Pesticide-induced suicide: Promoting global environmental health policy through a tailored community-based participatory intervention in Suriname

In Suriname, pesticide policies and regulations are lacking. Pesticide use is directly linked to agricultural activity. Located in the western region of Suriname, Nickerie has an agriculturally dependent, predominantly Hindustani population; 60-70% lives below the poverty line. Suicide and attempted suicide is a significant problem in Hindustanis ages 19-30. The 2011 suicide rate was 41/100,000, more than twice the country's rate. Approximately 58% was pesticide-induced. The University of Suriname, Tulane University and local communities are implementing the Integrated Pesticide Management Intervention Project- the first in-country investigation to develop a community-based participatory safe pesticide storage, use and disposal intervention. The needs assessment phase characterizes factors influencing pesticide use, misuse, including as a suicide agent, and options for safe storage and disposal. Six focus groups were convened and a demographic questionnaire, the SF 36 and Scale of Ethnic Experience instruments administered to assess health status and psychosocial functioning. The focus groups centered on 4 domains: pesticide management, community health, mental health, suicide and suicide support, psychosocial factors, community needs/ assets, and intervention strategies including community pesticide interventionists. Most of the 67 participants (92%) used or kept pesticides at home; 38% reported having a family member harmed by pesticides; 60% knew a family hurt or killed using pesticides. Almost all (97%) want more mental health support. The key focus groups recurring themes were identified using Atlas Ti. Participants confirmed pesticides mis/overuse. There was consensus suicide stems from ignored psychosocial problems and minimal support. The unrestricted availability of pesticides is considered a key suicide contributor. Among young adults, family/ relationship problems are main pesticide-induced suicide drivers. Community pesticide interventionists would be trusted resources. The results provide insight in the magnitude of pesticide-induced suicide, access, use and intervention strategies. Data from the SF 36 and SEE will be included in the final poster.