The ripple effect: a digital intervention to reduce suicide stigma among farming men

Abstract

Background: Compared with the general population, Australian farmers-particularly men-have been identified as at greater risk of suicide. A complex range of factors are thought to contribute to this risk, including the experience of Stigma. stigma also impacts those who have attempted suicide, their carers, and those bereaved by suicide-manifesting as shame, guilt, social isolation, concealment of death, reduced help seeking and ongoing risk of suicide. This paper evaluates the effectiveness of an intervention, tailored for the farming context, designed to reduce stigma among farming men with a lived experience of suicide. Methods: The digital intervention used an adult learning model providing opportunity to share insights, reflect, learn and apply new knowledge among people with shared farming interests, suicide experience and cultural context. A range of content-tailored to the gender, farming type and suicide experience of participants-included video stories, postcard messages, education and personal goal setting. Pre-and post-assessment of suicide stigma and literacy was complemented by qualitative data collection during the intervention and participant feedback surveys. Results: The intervention was successful in reaching members of the target group from across Australia's rural communities-with diverse geographic locations and farming industries represented. One hundred and sixty-nine participants from the target group (farming males aged 30-64 years) were recruited. While the Stigma of Suicide Scale failed to identify a reduction in self-or perceived-stigma, qualitative data and participant feedback identified behavioural indicators of stigma reduction. Four subthemes-'growth', 'new realisations', 'hope' and 'encouragement'-highlighted attitudinal and behaviour change indicative of reduced stigma associated with mental health and suicide. Participants' baseline suicide literacy (Literacy of Suicide Scale) was high when compared with previous community samples and total literacy scores did not demonstrate significant improvement over time, although literacy about the link between suicide and alcoholism did significantly improve. Conclusions: These results highlight opportunities in groups with high suicide literacy for targeted stigma reduction and suicide prevention efforts for both the target group and other populations within Australia and internationally. Results also highlight the need to reassess how stigma change is understood and evaluated across a wider range of population groups.

Acceptability, Safety, and Resonance of the Pilot Digital Suicide Prevention Campaign “Better Off With You”: Qualitative Study

“…Not only was the peer-to-peer approach seen to be an authentic and acceptable, participants felt that a campaign where the message was delivered by another person, such as a family member or friend, would not be as powerful. Our findings contribute new insights and knowledge about the design elements required for developing effective lived experience suicide prevention videos, as shown in recent studies reporting on the effectiveness of videos targeting farmers [ 28 ] and lesbian, gay, bisexual, transgender, intersex, and queer communities [ 29 ]. These findings also suggest that a third-person approach, while well intentioned, may not engage the target audience of those contemplating suicide effectively.…”

The Potential Impact of Adjunct Digital Tools and Technology to Help Distressed and Suicidal Men: An Integrative Review

“…Hegemonic masculinity was reported as being mostly resisted. The hindering issues to men obtaining mental health treatment in the rural Australian context include stigma, lack of emotional expression, non-disclosure of distress, and barriers to seeking and getting help ( Kennedy et al, 2020 ). A retrospective study of bereaved men’s help-seeking before suicide found themes of complex relationships to seeking and getting help – there were those entrapped by secrecy and concealing the need for help, those with overwhelming illness that couldn’t be helped, as well as those whom services and systems provided ineffectual help ( Oliffe et al, 2020 ).…”

Farmer Mental Health Interventions: A Systematic Review

“…Ripple Effect, an online intervention designed to reduce stigma among males in the Australian farming community with a lived experience of suicide, represents the greatest departure from the MHFA format in that it was designed solely to reduce suicide stigma among farmers [ 77 , 78 ]. Pre- and post-survey data failed to show any significant reduction in self- or perceived-stigma [ 78 ]. However, qualitative data and participant feedback suggested stigma reduction.…”