Background and significance:

Nickerie with high agricultural activity is burdened by very high suicide rates of 47/100,000 and suicide attempt rates of 207/100,000. Almost 44 % is committed by pesticide ingestion. Interventions, like safe storage and use of pesticides may assist in reducing the number of pesticide-induced suicides. This applies to so-called “impulsive” suicide attempts. To date, local activities on safe pesticide use had limited success by the community at large, making achieving sustainability difficult.

Methods:

Focus group meetings were held in a needs assessment phase for qualitative data. For quantitative data, two surveys, the SF-36v2 , to measure the health-related-quality-of-life and the SEE survey, to measure the perceived discrimination of the participants, was conducted. Data were analyzed by composing 2x2 tables and calculating odds ratios, chisquare tests and Fisher tests using SPSSv19 software.

Results:

Age groups 15-30, 30-45 and 45-60 years are at risk for poor mental health. Physical health is poor in Paradise. Low educated people are at risk for poor physical, poor mental and poor overall health. Alcohol and drugs use happen more among low educated participants, age groups 15-29 and above 60 years, in Henar, survivors and males. Awareness is more in age groups 15-44 and above 60 years and high-educated ones. Feelings expressions are more by low educated ones, while less by age group 15-29 years and males. Passive behavior is more among low educated ones, those above 45 years and in Paradise. Feelings of guilt are more among high-educated ones, those of 15-29 years, in Paradise and Nw. Nickerie and females. Attacking behavior is more among 15-44 and above 60 years, in Paradise and Nw. Nickerie and females.

Conclusions:

Low education is a risk factor for poor physical, mental and overall health. Age is a risk factor for poor mental health. Residence is a risk factor for poor physical health. Low education is a risk factor for alcohol and drugs, not being aware, feelings of guilt and being passive. Age is a risk factor for alcohol and drugs use, feelings of guilt, being passive, feelings expressions and attacking people. Residence is a risk factor for alcohol and drugs use, not being aware, feelings of guilt, being passive and attacking people. Gender is a risk factor for alcohol and drugs use, feelings of guilt, being passive, feelings expressions, and attacking people.

Recommendations:

Focus should be on mental health care for young and low educated people through enforcement, awareness to break the taboo and reduce other barriers and easy access. Creating different education opportunities to increase the education level and efforts to increase physical health in Paradise and the young; alcohol and drugs use awareness activities among people at risk and considering all observed associations of awareness, being passive and expressing feelings, to tailor intervention strategies can lower the pesticide-induced suicides rates. Training of health ambassadors, creating a “buddy” network, applying e-health by means of electronics and smart phones at short term and long-term phases can result in a decrease of the pesticide-induces suicides in Nickerie.