An Investigation into Suicides Among Bhutanese Refugees Resettled in the United States Between 2008 and 2011
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An increase of Bhutanese refugee suicides were reported in the US between 2009 and 2012. This investigation examined these reported suicides in depth to gain a better understanding of factors associated with suicide within this population. The study employed 14 psychological autopsies to elicit underlying motivations and circumstances for self-inflicted death and to identify potential future avenues for prevention and intervention among refugee communities. Disappointment with current (un)employment, lack of resettlement services and social support, and frustrations with separation from family were believed to contribute to suicidal acts. Suicide within refugee populations may be connected with experiences of family withdrawal, integration difficulties, and perceived lack of care. It is important to assess the effectiveness of improving refugee services on the mental health of migrants. More research is needed in order to better understand, and respond to, suicide in resettled populations.
KeywordsSuicide Refugee Psychological autopsy Mental health
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
- 1.Hutt M. Unbecoming citizens: culture, nationhood, and the flight of refugees from Bhutan. Oxford: Oxford University Press; 2003.Google Scholar
- 2.US Department of State, Bureau of Population, Refugees, and Migration (PRM), Worldwide Refugee Admissions Processing System (WRAPS). http://www.cdc.gov/immigrantrefugeehealth/pdf/bhutanese-health-profile.pdf.
- 3.Centers for Disease Control Prevention. Suicide and suicidal ideation among bhutanese refugees—United States, 2009–2012. MMWR Morb Mortal Wkly Rep. 2013;62(26):533.Google Scholar
- 4.Ao T, Taylor E, Lankau E, Sivilli TI, Blanton C, Shetty S, Lopes-Cardozo B. An Investigation into Suicides among Bhutanese Refugees in the US 2009–2012 Stakeholders Report. Center for Disease Control and Prevention. http://www.refugeehealthta.org/files/2011/06/Bhutanese-Suicide-Stakeholder_Report_October_22_2012_Cleared_-For_Dissemination.pdf.
- 6.Schinina G, Sharma S, Gorbacheva O, Mishra AK. Who am I? Assessment of psychosocial needs and suicide risk factors among bhutanese Refugees in Nepal and after third country resettlement. Geneva: International Organization for Migration (IOM); 2011.Google Scholar
- 15.Papadopoulos R. Systemic challenges in a refugee camp. Context. 2008;98:16–9.Google Scholar
- 20.Pradhan A, Poudel P, Thomas D, Barnett S. A review of the evidence: suicide among women in Nepal. Kathmandu: National Health Sector Support Program, Ministry of Health and Population; 2011. p. 117.Google Scholar
- 21.Suvedi BK, Pradhan A, Barnett S, Puri M, Chitrakar SR, Poudel P, Sharma S, Hulton L. Nepal maternal mortality and morbidity study 2008/2009: summary of preliminary findings. Kathmandu: Family Health division, Department of Health Services, Ministry of Health, Government of Nepal; 2009.Google Scholar
- 22.World Health Organization. Preventing suicide: a global imperative. Luxembourg: World Health Organization; 2014. http://www.who.int/mental_health/suicide-prevention/world_report_2014/en/.
- 23.Hendin H, Phillips MR, Vijayakumar L, Pirkis J, Wang H, Yip P, Wasserman D, Bertolote JM, Fleischmann A. Suicide and suicide prevention in Asia. Geneva: World Health Organization; 2008.Google Scholar
- 29.Clark DC, Horton-Deutsch SL. Assessment in absentia: the value of the psychological autopsy method for studying antecedents of suicide and predicting future suicides. In: Maris RW, Berman AL, Maltsberger JT, Yufit RI, editors. Assessment and prediction of suicide. New York, NY: Guilford Press; 1992. p. 144–182.Google Scholar
- 30.Gajalakshmi V, Peto R. Suicide rates in rural Tamil Nadu, south India: verbal autopsy of 39,000 deaths in 1997–98. Psychiatr Epidemiol. 2007;36:203–7.Google Scholar
- 40.Pyakurel R, Sharma N, Paudel D, Coghill A, Sinden L, Bost L, Larkin M, Burrus CJ, Roy K. Cause of death in women of reproductive age in rural Nepal obtained through community-based surveillance: is reducing maternal mortality the right priority for women’s health programs? Health Care Women Int. 2015;36(6):655–62. doi: 10.1080/07399332.2014.908193.CrossRefPubMedGoogle Scholar
- 43.Chua JL. In pursuit of the good life: aspiration and suicide in globalizing south India. Berkeley: University of California Press; 2014.Google Scholar
- 44.Marecek J. Young women’s suicide in Sri Lanka: cultural, ecological, and psychological factors. Asian J Couns. 2006;13(1):63–92.Google Scholar
- 45.Kohrt BA, Speckman RA, Kunz RD, Baldwin JL, Upadhaya N, Acharya NR, Sharma VD, Nepal MK, Worthman CM. Culture in psychiatric epidemiology: using ethnography and multiple mediator models to assess the relationship of caste with depression and anxiety in Nepal. Ann Hum Biol. 2009;36(3):261–80.CrossRefPubMedPubMedCentralGoogle Scholar
- 47.Warren KD. “We Do What We Can” Creating success in a New England Refugee Resettlement Agency. 2013.Google Scholar
- 48.Hefferan T. Bridging the gaps: faith-based organizations, neoliberalism, and development in Latin America and the Caribbean. Lexington: Lexington Books; 2009.Google Scholar
- 52.Chase L. Psychosocial resilience among resettled Bhutanese refugees in the US. Forced Migr Rev. 2012;40:47.Google Scholar
- 56.Hollifield M, Verbillis-Kolp S, Farmer B, Toolson EC, Woldehaimanot T, Yamazaki J, Holland A, St Clair J, SooHoo J. The Refugee Health Screener-15 (RHS-15): development and validation of an instrument for anxiety, depression, and PTSD in refugees. Gen Hosp Psychiatry. 2013;35(2):202–9.CrossRefPubMedGoogle Scholar