“I’ve given up”: Biopsychosocial factors preceding farmer suicide in Wisconsin.
Abstract
Recent studies have suggested that individuals working in certain occupations may be at increased risk for suicide. While occupation is an individual-level factor, one's work is situated in organizations, communities, and societies that are impacted by policies and systems. Analysis of existing data has identified that farmers are among those with elevated rates of suicide. This qualitative study reports themes that capture the experience of farmers prior to their death by suicide in Wisconsin. This retrospective qualitative study analyzed data from the Wisconsin Violent Death Reporting System. Data on farmer suicides that occurred in Wisconsin between 2004 and 2018 were accessed. Qualitative analyses followed an inductive thematic analysis approach. All study activities were approved by the institutional review board at the Medical College of Wisconsin. Between 2004 and 2018, 190 farmers died by suicide in Wisconsin. Five themes were identified in the qualitative analysis: "rugged individualism" clashes with a need to rely on others, interpersonal loss causes intense emotional pain and suffering, financial stress and strain overwhelm Wisconsin farmers, farmers are providers for families and communities, and alcohol and firearms are a lethal combination. Farmers who died by suicide in Wisconsin were facing significant stressors at the time of their death, many of which were not directly related to verifiable diagnosed mental illness. These circumstances varied, from physical health issues to financial stressors, to emotional pain from interpersonal conflict, and to access to lethal means. This study provides evidence calling for a public health solution to this issue, through changes at the policy, systems, and cultural levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Recent studies suggest benefits of multi-modal approaches tailored to the farming community, as the aetiology of problems in this community is diverse.
“These studies suggest the benefits of multi-modal approaches that are tailored to the farming community, as the aetiology of problems in this community is diverse.”
From Improving the mental health of farmers: what types of remote support are acceptable, feasible, and improve outcomes? A feasibility RCT (2024) · cites this paper as [28]
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Understanding the factors contributing to farmer suicide: a meta-synthesis of qualitative research
Purc-Stephenson, Doctor, & Keehn (2023) · Rural and Remote Health · doi:10.22605/rrh8189 · Cited by 32 · see citing works
Whitaker, S. H. (2024) · Agriculture and Human Values · doi:10.1007/s10460-024-10586-z · Cited by 21 · see citing works
“The majority of studies on farmer well-being have been conducted in developed countries (Daghagh Yazd et al. 2019; Kohlbeck et al. 2022; Lunner Kolstrup et al. 2013; Wheeler & Lobley 2022).”
Roth, K. B., Gaveras, E., Ghiathi, F., Shaw, E. K., Shoemaker, M., Howard, N. A., Dhir, M., Caiza, G. R., & Szlyk, H. S. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20247145 · Cited by 5 · see citing works
“Existing international work underscores barriers, such as stigma or aspects of rural culture [19,20], or reinforces addressing barriers, such as healthcare shortages [21].”
BackgroundFirearm Owner Identities and Storage Practices: Responsible Owners or Responsible Actions?
Warner, T. D., Buttrick, N. R., Carpenter, S. M., & Kohlbeck, S. A. (2025) · Health Promotion Practice · doi:10.1177/15248399251367349 · Cited by 6 · see citing works
Self-citationLamont, K., van Woerden, H. C., King, E., Wendelboe-Nelson, C., Humphry, R. W., Stark, C., Williams, C., & Maxwell, M. (2024) · Discover Mental Health · doi:10.1007/s44192-023-00054-1 · Cited by 5 · see citing works
“There has been a recent encouraging growth in studies addressing mental health and suicide prevention in farming communities, with the publication of a range of qualitative studies in different parts of the world [14, 28–31], and a number of intervention studies [32–34].”
Background“We’re All in This Together”: Farmers’ Reactions to the Farmer Suicide Crisis
Paskewitz, E. A., Bertram, V., & Miller, L. E. (2024) · Health Communication · doi:10.1080/10410236.2024.2378255 · Cited by 2 · see citing works
“Many farmers expressed disgust when needing to rely on others, especially when faced with physical ailments (Kohlbeck et al., 2023).”
InfluentialToward a Public Health Approach to Farmer Suicide Prevention: The Potential Power of Systems Change
Kohlbeck, S. A., Quinn, K. G., deRoon‐Cassini, T. A., Hargarten, S. W., Nelson, D., & Cassidy, L. D. (2024) · Journal of Agromedicine · doi:10.1080/1059924x.2024.2388253 · Cited by 2 · see citing works
“17 Firearms can be used as a tool of the trade in farming, in that farmers use fire-arms to manage pests and to protect their crops from larger threats.”
InfluentialSelf-citationUtilizing Artificial Intelligence for Suicide Risk Detection: Differences in Older Adults
Tapiavala, V. N., Moore, D. E., & Fortuna, K. L. (2026) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-026-00649-9 · Cited by 1 · see citing works
“These factors include diminished status and power, increased reliance on others, and reduced capacity for self-determination (Canetto, 2017; Kohlbeck et al., 2023).”
Soupene, V. A., Jennissen, C. A., Stange, N. R., Hoogerwerf, P. J., Branch, C. A., & Doobay, M. F. (2025) · Journal of Community Health · doi:10.1007/s10900-025-01533-y
“For instance, those residing on farms or within farming communities often hold distinct views on firearms and safe firearm storage compared to other rural residents [21, 22 ].”
Soupene, V. A., Davis, J., Cavanaugh, J. E., Platt, J., Romitti, P. A., & Casteel, C. H. (2026) · American Journal of Industrial Medicine · doi:10.1002/ajim.70078
“Job strain has been identified as a risk factor for suicide [3, 11–17].”
Suicide and Place: how do area characteristics affect suicidality? A Meta-ethnography
Gregory, B., Ambler, F., Brennan, C. A., & Brennan, C. (2026) · Social Science & Medicine · doi:10.1016/j.socscimed.2026.119646
Kohlbeck, S. A. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1937891
Self-citation
- Authors
- Kohlbeck, S. A., Quinn, K., deRoon-Cassini, T., Hargarten, S., Nelson, D., & Cassidy, L.
- Affiliations
- Medical College of Wisconsin (US)
- Venue
- American Journal of Orthopsychiatry
- Published
- 2023
- Volume
- 93
- Issue
- 2
- Pages
- 131-143
- ISSN
- 0002-9432 (ISSN-L)
- 1939-0025
- OpenAlex
- W4312095720
- Cited by
- 12
- References
- 0
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 4 · 2023: 2
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Orthopsychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Agriculture and Farm Safety
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- farmer suicide, occupational suicide risk, biopsychosocial factors, financial stress, interpersonal loss, rugged individualism, family responsibilities, suicide prevention policy
- MeSH terms
- Farmers, Humans, Retrospective Studies, Suicide, Wisconsin, Qualitative Research
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