BackgroundFarmers and farm workers have been recognised as a group at high risk of suicide in Australia; however this risk is not without geographic and demographic variation. This study aims to identify and better understand the complex interplay of risk and protective factors surrounding farmer suicide, with an emphasis on social influences, so as to inform tailored and effective suicide prevention initiatives.MethodsFocus groups were conducted in three diverse sites across two states in Australia with men and women separately to gain perceptions about suicide risk and protective factors and attitudes towards suicide and help seeking. The three communities in each state represented areas with a suicide rate similar to, above, and below the state average. The communities were also diverse in their population, types of farming, geographic location, distance from and access to services. There were a total of 33 female and 30 male participants.ResultsQualitative analysis indicated three major interrelated social factors: (1) changing rural communities, (2) community attitudes and stigma and (3) relationship issues.ConclusionsThe biopsycho-ecological model is considered useful to better understand and address social, as well as individual and environmental factors, pertaining to farmer suicide.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6287-7) contains supplementary material, which is available to authorized users.

Farmers and farm workers have been recognized as a group at high risk of suicide in Australia. This study aims to identify and better understand environmental factors associated with suicide among Australian farmers and farm workers. Qualitative analysis was undertaken in accordance with the Consolidated Criteria for Reporting Qualitative Research. Male and female focus groups were conducted separately with people who lived or worked on a farm in six farming communities. Qualitative analyses showed that a number of environmental influences may contribute to the increased risk of suicide: extreme climatic events; isolation; service availability; access to, and frequent use of firearms; death and suffering of animals; government and legislation; technology; and property values. Both the physical and socio-cultural environments in which farmers operate appear to contribute to farmer suicide and need to be considered in suicide prevention.

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.

Purpose Rural communities in Australia have an elevated risk of suicide. The aim of the current study was to evaluate a well‐being and suicide prevention education workshop, SCARF (Suspect, Connect, Ask, Refer, Follow‐Up) developed for Australian farming and rural communities. Methods The SCARF program was delivered to 14 groups, a convenience sample including frontline agricultural workers and farmers from New South Wales. The Literacy of Suicide Scale, Stigma of Suicide Scale, and items assessing confidence to assist others were administered immediately before and after the workshop, and at 3‐month follow‐up. The Warwick Edinburgh Mental Wellbeing Scale was given immediately before and at 3‐month follow‐up. In total, 255 agreed to participate in the study, with 127 completing 3‐month follow‐up. Data were analyzed using linear mixed‐effects regression. Findings There was a significant increase in suicide literacy and confidence to assist others immediately after the workshop, which remained significant at 3‐month follow‐up. Mental well‐being significantly improved at 3‐month follow‐up. Conclusion The SCARF program is unique for its brevity, cultural specificity, focus on health, and incorporation of the biopsycho‐ecological model and the Interpersonal Theory of Suicide. It represents a useful program for Australian farming and rural communities to improve mental well‐being, suicide literacy, and confidence to recognize and respond to suicidality.

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