Several French and international studies have observed an elevated risk of suicide-related death among agricultural workers.

In this context, Santé publique France (Occupational Health Directorate) and the Caisse centrale de la mutualité sociale agricole (CCMSA) have partnered to produce regular indicators of suicide mortality in this population and to provide insights to guide prevention efforts. This partnership is part of the Suicide Prevention Plans for the agricultural sector¹.

The research initially focused on farm owners and is currently being extended to agricultural workers. For farm owners, the research was supplemented by sociological doctoral studies.

¹ Mutualité sociale agricole. MSA National Action Plan Against Suicide 2011–2014 [Online]. : MSA, 2011. Available: http://ssa.msa.fr/lfrMutualité sociale agricole. MSA National Action Plan Against Suicide 2016–2020 [Online]. 2016. Available: http://ssa.msa.fr/lfr

Farmers

An initial collaboration between Santé publique France and the CCMSA focused on studying suicide mortality among active farmers between 2007 and 2011.

The study population included all farm managers and their assisting spouses who were professionally active between 2007 and 2011.

Suicide mortality compared to the general population

Suicide mortality among active farmers was compared for each year of the study to that of the general population of similar age and sex; this is known as "external analysis." Two reports were subsequently produced.

The first focused on the situation in 2007–2009: The analyses showed excess suicide mortality among male active farmers in 2008 (+28%) and 2009 (+22%) compared to the general population.

• This excess mortality was particularly pronounced among men aged 45 to 54 in 2008 (+31%) and those aged 55 to 64 in 2008 (+47%) and 2009 (+64%) compared to men of the same age in the general population.

• Two sectors of activity showed excess suicide mortality compared to the general population of similar age and sex: beef cattle farming in 2008 (+127%) and 2009 (+57%), and dairy cattle farming in 2008 (+56%) and 2009 (+47%).

The second report focused on the situation in 2010–2011 and trends between 2007 and 2011: Updated data showed that there was still excess suicide mortality among male farmers in 2010 (+20%) but not in 2011, compared to the general population. As in the previous report, this excess mortality was more pronounced in certain age groups and sectors of activity:

• Those aged 45 to 54 in 2010 (+30%) and 2011 (+33%) compared to men of the same age in the general population.

• Those working in the dairy cattle sector in 2010 (+52%) compared to men of the same age in the general population.

To monitor the situation, it is planned to repeat this surveillance every 5 years. Future analyses could thus cover the 2012–2016 period and be conducted in 2019 when the corresponding mortality data become available.

Suicide Mortality by Socio-Professional Characteristics

To supplement this initial work and, in particular, to better understand the profile of farmers who died by suicide, associations between suicide mortality and certain socio-professional characteristics were studied; these are referred to as “internal analyses.”

This work resulted in a third report focusing on the population of male farmers in metropolitan France between 2007 and 2011.

These analyses revealed differences in suicide mortality among male farmers based on their socio-professional characteristics, specifically:

• being between 45 and 54 years old compared to those under 35,

• operating a farm as a sole proprietor compared to operating a farm as a partner in a partnership,

• engaging in farming as a primary occupation compared to farming as a secondary occupation,

• an utilised agricultural area (UAA) of between 20 and 49 hectares compared to having a UAA of more than 200 hectares,

• a farm located in Auvergne-Rhône-Alpes, Bourgogne-Franche-Comté, Brittany, and Hauts-de-France compared to having a farm located in Grand-Est.

These analyses could not be conducted for self-employed women in agriculture due to insufficient sample size.

Socioeconomic determinants of suicide: a sociological approach

Research using a mixed qualitative and quantitative methodology was conducted in partnership with Santé publique France as part of a sociology dissertation defended on May 29, 2017, by a doctoral student at the National Institute for Agricultural Research (INRA) in Dijon.

This thesis, which focuses on the socioeconomic determinants of suicide among working farmers, contributes to our understanding of the phenomenon. Its findings can be taken into account when implementing prevention measures to identify and support farmers in distress.

Agricultural Employees

To deepen our understanding of suicides in the agricultural population and guide prevention efforts, a second collaboration with the CCMSA focuses on studying suicide mortality among employees affiliated with the MSA. This work is being conducted as part of a partnership expanded to include Inserm.

A first step involves comparing suicide mortality among agricultural employees between 2007 and 2013 with that of other populations (the general French population, the population of farming operators, and the population of employees affiliated with the General Social Security Scheme). Because they involve a comparison with populations other than employees, these analyses are referred to as "external."

A second phase will explore the population of agricultural employees in greater detail. These individuals hold a wide variety of jobs within the agricultural sector, as well as in other sectors of activity, including the insurance sector (employees of professional agricultural organizations) and education (teaching staff at private agricultural educational institutions). These analyses will thus consist of comparing suicide mortality among employees according to their various socio-professional characteristics (sector of activity, type of contract, etc.). Because they compare agricultural employees with one another, these analyses are referred to as "internal."

This work has been supplemented by a literature review, currently in the process of being published.

The results will be posted online as they become available.

The Agri'écoute telephone helpline

The 2011–2014 National Plan for Suicide Prevention in the Agricultural Sector (renewed for 2016–2020) was entrusted to the Mutualité sociale agricole (MSA) by the Ministry of Agriculture. It included the establishment of a helpline for agricultural workers (farmers and employees) experiencing psychological distress and for their loved ones. The national Agri'écoute helpline thus began operations in October 2014.

The Agri'écoute hotline

• is available at all times (24/7) at 09 69 39 29 19 (no surcharge, local call rate, free from a "box")

• is intended for the agricultural community (farm workers and farmers) experiencing psychological distress, and their loved ones

• consists of 56 stations (49 SOS Amitié counseling stations and 7 SOS Suicide Phenix counseling stations) staffed by personnel trained in emergency situations and psychological distress.

• has been operational since October 2014

• handled 794 calls in 2015 and 1,938 calls in 2016, representing a 144% increase between those two years

• was established by the Caisse Centre de la Mutualité Agricole (CCMSA), which enlisted Santé publique France and the organizations SOS Amitié and SOS Suicide Phénix to manage the technical platform.