The Protective Factors of Suicide in Agriculture: A Global Scoping Review.

Introduction: Each year, over 700,000 people die by suicide worldwide, and far more attempt and are impacted by the outcome. Agriculture is one of the most dangerous industries in which to work; it is also exposed to a lot of external stressors, such as climatic conditions, market forces (both input and output) and government regulation, as well as internal such as employment and of staff, multiple skills required and isolation. These stressors contribute to the higher rate of farm suicide cases. While there is growing evidence of the protective circumstances (factors) that protect against suicide and suicidality, more needs to be done in the agricultural sector.

Objective: To review global literature and consolidate the current knowledge regarding protective factors against suicide and suicidality in agricultural communities and elucidate the implications of these findings.

Method: A systematic scoping review following the Preferred Reporting Items for Systematic Scoping Reviews (PRISMA-Sc). A range of databases was searched for the terms "suicide*" or "suicidal behavior", "suicide attempt", or "suicidal ideation", or "suicidality", and "farm*" or 'agricultural worker*' or 'rancher*' and 'protective factors' or protect". Paper included had to be peer reviewed in English, include people living, working in or with agriculture or lived in an agricultural area.

Results: Fourteen studies met the study criteria, predominately (72%) from the United States of America and Australia. Four (29%) articles discussed individual coping mechanisms and self-reliance as protective factors against suicide and suicidality, while six (43%) described the influence of social support and perceived sense of belonging on suicide risk. Five (36%) papers examined the association between health-promoting and suicide-prevention initiatives as protective factors in agricultural communities.

Conclusion: There is limited, however, growing literature about protective factors for the prevention of suicide in agriculture; however, it is skewed to high-income countries. This review demonstrates a link between the development of individual coping skills as a protective factor against suicide in agricultural communities, with a primary focus on farming occupations within this setting. Social support was found to help reduce suicide risk by increasing a sense of belonging. These need to be exploited to drive down suicide rates.