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Background: Deliberate self-poisoning by ingesting pesticides is a serious health problem among farmers, especially in low- and middle-income countries. Preventing these suicides is a priority for a public mental health agenda.Objective: To examine the role of pesticide poisoning in suicide and nonfatal deliberate self-harm, and clarify awareness of risks, safe practices concerning storage and use of pesticides, and associated self-injury, both unintentional and intentional, within farmer households of the Sundarban region, India.Methods: Retrospective record review of adult cases of deliberate self-poisoning at the Block Primary Health Centres of 13 Sundarban Blocks was performed to analyze the relative roles of various methods of self-harm and their lethality. Focus group discussions, questionnaires, and in-depth interviews were undertaken in a community study of farmer households to examine pesticide-related views and practices, with particular attention to storage, use, and health impact.Results: Pesticide poisoning was the most common method of deliberate self-harm in both men and women. Pesticide storage in most households was unsafe and knowledge was inadequate concerning adverse effects of pesticides on health, crops, and the environment.Conclusions: An intersectoral approach linking the interests of public health, mental health, and agriculture is well suited to serve the collective interests of all three agendas better than each in isolation. Such an approach is needed to reduce morbidity and mortality from unintentional and intentional self-injury in low-income agricultural communities like those of the Sundarban region. [ABSTRACT FROM AUTHOR]

An ethnographic survey of six villages of two developmental blocks of Sundarban region was done as a part of a cultural epidemiological mental health research for the development of a community mental health service in the region. It was noted that the deliberate self-harm (DSH), specially by pesticide poisoning is an emerging public health problem in the entire region. The present paper deals with the DSH findings, both attempted and completed, of village survey. Different socio-cultural dynamics of DSH is discussed with a view to develop a need-based community mental health service programme in the region. [ABSTRACT FROM AUTHOR]