In terms of the number of respondents, Survey on Well-Being among Foreign Born Population (FinMonik) is so far the most extensive survey carried out among the population with foreign background in Finland. It comprises a wide range of self-reported data, including information on the respondent’s health, well-being and access to care, which can be widely utilized in planning and assessing integration, health and welfare policies. A mixed-method approach (an electronic questionnaire, a paper questionnaire and phone interviews) was used in collecting the data which consists of responses by 6836 respondents aged 18–64 years. All response types included, the response rate was 53.1% (n = 6836). This study describes in detail the methods used in the FinMonik survey. In addition, we describe the demographics of the respondents partaking in each response format. The aim of the study is to promote the development of mixed-method survey as a way of collecting reliable data that can be used to enhance foreign-born people’s health, well-being and access to health care. The survey responses will be used as a baseline in observing the respondents’ well-being through the register-based data available in several national registers on health, medicine use and access to care as well as the data collected in the study Impact of Coronavirus Epidemic on Well-Being among Foreign Born Population Study (MigCOVID). Furthermore, the FinMonik study protocol will be repeated every four years.

Background Sense of belonging (SoB) is an important determinant of health among foreign-born population and it has previously been found to be associated with perceived health. In this study we examined: 1) which types of SoB are associated with psychological strain (PS), and 2) whether this varies between different country groups. Methods The data were gathered from the cross-sectional Survey on Well-Being among Foreign-Born Population (FinMonik, n = 6 836), conducted in Finland in 2018-19. SoB was assessed by the question “Which of the following areas or groups you feel you belong to?”, classified into 1) both Finns/local municipality and citizens of country of origin CCO (acculturation identity), 2) only Finns/local municipality (local identity), 3) only CCO (origin identity), 4) only Europeans, world citizens, religious, work-related or political group (other identity), and 5) none of the previous. PS was measured by using the MHI-5 (psychological strain: yes; no). Logistic regression was used to test the association between SoB and PS, with age, sex and country of origin as confounding variables. In the analyses, weights were used to reduce non-response bias. Results Compared to the acculturation identity group, PS was more common among those with local identity (OR = 1.60, p < 0.01), origin identity (OR = 1.99, p < 0.001) or other identity (OR = 3.33, p < 0.001) and those with no belonging to any of the groups presented (OR = 5.40, p < 0.001). The last group was more likely to experience PS than the acculturation identity group in all five country groups included in the analysis. Acculturation identity was associated with less PS especially for those born in EU-, EFTA- and North American countries. Conclusions Acculturation identity was strongly associated with less psychological strain, especially when compared with the group reporting no belonging to any of the groups presented. Key messages Sense of belonging is associated with mental health and should be studied more extensively among different foreign-born population groups. Identification with both the local people and one’s own country of origin should be supported.

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There are relatively few calculations of the costs related to suicides. The aim was to produce a monetary estimate of the costs incurred as a result of suicides. The costs were divided into three categories: (1) loss of labor input, (2) costs directly following a suicide, and (3) costs associated with family members. In our two sample cases, the costs related to suicides were from EUR 309,020 to EUR 456,279. By putting the monetary costs of suicide prevention intervention and the calculation of costs related to a death by suicide side by side, this study may help when allocating funding for effective intervention.

Background National identities are socially constructed and imaginary groups with real-life consequences. Migrants are in a heightened risk to be treated as ‘others’ who do not belong to society. It remains unclear, to what extent national belonging is experienced among Finnish migrants and what consequences on health this has. We study migrants’ sense of belonging to Finns, how it’s manifested in sociodemographic groups and whether it’s associated with psychological strain. Methods We used nationally representative data from the cross-sectional Survey on Well-Being among Foreign-Born Population (FinMonik, n = 6836). National belonging was assessed by the item “Finns” in question “which of the following areas or groups you feel you belong to?”. Response options fully and quite a lot were coded to indicate sense of belonging. Logistic regression was used to test the association between belonging, sociodemographic factors and psychological strain (MHI-5). Weights were used to correct the sample. Results 51% reported sense of belonging to Finns. 46% of those aged 30-44 reported sense of belonging to Finns, whereas the youngest and oldest age groups yielded highest prevalences (18-29=53% and 45-64=58%, p<.001). Married persons reported sense of belonging to Finns more than those who weren't (55% vs. 48%, p<.01). Country group accounted for the variation in Finnish identification with a p-value of less than 0.001. Only 27 percent of those born in East Asia reported sense of belonging to Finns, whereas almost 60% of those born in Middle East and North Africa sensed belonging to Finns. Those with sense of belonging to Finns were twice as likely to report lack of psychological strain than those with no sense of belonging to Finns (p<.001). Conclusions Achieving national belonging to the receiving society seems to be more difficult or non-appealing for some migrant populations than others. Lack of national belonging poses risk of deterioration of mental health. Key messages • The socially constructed boundaries of national belonging can be exclusionary and have negative consequences for the health of migrant populations. • Experiencing a sense of national belonging to the country of residence has positive associations with mental wellbeing.