Prevalence of suicidal ideation and suicide attempts among refugees: a meta-analysis

Abstract

Background Suicidal ideation and attempts are one of the most serious mental health problems affecting refugees. Risk factors such as mental disorders, low socio-economic status, and stressful life events all contribute to making refugees a high-risk group. For this reason, this meta-analysis aims to investigate the prevalence of suicidal ideation and attempts among refugees in non-clinical populations. Method We searched PubMed, Web of Science, PubPsych, and PsycInfo for articles reporting (period) prevalence rates of suicidal ideation and attempts. Inclusion criteria were the population of refugees or asylum seekers (aged 16 years and older), assessment of the prevalence of suicidal ideation and attempts in empirical studies in cross-sectional or longitudinal settings, written in English, and published by August 2020. Exclusion criteria were defined as a population of immigrants who have lived in the host country for a long time, studies that examined children and adolescents younger than 16 years, and research in clinical samples. Overall prevalence rates were calculated using Rstudio. Results Of 294 matches, 11 publications met the inclusion criteria. The overall period prevalence of suicidal ideation was 20.5% (CI: 0.11–0.32, I2 = 98%, n = 8), 22.3% (CI: 0.10–0.38, I2 = 97%, n = 5) for women, and 27.7% for men (CI: 0.14–0.45, I2 = 93%, n = 3). Suicide attempts had an overall prevalence of 0.57% (CI: 0.00–0.02, I2 = 81%, n = 4). Conclusion There is a great lack of epidemiological studies on suicidal ideation and attempts among refugees. The high prevalence of suicidal ideation indicates the existence of heavy psychological burden among this population. The prevalence of suicide attempts is similar to that in non-refugee populations. Because of the large heterogeneity between studies, the pooled prevalence estimates must be interpreted with caution. The results underline the need for systematic and standardized assessment and treatment of suicidal ideation and attempts.

Suicide in Global Mental Health

“…Research around suicide and STB in humanitarian settings and refugee populations has grown in recent years, though a clear picture still emerging. One systematic review demonstrated higher prevalence of suicidal thoughts but similar prevalence of attempts in refugee compared to non-refugee populations; of note, this report highlighted the heterogeneity in studies and suggested interpretation with caution [ 53 ]. Another systematic review found that refugee status was an important factor in suicide, with refugees seeking asylum having higher risk of suicide but refugees granted asylum having lower risk of suicide than the host population [ 54 ].…”

Prevalence of suicidality and associated factors of suicide risk in a representative community sample of families in three East African refugee camps

“…Recent meta-analyses and systematic reviews summarize the current state of research on the prevalence of suicidality among refugee populations [ 27 – 30 ]. A meta-analysis of 11 studies with community samples of refugees aged 16 or older reported periodic prevalence rates of 20.5% for suicidal ideation and of 0.57% for suicide attempts [ 27 ].…”

“…Recent meta-analyses and systematic reviews summarize the current state of research on the prevalence of suicidality among refugee populations [ 27 – 30 ]. A meta-analysis of 11 studies with community samples of refugees aged 16 or older reported periodic prevalence rates of 20.5% for suicidal ideation and of 0.57% for suicide attempts [ 27 ]. Cogo and colleagues [ 28 ] included 77 studies (thereof 54 with community samples) with five different subgroups of displaced individuals of all age groups: refugees granted permanent asylum, refugees living in camps or with only temporary protection, asylum seekers, mixed samples of refugees and asylum seekers, and internally displaced people.…”

“…While the interpretability and comparability of the varying prevalence rates on suicidality strongly depend on contextual, e.g., the study setting and background of the sample, and methodological factors, e.g., the timeframe and formulation of the questions, a prominent gap in the current evidence on suicidality among refugees is the striking lack of studies focusing on refugees living in camps, which is also emphasized by Cogo et al in their systematic review [ 28 ]. Among the overall ten studies with refugees living in camps in the meta-analysis by Haase et al [ 27 ] and the systematic review by Cogo et al [ 28 ], only three studies were conducted in refugee camps in Sub-Saharan Africa. Furthermore, within refugee camps there is particularly scarce evidence for men, with only five out of nine studies with adults including men, as well as for children and adolescents.…”

Validation of the Farsi version of the Suicide Ideation and Behavior Scale

“…Suicide ideation and suicidal behavior is prevalent in Iran ( 1 , 2 ) and Afghanistan ( 3 , 4 ). Furthermore, suicide ideation and suicide attempts are frequent in migrant populations from the respective countries ( 5 ). Suicide ideation and suicide attempts are among the strongest risk factors for suicide ( 6 ), and they are deeply distressing ( 7 ).…”