Psychological Morbidity in the Farming Community: A Literature Review

ABSTRACT

The mental health of the farming community across industrialised nations has long been a major concern. Using an adapted procedure for a systematic literature review of observational epidemiological studies reporting prevalence (informed by the Joanna Briggs Institute method), this paper reviews peer-reviewed literature that explicitly compares farmer and non-farmer mental health (n = 48). In doing so, it provides a central and accessible evidence base for researchers and practitioners, and simultaneously reveals a stark lack of consensus; specifically, 54.0% of measures deployed to assess farmer mental health determined it to be the same as or even better than non-farming populations. This ambiguity sits in sharp contrast to the unequivocally worrisome farmer suicide statistics. Informed by the literature, the paper discusses potential reasons for this mismatch, including (i) farmers’ progression through a different “pathway” to suicide that is not always preceded by mental illness, and (ii) a failure of current methods to accurately gauge the mental health status of farmers. The paper concludes by recommending more research into farmers’ “pathway” to suicide, and highlights the need for a dedicated and multi-disciplinary programme of methods research that will afford a more culturally appropriate and effective means of understanding mental health in the farming community.

KEYWORDS:

• Farmers
• psychological morbidity
• suicide
• mental health

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/1059924X.2022.2089419

Acknowledgments

The author would firstly like to thank the Ruralia Institute for funding her visit and affording her the time to begin this important work. She would also like to thank Nick Lewis and Jane Mills (CCRI) for their input into the earlier versions of this paper. Dedicated to ‘the man on the bridge’.

Disclosure statement

No known conflicts of interest.

Notes

1. Note, we did not strictly define “farmer”, using the wildcard farm* instead (see Supplementary Information: Box 1 for search terms and syntax). This was a deliberate choice to see the variety of ways farmers are represented in the literature. The definition adopted in each paper is reported as a variable in Table 1.

2. Belgium, Bulgaria, Romania, Slovenia, Slovakia, Finland, Sweden, UK, Croatia, Denmark, Germany, Estonia, Greece, Spain, France, Ireland, Italy, Cyprus, Latvia, Lithuania, Luxemburg, Hungary, Malta, Netherlands, Austria, Poland, and Portugal.

3. Note that this figure differs from that of Bjornestad et al. who also cite the National Institute of Mental Health for the figure on “generalized anxiety disorder”. They are both referring to the NIMH data (which is based on the National Comorbidity Survey Replication data collected between 2001–2003), but the figures Rudolphi et al. are referring to match the pre-2007 analysis of the data (aligning with Kessler et al. in their 2005 analysis⁸⁸), and Bjornestad et al. are referring to the more contemporary analysis, available here.⁸⁹

4. From the pre-2007 analysis of the NCS-R data.

5. This table includes updated data as of July 19, 2007. Updates reflect the latest diagnostic, demographic, and raw variable information.

6. This included Devon and Cornwall only.

7. males, those in non-supervisory roles, those residing in rural areas (all at P < 0.001) and those aged 45–54 and 55–64, those who were self-employed and those not in paid employment (all at P < 0.005).

8. Subjective well-being (SWB) is derived from the difference between mental well-being (i.e. psychological functioning, life satisfaction and ability to develop and maintain mutually benefitting relationships, personal growth, purpose in life and self-esteem) and mental illness (i.e. mental disorders affecting mood, affect, and functioning).

9. ORs were adjusted for sex, age, working status, longstanding illnesses, disability, and infirmity.

10. Described as “approached but did not reach statistical significance”.

11. Although Weichelt et al., 2021 and Skegg et al., 2011 provide seemingly anomalous exceptions.

Additional information

Funding

This paper was made partly possible as a result of the Ruralia Institute (University of Helsinki) Visiting Scholarship.