The ripple effect: a digital intervention to reduce suicide stigma among farming men

摘要

Background: Compared with the general population, Australian farmers—particularly men—have been identifiedas at greater risk of suicide. A complex range of factors are thought to contribute to this risk, including theexperience of Stigma. stigma also impacts those who have attempted suicide, their carers, and those bereaved bysuicide—manifesting as shame, guilt, social isolation, concealment of death, reduced help seeking and ongoing riskof suicide. This paper evaluates the effectiveness of an intervention, tailored for the farming context, designed toreduce 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 culturalcontext. A range of content—tailored to the gender, farming type and suicide experience of participants—includedvideo stories, postcard messages, education and personal goal setting. Pre- and post- assessment of suicide stigmaand literacy was complemented by qualitative data collection during the intervention and participant feedbacksurveys.Results: The intervention was successful in reaching members of the target group from across Australia’s ruralcommunities—with diverse geographic locations and farming industries represented. One hundred and sixty-nineparticipants from the target group (farming males aged 30–64 years) were recruited. While the Stigma of SuicideScale failed to identify a reduction in self- or perceived-stigma, qualitative data and participant feedback identifiedbehavioural indicators of stigma reduction. Four subthemes—‘growth’, ‘new realisations’, ‘hope’ and‘encouragement’—highlighted attitudinal and behaviour change indicative of reduced stigma associated withmental health and suicide.Participants’ baseline suicide literacy (Literacy of Suicide Scale) was high when compared with previous communitysamples and total literacy scores did not demonstrate significant improvement over time, although literacy aboutthe link between suicide and alcoholism did significantly improve.Conclusions: These results highlight opportunities in groups with high suicide literacy for targeted stigmareduction and suicide prevention efforts for both the target group and other populations within Australia andinternationally. Results also highlight the need to reassess how stigma change is understood and evaluated across awider range of population groups.Trial registration: This research project was registered with the Australian New Zealand Clinical Trials Registry(ANZCTR) (ACTRN12616000289415) on 7th March, 2016.