presence of mental illness, low rates of treatment, lack of a close confiding relationship, work and financial problems and the availability of firearms) suggest that preventive interventions targeted at the farming community should involve medical, social and political strategies.
Malmberg, A., Simkin, S., Hawton, K. (1999) Suicide in farmers. British Journal of Psychiatry, 175, 103-105.
Malmberg, A., Hawton, K., Simkin, S. (1997) A study of suicide in farmers in England and Wales. Journal of Psychosomatic Research, 43, 107-111
Geographical distribution of farming suicides
The Office for National Statistics provided us with information on 719 farmers aged 17 years and over who died from suicide in England and Wales between 1981 and 1993, and, for comparison of regional rates, all deaths receiving suicide or open verdicts in 1987 for males aged 15 years and over. We analysed trends in rates of suicide in farmers and differences in rates between counties, regions and England and Wales. Farming suicide rates were compared between counties according to suicide rates in the general population, density of farmers in the local population and predominant type of farming. There was evidence of a decline in annual rates of farming suicide in the study period in England but not in Wales. There was no evidence of geographical heterogeneity of farming suicides according to counties, but a relatively high rate for Devon. County farming suicide rates did not appear to be related to local general population suicide rates, density of farmers or type of farm holding. While identification of counties with relatively large numbers of farming suicides should assist targeting of local preventive programmes, any significant prevention strategies should be implemented on a national basis.
Hawton, K., Fagg, J., Simkin, S., Harriss, L., Malmberg, A., Smith, D. (1999) The geographical distribution of suicides by farmers in England and Wales. Social Psychiatry and Psychiatric Epidemiology, 34, 122-7.
Methods used for suicide by farmers
It has been suggested that the high risk of suicide in farmers may be related to their ease of access to dangerous means of suicide. We investigated the methods used by 719 farmers who died from suicide in England and Wales between 1981 and 1993. We compared methods of suicide used by male farmers compared with males in the general population. Of 702 deaths in male farmers, firearms were involved in 40%, hanging in 30%, carbon monoxide in 16%, poisoning in 8% (over half of which involved agricultural or horticultural poisons), and other methods in 6%. Use of carbon monoxide showed an inverse relationship with age. There was a trend towards firearms being used more by the older age groups. There was a considerable excess of deaths due to firearms compared with males in the general population. Hanging was also somewhat more frequent. During the study period there was a reduction in firearm deaths; by 1993 hanging was more frequent than deaths involving firearms. Farmers who commit suicide tend to use methods to which they have easy access.
Hawton, K., Fagg, J., Simkin, S., Harriss, L., Malmberg, A. (1998) Methods used for suicide by farmers in England and Wales: the contribution of availability and its relevance to prevention. British Journal of Psychiatry, 173, 320-4.
Stress in farmers
This study investigated sources of stress for farmers in general, including financial and health problems, the effects of legislation and regulations, exposure to organophosphate compounds, and social isolation, according to geographical area, farm size and farm type. We sent a questionnaire to a random sample of 1000 farmers (members of National Farmers Union and Farmers Union of Wales (FUW)) between October 1995 and March 1996. 500 questionnaires were returned. Farmers had problems with record keeping and paperwork (62%), difficulty understanding forms (56%), and problems arising from the effects of new legislation and regulations (49%). Nearly a quarter reported financial problems and most were worried about money. Very few were socially isolated, with over 90% having at least one confidant. Nearly a third had health problems which interfered with their work. 16% of the sheep farmers reported symptoms which they attributed to organo-phosphate poisoning. The farmers most vulnerable to financial and other problems were those with small farms and mixed farming operations. Farmers in Wales also seemed more vulnerable than those in England, but a lower response rate from members of the FUW means this difference should be interpreted with caution. The survey confirmed findings from several regional studies that many farmers experience considerable stress from various causes.
Simkin, S., Hawton, K., Fagg, J., Malmberg, A. (1998) Stress in farmers: a survey of farmers in England and Wales. Occupational and Environmental Medicine, 55, 729-34.
A book containing the results of the research was published by the Stationery Office:
Hawton, K., Simkin, S., Malmberg, A., Fagg, J., Harriss, L. (1998) Suicide and Stress in Farmers. The Stationery Office, London.
Seasonality in farming suicides
Seasonality in suicide rates has long been reported. Spring peaks in suicide deaths have been positively correlated with the proportion of the workforce engaged in agriculture. Some studies have indicated that suicides using violent methods are more likely to show seasonality. Recent research has suggested that seasonal patterns have diminished. This study examined deaths in male farmers, an occupational group which might be expected to be more vulnerable to seasonal influences because of the nature of their work and the relatively high proportion of farmers using violent methods for suicide. Data on suicides between 1982 and 1999 by males in England and Wales aged 15 years and over were provided by the Office for National Statistics. Seasonal patterns of suicide in farmers and non-farmers were examined by non-parametric tests and harmonic analysis. No significant seasonal variation was found for farmers. For non-farmers, while a chi square test showed significant variation in monthly distribution, this disappeared when a harmonic analysis was applied. There was no significant difference in the variation of violent suicides through the year. This study reinforces recent findings that seasonal variation in suicide appears to be diminishing, even in an occupational group where these might be expected.
Simkin, S., Hawton, K., Yip, P. S. F., Yam, C. H. K. (2003) Seasonality in suicide: a study of farming suicides in England and Wales. Crisis, 24, 93-97.