Suicide of farmers is not only seen in India, but it is observed worldwide and across the cultures (Behere and Bhise 2009b). Farming is the one of the oldest industries in world. As civilisations have set in, man has learned cultivation to meet the demands of food. Farming made previously wandering human beings settle at one place. It has been one of the most respected professions and has a popular image as a peaceful and healthy way of life. Despite this fact, agriculture has one of the highest rates of mortality than any other industries (McCurdy and Carroll 2000). Although farming practices, production systems and type of farms are diverse, there are commonalities across the farms that are important to health (Behere and Bhise 2009a). Most farms continue to be family-owned and family-operated businesses and are exposed to volatility of commodity markets, the variability of weather patterns and the influence of governmental regulations (Fraser et al. 2005). This exposes farmers to a high level of stress. Economic concerns and government bureaucracy have been consistently identified as a major cause of stress and contributor to suicide (Malmberg et al. 1999). There is no customary or mandatory retirement age for farmers all over the world, and many tend to work beyond the customary retirement age, placing the younger generation in a dependent relationship with their parents for much longer than usual. This can lead to tension between the two generations on the farm. Roles between work, home and family are often blurred with farming operating as an occupation and way of life for many farmers (Melberg 2003). Research had shown a relationship between monetary and family problems with suicide. British farmers were more concerned about family problems (Thomas et al. 2003), while indebtedness and monetary concerns were reported to be major reason for suicide among Indian farmers (Behere and Behere 2008). From an early age, those in the farming families can be exposed to a range of risks to their physical and mental health, which continue in adulthood and later life. Many studies have found higher rates of depression and anxiety among farmers when compared with the general population (Eisner et al. 1998; Peck et al. 2002). A study in England found that even in the absence of psychiatric morbidity, farmers were more likely to report that life is not worth living compared with general population (Thomas et al. 2003), and suicide in them was an end point to a series of difficulties that accumulated over time.

In its seventh decade of independence, our nation is losing its vey sons of soil, our food growers. After the independence, according to Gandhiji’s vision of Gram Swaraj, villages and specially farmers were to be the main focus of any development plan of India. India consists of 16 % of world’s population, which is sustained on only on 2.4 % of the world land resource. The agriculture sector is the only livelihood to the two-third of its population, which gives employment to the 57 % of work force, and is a raw material source to large number of industries (Behere and Behere 2008). In the 1990s, India woke up to a spate of suicide by farmers. Since then, suicide by farmers has figured in the newspapers, the state assemblies and the parliament. It has been included in some of the election manifestos. According to the analysis by K. Nagraja of Madras Institute of Development Studies, between the years 1997 and 2006, about 200,000 farmers have committed suicide. Thus, on an average, nearly 16,000 farmers’ committed suicide every year, putting every seventh suicide in country as farmers’ suicide. Farmers’ suicides have increased at annual compound growth rate of about 2.5 % per annum over this time period. There is a high degree of variation in farmers’ suicide across different states in country. According to 2001 census of India, top five states in number of farmer suicides were Maharashtra, Karnataka, Andhra Pradesh, Chhattisgarh and Madhya Pradesh. In these, farmers’ suicide rate is nearly 60 % higher than the general suicide rate, indicating a very distressing situation in these states. For the state of Maharashtra, picture is even bleaker. Between years 1997 and 2006, the number of farmers’ suicide has more than doubled with annual compound growth rate of 9.8 % (Nagraja 2007). During this decade, every fifth farmers’ suicide committed in country had occurred in Maharashtra. Vidarbha region of Maharashtra, which lies in centre of India, is a particularly vulnerable pocket for farmers’ suicide making a continuous suicide belt with Telangana region of Andhra Pradesh (Behere and Bansal 2009). With much of media and political uproar on this issue, various steps were taken to mitigate this crisis. Most of the interventions done by states were directed towards survivors of farmers’ suicide. With politicisation of issue, especially prior to elections, various packages were announced for survivors by state governments. These mostly included financial ex gratia help to affected families. Media and government initiatives together led to the projection of farmers’ suicide as a mere economical and debt-driven crisis and adopted policy of only providing financial help to the bereaved (Behere and Bhise 2011).

Studies show that suicide in general is an outcome of multiple factors. At a given time, there are many forces that drive the people to commit suicide. Same forces apply to farmers who end their lives. Roles between work, home and family are often blurred with farming operating as an occupation and way of life for many farmers. Research had shown a relationship between monetary and family problems with suicide. On the other hand, farmers’ suicides also differ in some aspects from general suicides. Farmers are more likely to be in their middle ages, married with children in schools, living with family. Most are the sole bread earners for the family. Majority have small to marginal farms of 1–2 ha. Farmers who commit suicide tend to use methods to which they have easy access because of their occupation. In India, pesticides are easily available, and hence, its consumption is the most common method of suicide (Behere and Bhise 2012). Family of famers who committed suicide are under great stress and needs help (Behere and Reddy 2010; Behere 2010a). These factors need special attention when it comes to prevention of suicides and provision of help to survivors. This makes identification of persons at risk more difficult, as even under stress, most of them would be functioning normally. Family members often fail to recognise any minor changes in their behaviours that usually precede the suicide.

Female farmers’ suicide: Suicide among female farmers is on rise. Studies of women in farming have found high levels of stress, fatigue and depression (Walker and Walker 1988). Explanations most commonly given are role conflicts and high work load. Farm women, unlike men, experience stress not only related to the farm operations but also to the impact of farming stressors on the physical, social and financial well-being of all family members. As farming has become less profitable, women are taking more and more on- and off-farm work to supplement the family income (Gallagher and Delworth 2003). Farming women in this position often become stressed and fatigued due to multiple tasks, and the conflict between their traditional role as a house-makers and the need for off-farm income. Female farmers have to bear the additional burden of doing household chores apart from farming. This makes farm women a high-risk category for suicide. England, Australia and, now, India had reported suicide among female farmers. In India, the State Government’s report on farmers’ suicide in Karnataka State shows that approximately 20 % of victims were females (Veeresh 2002), while Kerala figures were 26 % of all farmers’ suicides. Surviving suicides is more common among females. As most of the farmers’ suicide victims are married and have families, spouses are more vulnerable to psychological distress (Behere and Bhise 2011).

In one of the study we found that 30 % of the study group (i.e. farmers included in the study exposed to pesticide) was having suicidal ideation as compared to control group, (8 % of the sample had suicidal ideation). It is also noticed that those who got suicidal ideation were having depressive symptoms as well on the Self-Reporting Questionnaire (SRQ), as compared to controls. These raised important question whether exposure to pesticide causes suicidal ideas and depressive symptoms (Behere et al. 2013).

“Farmers” suicides are preventable! This is the basic concept that needs to be understood when we think of any policies to reduce the suicide numbers (Behere and Bhise 2012). Studies across world have revealed that a strategic policy for prevention with a multifaceted prevention approach involving community participation is the most effective method in suicide prevention. Most of the developed countries have devised their national suicide prevention policies, which have been effective in reducing suicides. The United Kingdom had witnessed high rates of suicide by farmers in 1980s and implemented its national suicide prevention strategy. As part of prevention programme, the Firearms Act was amended in 1988, making rules more stringent. Studies have found that suicide rate had declined significantly after this act was implemented, highlighting the importance of restriction of availability of means to commit suicide. Another inspiring example is from our neighbouring country, Sri Lanka. Suicide rates among farmers have declined by 50 % in a decade in Sri Lanka. This was an outcome of series of legislative activities that systematically banned the most highly toxic pesticides that had been responsible for the majority of pesticide deaths in the preceding two decades (Jayewardene and Saravanabananthan 1966). In addition to restricting or withdrawing a number of pesticides, Sri Lanka has also actively pursued a number of initiatives to reduce use and increase the safety of pesticide use by farmers, e.g. integrated pest management, use of lockable boxes to restrict access to pesticides (Hawton et al. 2009). Furthermore, there has been considerable research interest in Sri Lanka in the medical management of self-poisoning, and so it is possible that the improved management of pesticide self-poisoning has also contributed to the favourable trends observed in terms of suicide incidences. There are many similarities in farmers’ suicides in India and Sri Lanka, implying that in India, we can also reduce the burden of farmers’ suicides by significant numbers. The following are the few suggested strategies on various aspect of farmers’ suicide prevention: