The mental health of farmers
Rural Mental Health Research,University of Southampton,Southampton,UK
Farmers are subject to a number of unique occupational stressors, many of which
have been aggravated in recent years by changes in farming practice and by
economic factors. These are probably part of the explanation for the high rates of
suicide in farmers and farm workers, which in the UK account for the largest number
of suicides in any occupational group. Suicide is usually associated with mental
illness, which, in farming communities, appears to be particularly stigmatized and
poorly understood. This affects health-seeking behaviour, which is compounded by
the geographical isolation and inaccessibility of many services in rural areas. Our
current understanding of these issues suggests a number of potentially valuable
Key words: Farmers; mental health; mental illness; rural; suicide.
Received 17 April 2002; revised 11 June 2002; accepted 11 September 2002
Recent figures released by international accountants
Deloitte & Touche , based on their client group
covering 250000 acres of farmland, reveal the depth of
the decline in farming income that has occurred in the
UK in recent years. The average income from a 500 ha
farm fell from £80000 in 1995/1996 to £2500 in
2000/2001. This dramatic drop was not just the result of
the BSE (bovine spongiform encephalopathy) and foot
and mouth crises, but applied across all sectors of the
farming industry as a result of the fall in the price of
wheat and other produce, as well as poor recent harvests.
This decline in income was seen despite a 10% increase
in efficiency, which resulted from farmers cutting down
overheads. These changes are not just of theoretical
interest to economists and accountants, but represent a
highly relevant increase in the economic stressor which
has consistently emerged as one of the important pre-
dictors of psychiatric morbidity and even suicide. This
review will examine the influence of this and other factors
on psychiatric morbidity and mortality in farmers, and
the potential for preventative interventions.
Farmers and agricultural workers, uniquely amongst
the main occupational groups, live and work almost
exclusively in rural areas. It is therefore important to
understand the nature of rural areas in the context of
health and health care. Although almost 90% of the land
in the UK is rural, <20% of the population lives in rural
areas. Rural areas have a similar mix of industry and
services to urban areas, but greater proportions of the
rural workforce are self-employed, employed in their own
homes or work part-time. Although the most dramatic
drop in income over the past few years has occurred
amongst farmers, the proportion of men and women in
rural areas who earn low wages is greater than in the rest
of the population of the UK . Rural areas have
less social housing than urban areas, and housing is a
particular concern to agricultural workers and tenant
farmers whose housing is frequently tied to their work,
which has become increasingly insecure as a result of the
mechanization of farming and the drop in farm incomes.
Access to all types of services, including health, is poor,
particularly in remote rural areas, and this particularly
disadvantages older people, the disabled and the rural
poor because of the dependency on cars as the main
means of transport.
Although the prevalence of most mental health prob-
lems in rural areas in the UK appears to be significantly
lower than in inner-city areas, the range of services that
people with mental health problems can access in rural
areas tends to be very limited . This relative inaccess-
ibility to services appears to be compounded by a greater
sensitivity to the stigma of mental health problems and
greater concerns about confidentiality in small rural
communities . This has been confirmed by a recent
study which showed that perceived stigma about mental
health interventions and services has a negative impact on
Occup. Med. Vol. 52 No. 8, pp. 471–476, 2002
Copyright © Society of Occupational Medicine. Printed in Great Britain. All rights reserved. 0962-7480/02
Correspondence to: Dr Alain Gregoire, Rural Mental Health Research,
University of Southampton, Tatchbury Mount, Calmore, Southampton,
UK.Fax: +44 23 8087 4360; e-mail: firstname.lastname@example.org
by guest on May 23, 2011
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