"I've given up": Biopsychosocial factors preceding farmer suicide in Wisconsin.

Recent studies have suggested that individuals working in certain occupations may be at increased risk for suicide. While occupation is an individual-level factor, one's work is situated in organizations, communities, and societies that are impacted by policies and systems. Analysis of existing data has identified that farmers are among those with elevated rates of suicide. This qualitative study reports themes that capture the experience of farmers prior to their death by suicide in Wisconsin. This retrospective qualitative study analyzed data from the Wisconsin Violent Death Reporting System. Data on farmer suicides that occurred in Wisconsin between 2004 and 2018 were accessed. Qualitative analyses followed an inductive thematic analysis approach. All study activities were approved by the institutional review board at the Medical College of Wisconsin. Between 2004 and 2018, 190 farmers died by suicide in Wisconsin. Five themes were identified in the qualitative analysis: "rugged individualism" clashes with a need to rely on others, interpersonal loss causes intense emotional pain and suffering, financial stress and strain overwhelm Wisconsin farmers, farmers are providers for families and communities, and alcohol and firearms are a lethal combination. Farmers who died by suicide in Wisconsin were facing significant stressors at the time of their death, many of which were not directly related to verifiable diagnosed mental illness. These circumstances varied, from physical health issues to financial stressors, to emotional pain from interpersonal conflict, and to access to lethal means. This study provides evidence calling for a public health solution to this issue, through changes at the policy, systems, and cultural levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).