The hidden toll: rural suicide
Health researchers are trying to find ways to improve support for growers for whom isolation and cumulative financial and emotional pressures lead to a tragically high incidence of suicide.
It was no coincidence that the Australian Government’s commitment to increase funding for mental health services was part of its drought-relief package announced in February.
The pledge came in the wake of 60 per cent of New South Wales and 70 per cent of Queensland not receiving any significant rain for almost two years, while October frosts ruined a promising season in parts of NSW and Victoria, and unseasonal rains reduced 2013 harvest outputs in Western Australia.
It was clear to rural health experts that the emotional toll would be high.
Behavioural scientist and rural health researcher Alison Kennedy, based at Victoria’s National Centre for Farmer Health (NCFH) in Hamilton, says the underlying reality for so many growers is that pressures have accumulated from occurrences such as severe and unpredictable climatic patterns, higher workload demands, regulatory red tape, commodity price volatility and a decline in rural infrastructure – especially social infrastructure.
“It is not an isolated incident but rather the cumulative impact of multiple factors that pushes people over the edge,” she says.
“Suicide can never be pinned down to one cause. Farmers today are confronted by many burdens, including issues that didn’t exist in the past, but it’s the sudden change in circumstances that hits people the hardest.”
The government’s commitment to mental health issues is seen as a necessary recognition of the circumstances facing many people in rural areas. The most recent Australian Bureau of Statistics suicide figures (2011) identified male agricultural workers aged 25 to 44 as the third most likely group to take their own lives after young Aboriginal men and isolated elderly men.
A review, published in the latest edition of the journal Rural and Remote Health, co-authored by Alison Kennedy, Associate Professor Myfanwy Maple and Dr Kathy McKay from the University of New England (UNE), and Associate Clinical Professor Susan Brumby from the NCFH, cites Australian research that showed suicide rates among growers and farm managers were more than double that of other occupational groups.
Mrs Kennedy says while there is consistent reporting of heightened levels of this risk in farming communities, the research is limited. This is because data collection is complex and varies between state and national jurisdictions, and “it takes years for accurate numbers to come out of the Coroners Court”.
“Rural suicide may also be under-reported due to concerns about stigma and confidentiality in smaller communities, or where survival of a family farm relies on a successful insurance claim,” she says. She says there is no standardised process across Australia for investigating these tragedies.
The situation is also intensified by growers’ aversion to seeking help for mental health issues, particularly depression, which health researchers attribute partly to the traditional masculine paradigm of farming and also time pressures created by heavy workloads.
“People in rural areas have poorer access to doctors, psychiatrists and psychologists than those in the cities, but even in cases where resources exist, the stoic attitude typical of many farmers and their reluctance to talk about emotional issues are barriers,” she says.
“Rural people are, by nature, more self-reliant because of their isolation, and this is being further exacerbated by the amalgamation of agricultural holdings and the reduced opportunity for social interaction and support.”
Mrs Kennedy says research is needed that explores and understands the realities faced by farming communities: “Suicide has an enormous impact on families and communities and there is an elevated risk of suicide among people who are grieving,” she says. Mrs Kennedy is undertaking a PhD at UNE to address this gap.
She has already interviewed 11 farming family members affected by traumatic death in southern NSW, Victoria and eastern South Australia, and plans to speak to a further 19 farming family members.
“Based on my research to date, the vast majority of those impacted by suicide had no idea this [suicide] would happen and they question why they didn’t see it coming. That’s a huge weight to carry,” Mrs Kennedy says. “Most do not access formal support services, but those that do often don’t like the way they are structured. They feel uncomfortable bringing up emotional issues.”
Working with researchers from UNE and the NCFH, Mrs Kennedy has two aims: to break the stigma surrounding suicide to enable people to speak openly; and to develop a framework for understanding other bereaved farming community members, and to inform government policy and procedures. “We hope this [study] will lead to services that are culturally appropriate, acceptable and accessible to farming communities,” she says. “What works in the city doesn’t necessarily work in the country and most services have been developed for urban areas.”
Her study is also including farming family members affected by deaths resulting from accidents and homicides.
“Those closely affected by these tragedies are able to offer exceptional insight, allowing us to challenge assumptions, develop more appropriate prevention strategies, and understand the phenomenon more broadly,” Mrs Kennedy says.
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