Year: 2020 Source: BMC Public Health. (2020).DOI: SIEC No: 20200400

Background: Compared with the general population, Australian farmers—particularly men—have been identified
as at greater risk of suicide. A complex range of factors are thought to contribute to this risk, including the
experience of Stigma. stigma also impacts those who have attempted suicide, their carers, and those bereaved by
suicide—manifesting as shame, guilt, social isolation, concealment of death, reduced help seeking and ongoing risk
of suicide. This paper evaluates the effectiveness of an intervention, tailored for the farming context, designed to
reduce stigma among farming men with a lived experience of suicide.
Methods: The digital intervention used an adult learning model providing opportunity to share insights, reflect,
learn and apply new knowledge among people with shared farming interests, suicide experience and cultural
context. A range of content—tailored to the gender, farming type and suicide experience of participants—included
video stories, postcard messages, education and personal goal setting. Pre- and post- assessment of suicide stigma
and literacy was complemented by qualitative data collection during the intervention and participant feedback
Results: The intervention was successful in reaching members of the target group from across Australia’s rural
communities—with diverse geographic locations and farming industries represented. One hundred and sixty-nine
participants from the target group (farming males aged 30–64 years) were recruited. While the Stigma of Suicide
Scale failed to identify a reduction in self- or perceived-stigma, qualitative data and participant feedback identified
behavioural indicators of stigma reduction. Four subthemes—‘growth’, ‘new realisations’, ‘hope’ and
‘encouragement’—highlighted attitudinal and behaviour change indicative of reduced stigma associated with
mental health and suicide.
Participants’ baseline suicide literacy (Literacy of Suicide Scale) was high when compared with previous community
samples and total literacy scores did not demonstrate significant improvement over time, although literacy about
the link between suicide and alcoholism did significantly improve.
Conclusions: These results highlight opportunities in groups with high suicide literacy for targeted stigma
reduction and suicide prevention efforts for both the target group and other populations within Australia and
internationally. Results also highlight the need to reassess how stigma change is understood and evaluated across a
wider range of population groups.