European Journal of Cardiovascular Medicine

Suicide is a serious public health problem around the world and one of the biggest causes of early mortality, especially in nations with low or medium income levels. Researchers, public health specialists, and policymakers in India have noticed that the number of farmers who kill themselves has been going up alarmingly over the past few decades [1, 2]. This is a big social, economic, and mental health problem. Farming used to be seen as a safe job, but now it's increasingly usual for farmers to experience financial problems, work-related stress, and mental health issues [3, 4].

Farmers are under a lot of stress because of things like climate change, crop failure, rising input costs, unstable market pricing, and not being able to get institutional finance. Debt is a big reason why people are having more and more trouble with money, and using informal moneylenders often makes things worse. There are already a lot of problems with the economy, and social commitments, family expectations, a lack of good work options, and weak social security systems all make things worse. All of these conditions make farmers more likely to have mental health problems, feel unhappy, or even think about or act on suicide [4, 5].

Socio-demographic parameters such as age, gender, married status, education level, family composition, landholding pattern, and socioeconomic status significantly influence the probability of an individual attempting suicide. To identify high-risk groups and underlying sociocultural causes, it is essential to comprehend these factors among farmers who attempt suicide. Research on suicide thoughts and attempts undertaken in hospitals is beneficial since it encompasses individuals who have survived and can articulate their personal experiences leading to the attempt [6, 7].

There is insufficient complete data regarding the socio-demographic profile of farmers hospitalized following suicide attempts, which is a significant issue. This type of data is needed to make mental health services better and to create successful agricultural and social welfare projects [8]. This study aimed to analyze the socio-demographic characteristics of farmers who were hospitalized following suicide attempts, to aid in the formulation of preventive measures and policies.

This was a descriptive, cross-sectional study conducted in the emergency and psychiatric departments of a tertiary care teaching hospital. The research was conducted over the span of one year including farmers who were admitted subsequent to a suicide attempt. This study was conducted at the Department of Psychiatry, Deccan College of Medical Sciences (DCMS) Kanchanbagh, Hyderabad, Telangana - 500058, India between October 2019 to September 2020. The study included 30 patients who were classified as farmers and admitted following suicide attempts during the study period. Data Collection Tool and Procedure: We used a pre-designed, semi-structured proforma to gather data after we got informed consent. Demographic information was documented, including details about the participants' ages, genders, marital statuses, educational backgrounds, family types, landholding sizes, income levels, debt levels, and crop failure histories. From patient interviews and medical records, details regarding the technique of suicide attempt were also noted. The privacy of the people who took part was guaranteed. Inclusion Criteria: • Farmers admitted to the hospital following a suicide attempt. • Patients aged 18 years and above. • Patients who were medically stable and able to provide informed consent. • Both male and female farmers. Exclusion Criteria: • Patients with accidental poisoning or injuries not related to suicide attempts. • Farmers with severe cognitive impairment or altered sensorium preventing reliable data collection. • Patients who refused to give informed consent. • Non-farmers admitted following a suicide attempt. Statistical Analysis: Microsoft Excel was used for data entry, and the right statistical programs were used for analysis. The outcomes were presented as percentages and frequencies after descriptive statistics were used.

In this study, 30 farmers were included who had admitted to having attempted suicide. Tables 1–5 show the socio-demographic parameters, economic variables, and suicide attempt techniques.

Table 1: Distribution of patients according to age and gender

Table 1 shows that men made up the bulk of the patients. Farmers in their middle years were the most at risk, since 60% of suicide attempts occurred in the 31-50 age bracket.

Table 2: Marital status and type of family of the study participants

It appears that those who attempted suicide had more familial and financial commitments, as Table 2 reveals that 73.3% of the farmers were married and 63.3% belonged to nuclear families.

Table 3 shows that 56.7% of the patients were either completely illiterate or had only completed elementary school. Their low socio-economic position was seen in the large percentage (66.7%) whose monthly income was less than ₹10,000.

Seventy percent of the patients were small-scale or marginal farmers, as seen in Table 4. Major economic stresses contributing to suicide attempts were highlighted by the fact that 76.7% were indebted and 56.7% had reported crop failure in the preceding year.

Table 3: Educational status and monthly income of the patients

Table 4: Landholding pattern, indebtedness, and crop failure

Table 5: Method of suicide attempt among the study participants

The simple availability of harmful substances among farmers is reflected in the most common means of suicide attempt, as indicated in Table 5, which is pesticide poisoning (66.7%) followed by other chemical poisoning and hanging.

This cross-sectional study examined the demographics and socioeconomic status of 30 farmers who were hospitalized following an attempt at suicide. It found that these farmers are particularly susceptible to the devastating effects of agricultural and social stresses.

Consistent with other studies conducted in India that found greater rates of suicide attempts among male farmers, the present study found a strong male predominance (76.7%) [9, 10]. This might be because men have traditionally been expected to take care of the home front, be financially secure, and work the land. People between the ages of 31 and 50, who are often seen as being in the prime of their lives in terms of both economic productivity and social responsibility, made up the bulk of those who attempted suicide. Consistent with earlier research, this is the age at which accumulated stress from work, debt, and family obligations reaches its highest point [11-13].

Most of the people who took part were married (73.3%) and most of the families who participated were nuclear (63.3%). In times of economic hardship, farmers may experience even more stress due to the increased financial and emotional obligations that come with marriage and the nuclear family structure. During times of crisis, it might be even more difficult to cope without the support of extended family, which is often present in mixed families [14, 15].

Half or more of the farmers did not have a high school diploma or equivalent, meaning they were unaware of government assistance programs, crop insurance, or other ways to supplement their income. There is strong evidence linking low levels of education to an individual's inability to cope and their lack of access to social services. Also, it is known that poor socio-economic position and financial instability are risk factors for suicide conduct, and two-thirds of the patients had monthly incomes below ₹10,000, indicating this [16-18].

Among the factors that contributed most to suicide attempts, this study found agricultural and financial stresses to be significant. Most of the farmers were small or marginal farmers, accounting for 70% of the total. These farmers are especially susceptible to changes in crop yield, market pricing, and weather. Due to recurring crop failures and dependence on high-interest loans, 76.7% of participants reported being indebted. Suicide attempts were likely triggered by the fact that over half of the farmers had agricultural failure the year before [19]. These findings highlight the significant impact of agricultural hardship on farmer suicides that have been documented in several parts of India.

Given the prevalence of harmful agricultural pesticides and their relative ease of access, it is not surprising that pesticide poisoning accounted for 66.7% of all suicide attempts. Consistent with previous research, this conclusion highlights the necessity of better pesticide control, safer storage methods, and more public understanding of their deadly potential [20, 21].

A number of factors, including socio-demographic vulnerabilities, economic stress, indebtedness, and agricultural instability, contribute to the present study's overall conclusion that suicide attempts among farmers are multifactorial. There needs to be a concerted effort to reduce farmer suicides across several domains, such as primary care mental health services, social and financial support networks, government assistance programs, and agricultural sustainability. The key to preventing suicide attempts among high-risk farmers could lie in early identification and prompt intervention [22, 23].

The present study identified that middle-aged married men from nuclear families, characterized by low educational achievement and income, exhibited the highest propensity for suicide while engaged in farming activities. Most importantly, there were economic and agricultural stresses, notably those related to small or marginal landholdings, debt, and recent crop failure. Suicide attempts through pesticide poisoning are prevalent, underscoring the necessity of accessible dangerous agricultural pesticides. These findings underscore that farmers' suicide attempts are influenced by socioeconomic and agricultural adversities, rather than only by individual mental health issues. A comprehensive preventative approach is essential, encompassing financial assistance, debt alleviation, and crop insurance, regulated pesticide access, and enhanced mental health services. Early identification of high-risk farmers and targeted socio-economic interventions may help lower the number of suicide attempts and improve the overall health of the farming community. Funding None Conflict of Interest: None

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