Factors associated with the farmer suicide crisis in India

Background: In India, it is estimated that similar to 16,000 farmers die by suicide each year, and at rates far above those of the general population. This paper reviews much of the literature concerning the factors associated with this crisis. Methods: A literature search was undertaken from multiple databases on Ovid, as well as more elementary searches of Google, Google Scholar, and PubMed. This paper presents a review of the key results. Results: Socioeconomic factors, rather than mental health problems, are associated with farmer suicides, with increased indebtedness playing the predominant role. Available research suggests this has arisen to a greater extent recently, due to an agrarian crisis affecting the most vulnerable farmers. This has multiple manifestations, including a lack of agricultural investment and irrigation improvement, use of cash crops, the increased use of noninstitutional credit sources, and the reduction of trade barriers. Bt cotton is unlikely to be an important factor and no studies reported a significant burden of mental health problems. Conclusion: Indebtedness and numerous factors relating to this are clearly identified as the most important risk factors. Further large-scale assessments are required to further understand the situation. (C) 2016 Ministry of Health, Saudi Arabia, Production and hosting by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).