Chiswell Hannah
Francis Close Hall, Countryside and Community Research Institute, University of Gloucestershire, Cheltenham, UK.
J Agromedicine. 2023 Apr;28(2):151-176. doi: 10.1080/1059924X.2022.2089419. Epub 2022 Jun 22.
The mental health of the farming community across industrialised nations has long been a major concern. Using an adapted procedure for a systematic literature review of observational epidemiological studies reporting prevalence (informed by the Joanna Briggs Institute method), this paper reviews peer-reviewed literature that explicitly compares farmer and non-farmer mental health ( = 48). In doing so, it provides a central and accessible evidence base for researchers and practitioners, and simultaneously reveals a stark lack of consensus; specifically, 54.0% of measures deployed to assess farmer mental health determined it to be the same as or even better than non-farming populations. This ambiguity sits in sharp contrast to the unequivocally worrisome farmer suicide statistics. Informed by the literature, the paper discusses potential reasons for this mismatch, including (i) farmers' progression through a different "pathway" to suicide that is not always preceded by mental illness, and (ii) a failure of current methods to accurately gauge the mental health status of farmers. The paper concludes by recommending more research into farmers' "pathway" to suicide, and highlights the need for a dedicated and multi-disciplinary programme of methods research that will afford a more culturally appropriate and effective means of understanding mental health in the farming community.
长期以来，工业化国家农业社区的心理健康一直是一个主要问题。本文采用一种经过调整的程序，对报告患病率的观察性流行病学研究进行系统的文献综述（以乔安娜·布里格斯研究所的方法为依据），回顾了明确比较农民和非农民心理健康状况的同行评议文献（n = 48）。在此过程中，它为研究人员和从业者提供了一个核心且易于获取的证据基础，同时揭示出明显缺乏共识的情况；具体而言，用于评估农民心理健康状况的指标中有54.0%确定其与非农业人口相同甚至更好。这种模糊性与令人担忧的农民自杀统计数据形成鲜明对比。基于文献，本文讨论了这种不匹配的潜在原因，包括：（i）农民通过不同的“自杀途径”发展，这种途径并不总是以精神疾病为先导；（ii）当前方法未能准确衡量农民的心理健康状况。本文最后建议对农民的“自杀途径”进行更多研究，并强调需要开展专门的多学科方法研究计划，以提供一种在文化上更合适、更有效的方式来理解农业社区的心理健康。
