Why our farming patients are at an increased risk of taking their own lives this year

Bridget Osborne's editorial (1) describing the increased risk of suicide among farmers overlooks the effects of HS2 on the mental health of the rural community. The proposal for HS2 marches on despite an enormous amount of doubt from all quarters. Furthermore the technical report from Temple-ERM (2) regarding the health impact has been superficial to say the least, hidden quietly as appendix 9 of the HS2 Sustainability Statement and with only 29 references. For example there is no mention in HS2 health assessment policy of the suicide risk of farmers, apparently well known to the government through their Suicide Prevention Policy.(3) Surprisingly, according to the health analysis there is no legislative requirement for health impact assessments with these major projects, something which should sound alarm bells in the corridors of medical and public health colleges and the Department of Health. HS2 will take up to 20 years to complete.(4) The effects of 20 years of emotional, economic, and financial uncertainty will lead to mental health issues for many communities. There is anecdotal evidence that rural businesses that supply farmers have already seen a 20% drop in turnover (5) reflecting farmers' insecurities about their business future. Furthermore farmers have little reassurance in a fickle and as yet unclear compensation scheme to counteract their hardship. The government has already stated the project has a limited budget and should represent 'best value' for the public rather than supporting farmers and rural communities to the degree of the true financial loss. This merely provides further justification for farmers worries that they will be last in line for any handouts, after consultant and construction costs. I fear for the mental health of hard working farmers as a result of the economic suffocation HS2 planning is producing on farmers and rural communities, the hidden blight of the 'pre-construction threat' never mentioned in any press release or government statement so far.

Osborne refers to the 'ups and downs' of farming. It is likely to be down for a long time in certain parts of central England and the mental health effects will be on the whole of the rural community not just farmers. Public Health should ensure all major projects should have a more robust, deeply evidenced and searching analysis of health outcomes.

References

1. Osborne B. Why our farming patients are at an increased risk of taking their own lives this year. Br J Gen Pract 2013; 63: 624.

2. Temple-ERM. High Speed Rail: Consultation on the route from the West Midlands to Manchester, Leeds and beyond Appendix E9 - Health Analysis, A report by Temple-ERM for HS2 Ltd. July 2013. www.gov.uk/government/uploads/system/uploads/attachment_data/file/216928/Preventing -Suicide-in-England-A-cross-government-outcomes-strategy-to-save-lives.pdf (accessed 1 Nov 2013).

3. Department of Health. Preventing suicide in England, A cross- government outcomes strategy to save live. September 2012 www.gov.uk/government/uploads/system/uploads/attachment_data/file/216928/Preventing -Suicide-in-England-A-cross-government-outcomes-strategy-to-save-lives.pdf (accessed 30 Nov 2013).

4. HS2 Ltd, Key Date, http://www.hs2.org.uk/about-hs2/key-dates (accessed 1 Dec 2013)

5. Verbal communication with author

Conflict of Interest:

None declared