Journal of Immigrant and Minority Health

, Volume 19, Issue 3, pp 755–768 | Cite as

Factors Influencing Suicide Behaviours in Immigrant and Ethno-Cultural Minority Groups: A Systematic Review

  • Daniel W. L. Lai
  • Lun Li
  • Gabrielle D. Daoust
Review Paper


This paper reviews recent literature on factors influencing suicide behaviours, including thoughts, plans, and attempts, in immigrant and ethno-cultural minority groups, to inform a more comprehensive understanding of suicide behaviours in increasingly culturally diverse populations. Thirty-three studies published between 2002 and 2013 were identified through digital databases searches and included in this review. Analysis of study findings focused on impacts of ethno-cultural identity and acculturation, other cultural and immigration influences, and family and community supports on suicide behaviours. Policy, practice, and research recommendations are identified, to inform relevant suicide prevention efforts and enhance mental health supports for immigrant and ethno-cultural minority populations.


Suicide Immigrant Ethno-cultural Minority 


  1. 1.
    World Health Organization (WHO). Suicide prevention (SUPRE); 2011.
  2. 2.
    Statistics Canada. Suicide rates: an overview; 2012.
  3. 3.
    Centers for Disease Control and Prevention. National center for injury prevention and control. Web-based injury statistics query and reporting system (WISQARS); 2010.
  4. 4.
    Statistics Canada. Immigration and ethno-cultural diversity in Canada; 2014.
  5. 5.
    United States Census Bureau. The foreign-born population in the United States: 2010; 2012.
  6. 6.
    United Nations. Report of the department of economic and social affairs population division: international migration; 2009.
  7. 7.
    Earner I. Immigrant families and public child welfare: barriers to services and approaches for change. Child Welf. 2007;86(4):63–91.Google Scholar
  8. 8.
    Zhou M. Growing up American: the challenge confronting immigrant children and children of immigrants. Annu Rev Sociol. 1997;23:63–95.CrossRefGoogle Scholar
  9. 9.
    John DA, de Castro AB, Martin DP, et al. Does an immigrant health paradox exist among Asian Americans? associations of nativity and occupational class with self-rated health and mental disorders. Soc Sci Med. 2012;75(12):2085–98.CrossRefPubMedGoogle Scholar
  10. 10.
    Oh Y, Koeske GF, Sales E. Acculturation, stress, and depressive symptoms among Korean immigrants in the United States. J Soc Psychol. 2002;142(4):511–26.CrossRefPubMedGoogle Scholar
  11. 11.
    Shin HS, Han HR, Kim MT. Predictors of psychological well-being amongst Korean immigrants to the United States: a structured interview survey. Int J Nurs Stud. 2007;44(3):415–26.CrossRefPubMedGoogle Scholar
  12. 12.
    Ayers JW, Hofstetter CR, Usita P, et al. Sorting out the competing effects of acculturation, immigrant stress, and social support on depression: a report on Korean women in California. J Nerv Ment Dis. 2009;197(10):742–7.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Choi J, Miller A, Wilbur J. Acculturation and depressive symptoms in Korean immigrant women. J Immigr Minor Health. 2009;11(1):13–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Fenta H, Hyman I, Noh S. Determinants of depression among Ethiopian immigrants and refugees in Toronto. J Nerv Ment Dis. 2004;192(5):363–72.CrossRefPubMedGoogle Scholar
  15. 15.
    Zhang W, Ta VM. Social connections, immigration-related factors, and self-rated physical and mental health among Asian Americans. Soc Sci Med. 2009;68(12):2104–12.CrossRefPubMedGoogle Scholar
  16. 16.
    Beautrais AL. Risk factors for suicide and attempted suicide among young people. Aust N Z J Psychiatry. 2000;34(3):420–36.CrossRefPubMedGoogle Scholar
  17. 17.
    Brown GK, Beck AT, Steer RA, et al. Risk factors for suicide in psychiatric outpatients: a 20-year prospective study. J Consult Clin Psychol. 2000;68(3):371–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Cheng AT, Chen TH, Chen CC, et al. Psychosocial and psychiatric risk factors for suicide: case-control psychological autopsy study. Br J Psychiatry. 2000;177(4):360–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Conwell Y, Duberstein PR, Caine ED. Risk factors for suicide in later life. Biol Psychiatry. 2002;52(3):193–204.CrossRefPubMedGoogle Scholar
  20. 20.
    Fergusson DM, Woodward LJ, Horwood LJ. Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychol Med. 2000;30(01):23–39.CrossRefPubMedGoogle Scholar
  21. 21.
  22. 22.
    Banting K, Soroka S. Minority nationalism and immigrant integration in Canada. Nations Natl. 2012;18(1):156–76.CrossRefGoogle Scholar
  23. 23.
    Aubert P, Daigle MS, Daigle J. Cultural traits and immigration: hostility and suicidality in Chinese Canadian students. Transcult Psychiatry. 2004;41(4):514–32.CrossRefPubMedGoogle Scholar
  24. 24.
    Gomez J, Miranda R, Polanco L. Acculturative stress, perceived discrimination, and vulnerability to suicide attempts among emerging adults. J Youth Adolesc. 2011;40(11):1465–76.CrossRefPubMedGoogle Scholar
  25. 25.
    Hirsch JK, Chang EC, Jeglic EL. Social problem solving and suicidal behavior: ethnic differences in the moderating effects of loneliness and life stress. Arch Suicide Res. 2012;16(4):303–15.CrossRefPubMedGoogle Scholar
  26. 26.
    O’Donnell S, Meyer IH, Schwartz S. Increased risk of suicide attempts among Black and Latino lesbians. Am J Public Health. 2011;101(6):1055–9.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Malenfant EC. Suicide in Canada’s immigrant population. Health Rep. 2004;15(2):9–17.PubMedGoogle Scholar
  28. 28.
    Hansson EK, Tuck A, Lurie S. Rates of mental illness and suicidality in immigrant, refugee, ethnocultural, and racialized groups in Canada: a review of the literature. Can J Psychiatry. 2012;57(2):111–21.CrossRefPubMedGoogle Scholar
  29. 29.
    Trovato F. Migration and survival: the mortality experience of immigrants in Canada. Research report submitted to the Prairie Centre for Research on Immigration and Integration. Edmonton: University of Alberta; 2003.Google Scholar
  30. 30.
    Eggertson L. Canada lacks national suicide prevention strategy. Lancet. 2015;385(9987):2562–3.CrossRefPubMedGoogle Scholar
  31. 31.
    Olson R. Suicide prevention and cultural sensitivity. Centre for Suicide Prevention InfoExchange 7; 2012.
  32. 32.
    Canadian Association for Suicide Prevention. The CASP blueprint for a Canadian national suicide prevention strategy. Winnipeg: Canadian Association for Suicide Prevention; 2009.Google Scholar
  33. 33.
    Canadian Mental Health Association. Preventing suicide; 2014.
  34. 34.
  35. 35.
    Abe-Kim J, Takeuchi DT, Hong S, et al. Use of mental health-related services among immigrant and US-born Asian Americans: results from the National Latino and Asian American Study. Am J Public Health. 2007;97(1):91–8.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Leong FT, Lau AS. Barriers to providing effective mental health services to Asian Americans. Ment Health Serv Res. 2001;3(4):201–14.CrossRefPubMedGoogle Scholar
  37. 37.
    Bridges AJ, Andrews AR, Deen TL. Mental health needs and service utilization by Hispanic immigrants residing in mid-southern United States. J Transcult Nurs. 2012;23(4):359–68.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Fortuna LR, Porche MV, Alegria M. Political violence, psychosocial trauma, and the context of mental health services use among immigrant Latinos in the United States. Ethn Health. 2008;13(5):435–63.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Huang SL, Spurgeon A. The mental health of Chinese immigrants in Birmingham, UK. Ethn Health. 2006;11(4):365–87.CrossRefPubMedGoogle Scholar
  40. 40.
    Shin JK. Help-seeking behaviors by Korean immigrants for depression. Issues Ment Health Nurs. 2002;23(5):461–76.CrossRefPubMedGoogle Scholar
  41. 41.
    Guiao I, Thompson AE. Ethnicity and problem behaviors among adolescent females in the United States. Health Care Women Int. 2004;25:296–310.CrossRefPubMedGoogle Scholar
  42. 42.
    Outlaw AY, Phillips G, Hightow-Weidman LB, et al. Age of MSM sexual debut and risk factors: results from a multisite study of racial/ethnic minority YMSM living with HIV. AIDS Patient Care STDS. 2011;25(1):S23–9.CrossRefPubMedGoogle Scholar
  43. 43.
    Zayas L, Gulbas LE, Fedoravicius N, et al. Patterns of distress, precipitating events, and reflections on suicide attempts by young Latinas. Soc Sci Med. 2010;70(11):1773–9.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Garlow SJ, Purselle DC, Heninger M. Cocaine and alcohol use preceding suicide in African American and White adolescents. J Psychiatr Res. 2007;41:530–6.CrossRefPubMedGoogle Scholar
  45. 45.
    Supple AJ, Graves K, Kiang L, et al. Ethnic, gender, and age differences in adolescent nonfatal suicidal behaviors. Death Stud. 2013;37:830–47.CrossRefPubMedGoogle Scholar
  46. 46.
    Wong SS, Sugimoto-Matsuda JJ, Chang JY, et al. Ethnic differences in risk factors for suicide among American high school students, 2009: the vulnerability of multiracial and Pacific Islander adolescents. Arch Suicide Res. 2012;16:159–73.CrossRefPubMedGoogle Scholar
  47. 47.
    Winterrowd E, Canetto SS, Chavez EL. Friendship factors and suicidality: common and unique patterns in Mexican American and European American youth. Suicide Life Threat Behav. 2011;41(1):50–65.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Bhugra D. Suicide and gender: cultural factors. Harv Health Policy Rev. 2006;7(2):166–80.Google Scholar
  49. 49.
    Langhinrichsen-Rohling J, Friend J, Powell A. Adolescent suicide, gender, and culture: a rate and risk factor analysis. Aggress Violent Behav. 2009;14:402–14.CrossRefGoogle Scholar
  50. 50.
    Lipsicas CB, Mäkinen IH, Apter A, et al. Attempted suicide among immigrants in European countries: an international perspective. Soc Psychiatry Psychiatr Epidemiol. 2012;47:241–51.CrossRefGoogle Scholar
  51. 51.
    Mirsky J, Kohn R, Dolberg P, et al. Suicidal behavior among immigrants. Soc Psychiatry Psychiatr Epidemiol. 2011;46:1133–41.CrossRefPubMedGoogle Scholar
  52. 52.
    Han CS, Oliffe JL, Ogrodniczuk JS. Suicide among East Asians in North America: a scoping review. J Ment Health. 2013;22:361–71.CrossRefPubMedGoogle Scholar
  53. 53.
    Cho YB, Haslam N. Suicidal ideation and distress among immigrant adolescents: the role of acculturation, life stress, and social support. J Youth Adolesc. 2010;39(4):370–9.CrossRefPubMedGoogle Scholar
  54. 54.
    Else IRN, Goebert DA, Bell CK, et al. The relationship between violence and youth suicide indicators among Asian American and Pacific Islander youth. Aggress Violent Behav. 2009;14(6):470–7.CrossRefGoogle Scholar
  55. 55.
    Greenfield B, Rousseau C, Slatkoff J, et al. Profile of a metropolitan North American immigrant suicidal adolescent population. Can J Psychiatry. 2006;51(3):155–9.CrossRefPubMedGoogle Scholar
  56. 56.
    Kennedy MA, Parhar KK, Samra J, et al. Suicide ideation in different generations of immigrants. Can J Psychiatry. 2005;50(6):353–6.CrossRefPubMedGoogle Scholar
  57. 57.
    Winterrowd E, Canetto SS, Chavez EL. Friendships and suicidality among Mexican American adolescent girls and boys. Death Stud. 2010;34(7):641–60.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Borges G, Angst J, Nock MK, et al. A risk index for 12-month suicide attempts in the National Comorbidity Survey Replication (NCS-R). Psychol Med. 2006;36(12):1747–57.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Kang HJ, Stewart R, Jeong BO, et al. Suicidal ideation in elderly Korean population: a two-year longitudinal study. Int Psychogeriatr. 2014;26(1):59–67.PubMedGoogle Scholar
  60. 60.
    Wilkinson P, Kelvin R, Roberts C, et al. Clinical and psychosocial predictors of suicide attempts and nonsuicidal self-injury in the Adolescent Depression Antidepressants and Psychotherapy Trial (ADAPT). Am J Psychiatry. 2011;168(5):495–501.CrossRefPubMedGoogle Scholar
  61. 61.
    Miranda R, Scott M, Hicks R, et al. Suicide attempt characteristics, diagnoses, and future attempts: comparing multiple attempters to single attempters and ideators. J Am Acad Child Adolesc Psychiatry. 2008;47(1):32–40.CrossRefPubMedGoogle Scholar
  62. 62.
    Statistics Canada. Definitions, data sources and methods: variables: Ethno-cultural minority of person; 2012.
  63. 63.
    De Maio FG, Kemp E. The deterioration of health status among immigrants to Canada. Global Public Health. 2010;5(5):462–78.CrossRefPubMedGoogle Scholar
  64. 64.
    Premji S, Duguay P, Messing K, Lippel K. Are immigrants, ethnic and linguistic minorities over-represented in jobs with a high level of compensated risk? results from a Montréal, Canada study using census and workers’ compensation data. Am J Ind Med. 2010;53(9):875–85.PubMedGoogle Scholar
  65. 65.
    Samuel J, Basavarajappa K. The ethno-cultural minority population in Canada: a review of numbers, growth and labour force issues. Can Stud Popul. 2006;33(2):241–69.Google Scholar
  66. 66.
    Teixeira C, Lo L, Truelove M. Immigrant entrepreneurship, institutional discrimination, and implications for public policy: a case study in Toronto. Environ Plan C Gov Policy. 2007;25(2):176–93.CrossRefGoogle Scholar
  67. 67.
    Borum V. African American women’s perceptions of depression and suicide risk and protection. J Women Soc Work. 2012;27(3):316–27.CrossRefGoogle Scholar
  68. 68.
    Walker RL, Obasi EM, Wingate LR, et al. An empirical investigation of acculturative stress and ethnic identity as moderators for depression and suicidal ideation in college students. Cultur Divers Ethnic Minor Psychol. 2008;14(1):75–82.CrossRefPubMedGoogle Scholar
  69. 69.
    Kaslow NJ, Price AW, Wyckoff S, et al. Person factors associated with suicidal behavior among African American women and men. Cultur Divers Ethnic Minor Psychol. 2004;10(1):5–22.CrossRefPubMedGoogle Scholar
  70. 70.
    Street JC, Taha F, Jones AD, et al. Racial identity and reasons for living in African American female suicide attempters. Cultur Divers Ethnic Minor Psychol. 2012;18(4):416–23.CrossRefPubMedGoogle Scholar
  71. 71.
    van Leeuwen N, Rodgers R, Regner I, et al. The role of acculturation in suicidal ideation among second-generation immigrant adolescents in France. Transcult Psychiatry. 2010;47(5):812–32.CrossRefPubMedGoogle Scholar
  72. 72.
    Walker RL, Lester D, Joe S. Lay theories of suicide: an examination of culturally relevant suicide beliefs and attributions among African Americans and European Americans. J Black Psychol. 2006;32(3):320–34.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Oquendo MA, Dragatsi D, Harkavy-Friedman J, et al. Protective factors against suicidal behavior in Latinos. J Nerv Ment Dis. 2005;193(7):438–43.CrossRefPubMedGoogle Scholar
  74. 74.
    Castle K, Conner K, Kaukeinen K, et al. Perceived racism, discrimination, and acculturation in suicidal ideation and suicide attempts among Black young adults. Suicide Life Threat Behav. 2011;41(3):342–51.CrossRefPubMedGoogle Scholar
  75. 75.
    Chung I. Sociocultural study of immigrant suicide-attempters: an ecological perspective. J Soc Work. 2012;12(6):614–29.CrossRefGoogle Scholar
  76. 76.
    van Bergen DD, van Balkom AJLM, Smit JH, et al. ‘I felt so hurt and lonely’: suicidal behavior in South Asian, Surinamese, Turkish, and Moroccan women in the Netherlands. Transcult Psychiatry. 2012;49(1):69–86.CrossRefPubMedGoogle Scholar
  77. 77.
    Kamya HA, White E. Expanding cross-cultural understanding of suicide among immigrants: the case of the Somali. Fam Soc. 2011;92(4):419–25.CrossRefGoogle Scholar
  78. 78.
    Palmer D. An exploration into the impact of the resettlement experience, traditional health beliefs and customs on mental ill-health and suicide rates in the Ethiopian community in London. Int J Migr Health Soc Care. 2007;3(1):44–55.CrossRefGoogle Scholar
  79. 79.
    Baldwin S, Griffiths P. Do specialist community public health nurses assess risk factors for depression, suicide, and self-harm among South Asian mothers living in London? Public Health Nurs. 2009;26(3):277–89.CrossRefPubMedGoogle Scholar
  80. 80.
    Anglin DM, Gabriel KOS, Kaslow NJ. Suicide acceptability and religious well-being: a comparative analysis in African American suicide attempters and non-attempters. J Psychol Theol. 2005;33(2):140–50.Google Scholar
  81. 81.
    Noh E. Asian American women and suicide: problems of responsibility and healing. Women Ther. 2007;30(3/4):87–107.CrossRefGoogle Scholar
  82. 82.
    Donnelly TT, Hwang JJ, Este D, et al. If I was going to kill myself, I wouldn’t be calling you. I am asking for help: challenges influencing immigrant and refugee women’s mental health. Issues Ment Health Nurs. 2011;32(5):279–90.CrossRefPubMedGoogle Scholar
  83. 83.
    Baumann AA, Kuhlberg JA, Zayas LH. Familism, mother–daughter mutuality, and suicide attempts of adolescent Latinas. J Fam Psychol. 2010;24(5):616–24.CrossRefPubMedGoogle Scholar
  84. 84.
    Kuhlberg JA, Pena JB, Zayas LH. Familism, parent–adolescent conflict, self-esteem, internalizing behaviors and suicide attempts among adolescent Latinas. Child Psychiatry Hum Dev. 2010;41(4):425–40.CrossRefPubMedGoogle Scholar
  85. 85.
    Ahmed A, Stewart DE, Teng L, Wahoush O, Gagnon AJ. Experiences of immigrant new mothers with symptoms of depression. Arch Women Ment Health. 2008;11(4):295–303.CrossRefGoogle Scholar
  86. 86.
    Wong ST, Yoo GJ, Stewart AL. An empirical evaluation of social support and psychological well-being in older Chinese and Korean immigrants. Ethn Health. 2007;12(1):43–67.CrossRefPubMedGoogle Scholar
  87. 87.
    Sadavoy J, Meier R, Ong AYM. Barriers to access to mental health services for ethnic seniors: the Toronto study. Can J Psychiatry. 2004;49(3):192–9.CrossRefPubMedGoogle Scholar
  88. 88.
    Arnette NC, Mascaro N, Santana MC, et al. Enhancing spiritual well-being among suicidal African American female survivors of intimate partner violence. J Clin Psychol. 2007;63(10):909–24.CrossRefPubMedGoogle Scholar
  89. 89.
    Hirsch JK, Visser PL, Chang EC, et al. Race and ethnic differences in hope and hopelessness as moderators of the association between depressive symptoms and suicidal behavior. J Am Coll Health. 2012;60(2):115–25.CrossRefPubMedGoogle Scholar
  90. 90.
    Iliceto P, Pompili M, Candilera G, et al. Suicide risk and psychotherapy in immigrants: a multi-group confirmatory factor analysis. Soc Psychiatry Psychiatr Epidemiol. 2013;48(7):1105–14.CrossRefPubMedGoogle Scholar
  91. 91.
    Ron P. Depression, hopelessness, and suicidal ideation among the elderly: a comparison between veterans and new immigrants. Illn Crisis Loss. 2007;15(1):25–38.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Daniel W. L. Lai
    • 1
    • 2
  • Lun Li
    • 2
  • Gabrielle D. Daoust
    • 3
  1. 1.Department of Applied Social Sciences, Institute of Active AgeingThe Hong Kong Polytechnic UniversityKowloonHong Kong
  2. 2.Faculty of Social WorkUniversity of CalgaryCalgaryCanada
  3. 3.Department of International RelationsUniversity of SussexBrightonUK

Personalised recommendations