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Addressing mental health problem must to tackle farmers’ suicide


By Moin Qazi*
"How many deaths will it take ‘til he knows
That too many people have died
The answer, my friend, is blowin’ in the wind,
The answer is blowin’ in the wind."
–Bob Dylan, Nobel Laureate

India’s economy may be soaring as it glows as the new poster-child of emerging markets, but agriculture remains its Achilles heel. It is the source of livelihood for hundreds of millions of people but a contributor of just a fraction of the nation’s total economy and a symbol of its abiding problems.
Large swathes of cotton farms in the central India have been the epicentre of a debt crisis that has gripped the rural population. For years now, it has driven thousands of farmers to commit suicide. These suicides are debilitating scars on a nation’s development canvas. While debates continue to rage on reforming the agricultural sector to improve the economic conditions of the farmer, there has not been any serious attempt to focus on the possible psychological problems arising out of economic stress that may be leading to suicides.
Farmer suicides in India rose to 8,007 in 2015 from 5,650 the previous year – an increase of 41.7 percent, according to data released by the National Crime Records Bureau this year. Farmer suicides are not just a reflection of an ailing rural economy. It also shows a state of despair among farmers which make them so emotionally fragile that they are meekly taking their own lives.
A field-based research study in the prestigious medical journal “The Lancet” (by Pandit et al) concludes, “Most Indians do not have community or support services for the prevention of suicide and have restricted access to care for mental illnesses associated with suicide, especially access to treatment for depression, which has been shown to reduce suicidal behaviours.” According to the Lancet study, the overwhelming cause of suicide is mental stress, not financial stress. But the underlying mental issues cannot be cured by loan waivers and subsidies. Counseling has a great role to play in alleviating stress and helping depressed people improve their self-esteem and their ability to cope with despair.
The focus is now slowly shifting on addressing the psychological aspects of suicide and not restricting to just the financial dimension. It has been observed that palliatives like loan waivers have only a temporary effect and have not been able to address the root cause of suicides. An example of a successful initiative is VISHRAM (Vidarbha Stress and Health Programme). Designed by Dr Vikram Patel, a professor at the Public Health Foundation of India, VISHRAM was implemented in the Vidarbha region over a period of 18 months. There has been a significant change in the depressive conditions of farmers who were exposed to counselling during the programme.
Patel used community volunteers and trained them as mental health workers for his project. He runs focus groups to gauge community acceptance and conducts trial sessions to train new counsellors. The therapy includes diagnosis by a doctor or a health worker at a primary health centre, medication if necessary, and counselling from the staff. According to Patel, mental health support workers can be trained at a modest cost. In countries like India where there are significant shortages of psychiatrists, these mental workers can be a successful alternative. Even family elders are sometimes the best counsellors. With training in basic psychological skills, they can play a very useful role in curbing suicidal tendencies.
A much larger project is being launched by Punjab Agricultural University (PAU) which has now teamed up with its counterparts in Telangana and Maharashtra, and also the psychology department of the Punjabi University at Patiala, to create a “stress index” (SI) for farmers and prepare a training module for village-level volunteers to counsel those on the verge of committing suicide.
The exercise is part of a research project, for which the Indian Council of Agricultural Research has released INR 1.35 crores. It will focus on the psychological and behavioural aspects behind farmer suicides. The target is to survey 1,000 “vulnerable” farmer households at both baseline (before counselling) and end line (after counselling) stages, while also training 200 ‘peer support volunteers’ (PSVs) in Punjab and 100 each in the other two states. They would identify distressed farmers within their areas and provide about six months of counselling to prevent them from taking any extreme steps. The PSVs be would trained to provide sociological and psychological inputs and motivate farmers to follow a positive path and practice austerity and simple lifestyle.
The study has two major components – Stress Index (SI) and Psychological Resource Index (PRI). Stress index of the farmers will be measured on the basis of eight tools, including depression, suicidal tendencies, resilience, hopelessness among others. It will be a qualitative as well as a quantitative study. Typically, distressed farmers would show a high SI index and a low PRI – these two together would measure their mental strength and readiness to cope up with stress. A high PRI would indicate resilience – which should reflect after six months of counselling.

Working of the project

Step 1 – Survey will be conducted on 1,000 ‘vulnerable’ farmer households.
Step 2- The data collected from these farmers will be used to measure their stress levels and whether they are mentally strong enough to handle it.
Step 3- Distressed farmers would typically exhibit high SI and low PSI, a measure of their mental strength and resilience to cope up with stress.
Step 4- Around 200 PSVs in Punjab and 100 each in Telangana and Maharashtra will identify distressed farmers within their areas and provide about six months of counselling to prevent them from taking any extreme steps.
For every Indian farmer who takes his own life, a family is hounded by the debt he leaves behind, typically resulting in children dropping out of school to become farmhands. The Indian government’s response to the crisis—largely in the form of limited debt relief and compensation programs has failed to address the magnitude of the problem or its underlying causes.
Farmers’ suicides have to be tackled on several fronts and addressing mental health problems is just one of them, but certainly a major part of the solution. The new direction which farmers’ relief and welfare effort are taking is a good and hopeful sign. We increasingly have the tools, but we need to summon the will the way game changers like Patel are doing. People like him have shown there are solutions if we think out of the box.

*Author of the bestselling book, “Village Diary of a Heretic Banker”, has worked in the development finance sector for almost four decade

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