Suicide and suicide-related behavior among Bhutanese refugees resettled in the United States.

Abstract

Suicidal behavior and death by suicide are significant and pressing problems in the Bhutanese refugee community. Currently, Bhutanese refugees are dying by suicide at a rate nearly two times that of the general U.S. population. Proper identification of risk factors for suicide saves lives; however, if risk is underestimated due to culturally inflexible risk assessments, preventable deaths may continue to occur. In this review, we examine specific cultural factors related to psychopathology and suicide among Bhutanese refugees. To contextualize the current suicide crisis among Bhutanese refugees, we propose an integration of the interpersonal psychological theory of suicide (Joiner, 2005) and the cultural model of suicide (Chu, Goldblum, Floyd, & Bongar, 2010). We provide recommendations for preventing suicide from a systems framework and discuss practical lessons from a preliminary study designed to test a culturally responsive model of suicide in Bhutanese refugees.

A New Beginning: Early Refugee Integration in the United States

“…Bhutanese refugees have particularly high levels of depression and suicide. The suicide rate is not only twice that of the U.S. national average (Ao et al 2015;Meyerhoff, Rohan, and Fondacaro 2018), but also comparable to the rate among Bhutanese still living in refugee camps (Vonnahme et al 2015;Hagaman et al 2016). Laura Vonnahme and colleagues (2015) find that men who viewed themselves as family providers tended to demonstrate depressive symptoms at a rate four times higher than men who were not providers.…”

“…Furthermore, formal integration policies, though well intended, often cannot compensate for the lack of community and the feeling of isolation among refugees. Finally, high rates of mental illness and trauma among refugees remain unaddressed, which compromises their emotional well-being and impedes social integration (Ao et al 2015;Meyerhoff, Rohan, and Fondacaro 2018).…”

Risk of suicide attempt and suicide in young adult refugees compared to their Swedish-born peers: a register-based cohort study

“…The refugees who could obtain refugee status in Sweden can, therefore, be a selected group because some refugees with poorer mental health may not have overcome the complicated process of migrating to another country. A cultural aspect could also be protective, as many refugees come from Islamic countries where suicide is culturally not acceptable and thus, according to a cultural perspective of suicidal behaviour, this could affect how individuals from Islamic countries react to stressful events and to suicidal ideation [ 30 ]. Moreover, differences in adverse health behaviour might matter.…”

Recognizing and Breaking the Cycle of Trauma and Violence Among Resettled Refugees

“…In the academic space, community-based research has become the keystone of collaborative and equitable processes of knowledge creation [ 80 ]. In the clinical space, many interventions involve sharing resources with trusted community leaders, community health workers, and local volunteers, such as from a local place of worship, who can then relay resources to refugees in their community [ 81 •, 82 ]. Various peer-to-peer educational programs, for example, have been developed to tap into community members who share common beliefs and values with refugee communities and who can then serve as “peer educators” within those communities [ 81 •, 83 ].…”