Suicide is preventable.
The most effective way to prevent deaths from pesticide suicide is to restrict access to acutely toxic pesticides that are harmful to human health. This is best achieved through government regulation to ban or phase out lethal pesticides, replacing them with less toxic alternatives.
This approach is called “means reduction”– reducing access to highly lethal means of suicide. While this does not stop people from ingesting pesticides, it does save lives.
Studies have shown that when lethal means are made less available or deadly, suicide rates by that method decline.
Many people ingest pesticides as an act of self-harm and do not actually intend to die. They may be unaware that the pesticide they have chosen is deadly.
Pesticide suicide attempts are usually impulsive. More than half of people who self-harm with pesticides decided to do this less than 30 minutes beforehand.
The majority of people who attempt suicide and survive will not go on to die by suicide at a later date.
Between 1980 – 2010, Sri Lanka implemented a series of policies designed to limit the access and availability of pesticides responsible for deaths. This included bans on 36 highly hazardous pesticides. This resulted in a staggering 70% drop in the annual suicide rate, with an estimated 93,000 lives saved over 20 years.
In the 1990s and 2000s, 21 highly hazardous pesticides were partially or completely banned in Bangladesh. The rate of suicide from pesticide poisoning then fell significantly between 1996 and 2014, with a 65% decline.
In 2011, the South Korean government banned the sale of a specific deadly pesticide that was responsible for most pesticide suicide cases. Over the next two years, the number of pesticide suicides halved.
Effective surveillance systems are needed to collect data on cases of pesticide poisoning and death and identify the products responsible.
Alternative pest control measures must be identified for each crop and pest combination, ensuring that food production is not affected.
Crop yields must be monitored to ensure that agriculture, and the wider economy, is not adversely impacted by pesticide regulation.
Bans are the most effective way to prevent deaths from pesticide self-poisoning.
While other approaches, including mental health services and community interventions, are possible, these are not as effective in saving lives.
There is no doubt that mental health services are crucial to suicide prevention and must be available in rural farming communities in low and middle income countries.
However, you do not need to have a mental health disorder to self-harm with pesticides. Most instances are impulsive in short-term moments of crisis. Bans on lethal pesticides ensures that people survive (from ingesting less lethal pesticides) and can then benefit from mental health services to improve their lives.
The development and implementation of guidance for the management of pesticide poisoning can improve treatment in low and middle income countries.
However, some pesticides are so lethal that just a small amount is enough to kill a person. There is no effective antidote and, despite receiving exceptional patient care, it is unlikely that someone will survive.
Pesticide vendors may be able to act as ‘gatekeepers’ within their communities. Training can help them identify people at risk of self-harm, so that they do not sell to them. This intervention is currently being trialled in Sri Lanka.
However, even if this intervention is proven to be effective, it will only prevent deaths in instances where pesticides have been bought from a shop. It will not stop someone from harming themself with a pesticide stored in their home.
Safe storage, where pesticides are locked away when not in use, could help to restrict access to lethal pesticides in moments of crisis.
However, a large scale study in Sri Lanka, where lockable containers containers were provided to over 53,000 household, ultimately showed no effect or benefit to safe storage.