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Original Article
ARTICLE IN PRESS
doi:
10.25259/JNRP_403_2023

Farmer’s mental health and well-being: Qualitative findings on protective factors

Department of Psychiatric Social Work, National Institute of Mental Health and Nueroscinces, Bengaluru, Karnataka, India
Department of Psychiatry, Gadag Institute of Medical Sciences, Gadag, Karnataka, India
Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonepat, Haryana, India
Corresponding author: Shanivaram K. Reddy, Associate Professor, Department of Psychiatric Social Work, National Institute of Mental Health and Nueroscinces, Bengaluru, Karnataka, India. shanivaramreddyk@gmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Saju S, Reddy SK, Bijjal S, Annapally SR. Farmer’s mental health and well-being: Qualitative findings on protective factors. J Neurosci Rural Pract. doi: 10.25259/JNRP_403_2023

Abstract

Objectives:

Agriculture is associated with various physical and mental health risks. There has been growing concern about the psychological hazards associated with farming including high stress levels, depression, anxiety, and increasing rates of suicide. To bolster resilience and overall survival within the farmers, it is imperative to gain a comprehensive understanding of the protective factors that contribute to mental and psychological well-being.

Materials and Methods:

The study followed an explorative research design and used purposive sampling to select samples from Chikkaballapur District in Karnataka. Nine farmers were interviewed based on inclusion and exclusion criteria. The interview schedule was prepared based on the literature review. Experts in the field did content and face validation. The transcribed data were coded using the free version of QDA Miner. The thematic analysis approach was used for data analysis,

Results:

Three broader themes and 15 sub-themes emerged: (1) Personal protective factors: feeling of autonomy, purpose in life, passion for work, problem-solving skills, positive mindset and building resilience, learning new skills, and spiritual and religious beliefs; (2) social protective factors: friends and peer group, belongingness, family, and social engagements; and (3) environmental protective factors: lifestyle and being physically active, rural environment, government/institutional support, and recognition in the society.

Conclusion:

The study successfully emerged three overarching protective factors that farmers perceived as significant for their mental health and well-being, entitled personal, social, and environmental. The study findings provide valuable insights for social work practitioners, guiding them in developing interventions and strategies to support the mental health and well-being of the farming population.

Keywords

Mental health
Well-being
Farmers
Protective factors
Karnataka

INTRODUCTION

A farmer is a person who is involved in agriculture and raising living organisms for food or livelihood. Despite the enormous challenges of their occupations, farmers are regarded as the backbone of society, feeding, and clothing to people worldwide.[1] Agriculture is associated with various physical and mental health risks due to the hard work required under difficult conditions.[2] Farmers and their families face various physical health risks due to their work in agriculture associated with their work practices and physically demanding job with long working hours in different light and weather conditions.[3] Along with common health problems, extensive exposure to fertilizers, insecticides, pesticides, and mechanization leads to the emergence of specific health hazards that are associated with farming.[4]

India is an agrarian country, and agriculture plays a key role in India’s economy. About 54.6% of the total workforce is engaged in agriculture and allied sector activities.[5] There has been growing recognition of the psychological hazards associated with farming such as high stress levels, depression, anxiety, and increasing rates of suicide.[6] The mental health issues faced by farmers in India are influenced by several compounding factors, including shifts in lifestyle, fluctuating income, crop failures, natural disasters such as droughts and floods, economic crises, unemployment, limited social support, and growing insecurity.[7]

As per the 2021 report from the National Crime Records Bureau, farmer suicides account for 6.6% of all suicides in India. Between 1997 and 2005, 1.5 lakh farmers committed suicide. Poverty, a lack of support, illiteracy, mounting debts, and uncontrollable weather conditions all contribute to this disastrous situation for farmers.[8] The Indian states of Maharashtra, Andhra Pradesh, Karnataka, Chhattisgarh, and Madhya Pradesh contributed nearly two-thirds of total suicides.[9] One school of thought, among others, regarding these concerns about farmers’ suicide suggests the presumption of a poor mental health state, implying that farmers’ psychosocial needs have been overlooked and that supportive community professionals must help solve farmer distress.[10] But when it comes to interventions and help-seeking, the majority of health insurance plans do not cover mental health services, and there is only one psychiatrist for every 250,000 people and less than one mental health worker for every 100,000 people.[11]

It is estimated that one in every four people worldwide suffers from mental health problems each year.[12] If farmers suffer mental health issues at the same rate as the general population, this will imply that approximately 25% of farmers worldwide suffer from mental health issues yearly.[13] Numerous studies conducted on mental health within farming communities worldwide have highlighted several risk factors that are both common and specific to this community; these factors encompass elements such as financial debt, government regulations, conflicting roles, volatile commodity prices, demanding and strenuous labor, the impact of climate change, and substandard living conditions.[2,7,9,13-20]

The majority of the government’s response to the farmers’ crisis has been economic, intending to ease financial burdens, and does not address farmers’ mental health and well-being in any way.[4] The mental health systems and professionals have been relatively silent on the epidemic of farmer suicides and “Psy disciplines cannot remain apolitical in their quest to be” “scientific,” for human rights/social justice and mental health stand for one another, highlighting the crucial role of resistance, empowerment, collective understanding, and activism in realizing mental health for all.”[21]

The literature review examined various aspects of farmers’ mental health from a global perspective and studies that explored positive mental health and well-being among farmers, with a majority of the studies conducted in Western countries, one notable theme across these studies was the identification and enhancement of protective factors that contribute to farmers’ well-being, aiming to improve their quality of life and promote the development of farming communities.[4,8,12,14-19] It is important to note that only one study from India was identified, specifically emphasizing empowerment and community strengthening.[22] The literature emphasizes the need for further exploration of farmers and their psychosocial factors, specifically from a strengths-based perspective, particularly within the Indian context. Such research endeavors can contribute to the accumulation of knowledge which is essential for developing promotional interventions that aim to enhance farmers’ mental health and well-being.

To bolster resilience and overall survival within the population, it is imperative to gain a comprehensive understanding of the protective factors that contribute to mental and psychological well-being. This study aims to adopt a strengths perspective in investigating farmers’ mental health, providing valuable insights for professionals, policymakers, and community workers. The resultant data can inform the development of policies and interventions that prioritize the promotion of mental health among farmers.

MATERIALS AND METHODS

The study was conducted as a part of the MPhil research and the Institute’s Ethics Committee (National Institute of Mental Health and Neurosciences), Bengaluru, India, reviewed and approved this study (Institute Ethical Committee Clearance Number No: NIMH/DO.BEH: SC.Div/2022-23). This study aimed to explore the protective factors surrounding the mental health and well-being of farmers in Karnataka. This study followed an explorative research design and used a purposive sampling technique. The farmers’ population is actively involved in agriculture and its allied activities in the Chikkaballapur District in Karnataka. Nine farmers were in-depth interviewed based on inclusion (farmers working as cultivators for at least 5 years, aged between 25 and 60 years, and who can speak Kannada and provided consent to participate in the study) and exclusion criteria (Farmland owners who are not directly involved in agriculture, cultivation in more than 5 acres of land and secondary source of income apart from agriculture and allied activities).

The researcher developed a sociodemographic data sheet to collect general information on the farmers, including age, sex, religion, caste, education, occupation details, financial obligations, and family details. A semi-structured interview schedule was administered to explore farmers’ protective factors of mental health and well-being. The interview schedule was prepared based on the literature review and content, and face validation was done by experts in the field, including; four mental health professionals, and one agricultural researcher.

Farmers were contacted and interviews were scheduled with the help of local farmer organizations. The researcher visited the village and had a group interaction with the farmers before the interview to establish rapport and to explain the nature of the study. Data collection was done using a semi-structured interview schedule face to face; in their native language, Kannada. Around 16 participants were approached, and 10 showed interest in participating in the study. One interview was later rejected, as it did not qualify for the inclusion criteria. Interviews were conducted by visiting them in a previously decided and mutually agreed on venue, usually their homes or a common meeting area in the village. The interviews lasted between 45 min and 60 min.

The data collected from the farmers were recorded, translated, and transcribed into English. During the analysis stage, participants were further contacted by phone for clarification on their responses. The transcribed data was then coded by the researcher using the free version of QDA Miner.[23]

The thematic analysis approach, as proposed by psychologists Virginia Braun and Victoria Clarke, was used to analyze the data.[24] The process included the prescribed six phases: Familiarizing with data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report. An inductive approach was used in the process of thematic analysis to identify themes relating to perceived protective factors of mental health well-being and the researcher has attempted to categorize the emergent themes into three broader domains, namely, individual, social, and environmental.

RESULTS

The sociodemographic details, sources of income, and financial obligations of the farmers are presented in Tables 1 and 2.

Table 1: Sociodemographic details of farmers.
Participant Age Marital Status Sex Religion Experience in farming (in years) Total Family members Members involved in farming
1 51 Married Male Hindu 30 4 2
2 56 Married Male Hindu 40 5 2
3 48 Married Male Hindu 30 3 2
4 55 Married Male Hindu 35 4 2
5 52 Married Male Hindu 38 3 1
6 53 Married Male Hindu 25 2 2
7 30 Unmarried Male Hindu 06 3 3
8 38 Married Male Hindu 07 4 2
9 42 Married Male Hindu 30 4 2
Table 2: Sources of income and financial obligations of farmers.
Type of debt and source of income Number of participants
Public Institution Loans 3
Money Lenders 1
Both (Public Institution Loans and Money Lenders) 3
No obligations (No debt) 2
Cultivation only (source of income) 5
Cultivation and other allied activities (source of income) 4

Themes and subthemes identified

The three themes talk about the factors that positively influence farmers’ mental health in their social, personal, and environmental domains. The personal theme discusses about the psychological aspects of the participants that help them in maintaining their well-being. The social and environmental theme focuses on their community living, relationship, and lifestyle. The personal theme has seven subthemes, the social theme has four subthemes, and the environmental theme has four subthemes. The content of the themes and subthemes is provided in the following paragraphs.

Personal protective factors

Under this theme, farmers’ reported that (1) the feeling of autonomy being a farmer involves having more control over their life and acknowledges that a contributor to their better well-being is the availability of free time to take adequate breaks and relax as per choice. (2) Having a purpose in life acts as a motivator in life, encouraging them to take responsibility, thereby having a positive impact on their mental health and their family’s future was the most important thing in their life. (3) Passion/love toward work they are doing contributes to their mental well-being. (4) Concerning dealing with problems effectively that having certain skills and attitudes helps in coping as well as solving the issues, strategic planning involves diversifying crops, finding avenues for making more profit, managing with available resources, taking few risks, having alternate income sources, practicing discipline, educating oneself, and focusing on the present. (5) Positive mindset and Building Resilience, the farmers agreed that attitude toward the problems also has a huge impact on how it affects your mental health, sharing knowledge among others as a way of developing these skills. (6) Learning new skills, most of the farmers acknowledge learning new skills and techniques related to their profession as a confidence-boosting exercise. (7) Spiritual and religious beliefs as their source of confidence and positive outlook, activities associated with religious beliefs included; praying, visiting temples, and giving offerings.

Social projective factors

Under this theme, farmers have informed that (1) friends were perceived as support for the most important contributor to their well-being and emphasized the importance of sharing worries for better mental health. (2) Belongingness of togetherness’ to convey the feeling in the community. (3) Family plays a major role in their mental health and well-being; family supports them emotionally by being a part of the decision-making process and contributes to the feeling of happiness. (4) Social engagements, farmers mentioned that engaging in social activities is a source of relaxation and stress relief. Social activities included visiting friends and family, spending time with friends and family, use of technology, reading, shopping, and going on trips.

Environmental protective factors

Under this theme, farmers’ stated that (1) the role of their lifestyle and being physically active positively impacts their mental health and well-being; working as a farmer influences their lifestyle, and farming demands a physically active life. (2) Rural environment has a pleasant environment as a main contributor to their mental clarity. (3) The effect of institutional support as a contributor to well-being as it provides a sense of security. (4) Farmers believe that there is respect for farmers in society; this indirectly contributes to their well-being as it increases their feelings of self-worth.

Supplementary material Table 1 lists quotes/descriptions supporting the themes and subthemes identified.

DISCUSSION

The study explored the protective factors in the individual, social, and environmental domains. The identified themes were categorized into three overarching domains. Within these domains, there were a total of fifteen subthemes, the personal domain aimed to identify individual factors independent of external influences; it primarily encompassed psychological elements such as perception, understanding, awareness, and motivation. The social domain addresses the participant’s immediate surroundings and their impact on mental health and well-being; they primarily revolve around friends, family, and a sense of community, and the significance of social activities and engagements as factors contributing to mental health. The environmental themes shed light on the rural environment, which participants describe as “simple” and “pleasant,” emphasizing its significant role in their mental health and well-being.

The personal theme revealed additional determinants that align with previous literature on the farming community, including problem-solving skills, self-learning, a positive outlook, and resilience building. These findings are consistent with studies conducted by Woolford et al.;[25] Shrivastava and Desousa[26] and Padhy and Pattanayak.[27] Woolford et al.[25] emphasized the importance of farmers proactively educating themselves on topics related to well-being, while Shrivastava discussed the protective approach to resilience, whereby individuals employ specific mechanisms or measures to maintain their mental health. It is also noteworthy that two participants highlighted the significance of formal education in cultivating these skills, which underscores its crucial role in preventive interventions.

The mention of religious belief as a determinant corresponds with the idea that spiritual intervention programs also enhance mental health and promote overall well-being.[28]

Moreover, the majority of participants expressing a sense of autonomy in their occupation align with the findings of a study conducted in 2022, which demonstrated that individuals with a high level of job autonomy exhibited effective stress management.[29]

Earlier research conducted among farmers highlights that enhanced social support, such as friends and significant others,[30] as well as being part of farming communities,[31] along with a sense of belonging,[32] act as protective factors for managing stress and promoting overall mental health. These findings align with the themes identified within the social domain. The farmers’ preference for engaging in activities with others is consistent with the findings of a study that emphasizes the establishment of social relationships through leisure as a crucial factor in preventing the deterioration of mental health;[33] these findings further support the increasing body of evidence that underscores the importance of social connectedness in promoting and sustaining mental well-being among the broader population.[34]

While the previous studies suggest that climate variables and pesticide exposure can pose risks to well-being,[20] the participants in the present study emphasized the positive impact of the rural environment and lifestyle on their well-being. Despite acknowledging challenges such as insufficient rainfall and increased pesticide use, they still regarded rural life as superior to that of their urban counterparts. The recognition of an active lifestyle as a contributor to improved well-being aligns with a Japanese study that found a positive association between physical activity in rural areas and happiness and a sense of purpose.[35]

The concept of social security, encompassing governmental and institutional support, emerged as a significant theme all participants discussed. This sheds light on the risk factors for mental well-being identified in the previous literature, including financial distress,[36] health issues,chronic pain,[37] limited access to healthcare,[36] and a sense of marginalization.[38] Participants rightly identified these issues as being “beyond their control,” highlighting the importance of systemic-level care that should be provided to farmers. The recognition by one participant regarding the importance of having mental health professionals specifically trained to work with farmers aligns with the findings of Rudolphi’s study. The concept of social security, encompassing governmental and institutional support, emerged as a significant theme all participants discussed. This sheds light on the risk factors for mental well-being identified in the previous literature, including financial distress,[36] health issues, chronic pain[37] limited access to healthcare,[36] and a sense of marginalization.[38] Participants rightly identified these issues as being “beyond their control,” highlighting the importance of systemic-level care that should be provided to farmers. The recognition by one participant regarding the importance of having mental health professionals specifically trained to work with farmers aligns with the findings of Rudolphi’s study. In Rudolphi’s research, it was observed that agribusiness professionals who interact with farmers face barriers such as a lack of training and confidence when it comes to addressing mental health concerns with their clients.[39]

The strength of this study is the utilization of a qualitative approach, which enables a comprehensive understanding of farmers’ perspectives on mental health and well-being, providing valuable insights and allowing for the effective expression of their views, mental health, and well-being specifically in the context of farmers is a relatively novel investigation within the Indian population, where the previous studies have predominantly focused on identifying risk factors to address them. This study emphasizes the significance of a strength-based approach to mental health, highlighting the importance of identifying, and building on existing protective factors.

The limitation of the study is a smaller sample size to facilitate in-depth data collection and consideration of contextual factors. However, in the present study, the sample size was insufficient to validate all the identified themes fully. Female participants were not included in the research due to the unavailability of suitable candidates, resulting in a gender imbalance within the sample.

CONCLUSION

The study successfully emerged three overarching protective factors that farmers perceive as significant for their mental health and well-being, namely, personal, social, and environmental. The study findings provide valuable insights for social work practitioners, guiding them in developing interventions and strategies to support the mental health and well-being of the farming population. In addition, the study’s findings contribute to the existing body of research in this field, enhancing our understanding of the protective factors and their impact on farmers’ well-being.

Highlights

  • There has been growing concern about the psychological hazards associated with farming, such as high stress levels, depression, anxiety, and increasing rates of suicide.

  • It is imperative to understand the protective factors that contribute to mental and psychological well-being.

  • The study emerged three overarching protective factors (personal, social, and environmental) that farmers perceived as significant for their mental health and well-being.

  • The study findings provide valuable insights for social work practitioners, guiding them in developing interventions and strategies to support the mental health and well-being of the farming population.

Ethical approval

The research study was approved by the Institute Ethical Committee at National Institute of Mental Health and Neurosciences, Bangalore, number NIMH/DO.BEH:SC. Div/2022-23.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.

Financial support and sponsorship

Nil.

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SUPPLEMENTARY TABLE

Supplementary Table 1: Themes and subthemes and quotes/descriptions Themes Subthemes Quotes
Themes Subthemes Quotes
Personal protective Factors Feeling of autonomy • Farming is a good occupation. I feel it is a more relaxed profession in terms of the freedom to choose your work. If you have a salaried job you should fit into that one routine and only get the monthly salary. In farming, you have a lot more options. You can choose what you want to cultivate, you can do commercial farming, you can do long-harvest things like banana plantations, or sugarcane. You can choose your work and that itself is a good feeling -(Participant 1)
• Farmers do get a lot of free time by choice. I can take a break whenever I want nobody will ask me. My life is happy, my health is good, and I might not be able to earn and save lakhs but I have peace. I don’t have to go and work for someone else - (Participant 8)
Purpose in life • I have a life and have to do something; I have to meet my purpose in life. And for me, it’s my farming I have to do it nicely. I want to take care of my children nice for that I have to do my things. And everybody we’re doing the same thing. So, I feel like I can also do that. We need money to live, to build a home, and I have to get my son married - (Participant 3).
• For me, I want to influence youth to come forward and do agriculture. They have to feel like “I should also do like him.” I don’t want to just earn money from agriculture. At least if some person realizes that I can be in agriculture and earn by doing things like this. If 10 people feel that way that's what I want. - (Participant 7).
Passion for work • I love my job one hundred percent. He also adds, “I'm happy with it. I have never thought about doing anything else other than farming because I like what I'm doing.” Another participant talks about his happiness in seeing his work pay off by saying; when the crops are successful there is no satisfaction and happiness more than that - (Participant 1)
• I love my job. I do it because I love to do it. I used to be a driver before. I was working for someone else; I have to go when he calls and if he says no work, then I can’t go. Farming doesn't have any of those tensions. I am not saying farming is tensionless, it will have problems but I resolve them and be happy about what I have - (Participant 8)
Problem-solving skills • I have alternative income sources so I don’t have financial troubles. Problems are when some climate conditions affect our crops but at that time if you have an alternate income, it won’t affect us. It will maintain you through the problem- (Participant 7).
• I take very few risks in my work. I try to manage with whatever I have. I take loans only if I am confident that I can afford it. Also, I try to learn and understand things before I decide on my work or finances -(Participant 6).
Positive mindset and Building Resilience • I don’t get tensed that much. If something happens, what can I do? If I get tense will the problems get solved? Say, today there is no electricity and if I get tense, will the electricity come back? So, I’ll just have to wait maybe I’ll move that work to tomorrow and work on things that can be done today- (Participant 3)
• When I learn new things and try them and when I get good results, I share them with others. It gives me a kind of happiness -(Participant 9)
Learning new skills • I always keep learning new things in my area. There will be “melas” run by the agriculture and horticulture department, and I will go and learn new things. They will equip us to implement multiple earning points from our profession and it is very helpful in the development of farmers - (Participant 7).
• I do feel confident that I learn I look on mobile, there are apps and all farming apps and also in that I will look and I will study - (Participant 5).
Spiritual and Religious beliefs • When I go to the temple and give an offering, I feel like something good will happen for me -(Participant 8)
• Praying to god gives me so much belief, confidence, and trust. So, I do it and if I don’t, I’ll feel like something I have not done that day. And I will be constantly thinking about some trouble that is going to come because of that - (Participant 5).
Social protective factors Friends and peer group • Better than one person sitting and worrying about the problems we need to share and talk about them. I have my friend group for that - (Participant 7).
• Whenever there are some difficulties it’s a usual thing for me to go and talk to. We’re a farming community and we always have the same kind of issues all the time. Any time when others are having problems. I will tell them what I can, like how to do things and all because they might not know so I will tell them what they can do - (Participant 3).
Belongingness • We are into agriculture and if any problem comes up related to agriculture, I will go to other farmers to share the worries. Then what happens is that it relieves stress as they understand better - (Participant 7).
• Especially during times of difficulties, everyone will be facing similar issues so we come to each other and talk about these things and help each other out. We will feel better after that. We will get a feeling of togetherness. When everyone comes together and shares, we also come up with ideas to overcome the trouble. It makes me happy - (Participant 8).
Family • Family can be a huge support. My children are small, and school-going. My wife after taking care of the kids helps me with the agricultural requirements. She also listens to me and tries to calm me down whenever I say things-(Participant 8).
• Family is happiness and they are there for me. And I have to do something for my family, it’s a good feeling - Participant 3).
Social Engagements • Then there are family functions where I spend with family. Also, when we need to make decisions, we come together as a family for that. Except for my immediate family whom I interact with every day, these are the occasions where we come together as a family. But there is a strong feeling of unity and togetherness for me in the family. - (Participant 7).
• Every day we friends sit together around 6 o’clock or 7 o’clock and discuss our difficulties and concerns and listen to others. This happens every day and that is where we feel a little bit of relief and a feeling of being supported. Only my friends come and we sit in a circle, 7-8 people and talk about what all happened that day, crop issues and brainstorm solutions. - (Participant 2).
Environmental protective factors Lifestyle and being physically active • For us after waking up we get a good walk through the fields and our work is a good exercise for us. This keeps me healthy. I don’t have any illness and I don’t use any substance. Most of the farmers are healthy in that way - (Participant 9).
• Our job in the field in itself is our exercise. Why do we need another physical exercise? Also, I don’t eat much from outside. I need “ragi mudde.” Because of all that I don’t have any illness as of now. I don’t smoke or drink either - (Participant 8).
Rural environment • The environment we live in also helps us in being mentally healthy for sure. Especially since we wake up early in the morning and hear nature’s sound and the fresh air makes our mind clear. My mind will be free and can plan my day better. I wake up at 3 every day for many years now - (Participant 1).
• Here, we get to spend time in a peaceful atmosphere and good weather. In the city, you don’t get that -(Participant 9).
Government/Institutional Support • At times of struggle, the system does support us by giving us time to build up things back and giving us schemes to support us financially - (Participant 8).
• It’s helpful when company (NGOs) people do come and take classes for us at once every three months - (Participant 8).
Recognition in society • I think farming is a respectful job and people do see that. I am also proud to be a farmer. My father was also a farmer. The government also tries to support us by giving loans and subsidies - (Participant 4).
• Generally, there is respect for farmers and agriculture. But if we look at it, we don’t get as much respect as a city person or a person doing a job in the city. We have different ways of life. We are valued more in villages than people living in cities or non-farming communities. They don’t understand the complexities of farming - (Participant 1).
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