Understanding Bhutanese refugee suicide through the interpersonal-psychological theory of suicidal behavior.

Abstract

Attention has been drawn to high rates of suicide among refugees after resettlement and in particular among the Bhutanese refugees. This study sought to understand the apparent high rates of suicide among resettled Bhutanese refugees in the context of the Interpersonal-Psychological Theory of Suicidal Behavior (IPTS). Expanding on a larger investigation of suicide in a randomly selected sample of Bhutanese men and women resettled in Arizona, Georgia, New York, and Texas (Ao et al., 2012), the current study focused on 2 factors, thwarted belongingness and perceived burdensomeness, examined individual and postmigration variables associated with these factors, and explored how they differed by gender. Overall, factors such as poor health were associated with perceived burdensomeness and thwarted belongingness. For men, stressors related to employment and providing for their families were related to feeling burdensome and/or alienated from family and friends, whereas for women, stressors such as illiteracy, family conflict, and being separated from family members were more associated. IPTS holds promise in understanding suicide in the resettled Bhutanese community.

Suicidal Ideation and Mental Health of Bhutanese Refugees in the United States

“…The survey instruments included content on demographics, mental health history and current symptoms, current substance use, past or current suicide attempts or ideation, and post-migration difficulties [8] and coping mechanisms [9] and have been previously described in detail [10]. The Perceived Social Support Scale was used to assess how the participant perceived his/her social supports [11] and categorized as low (0–39), moderate (40–49), or high (50–60).…”

Lethal hopelessness: Understanding and responding to asylum seeker distress and mental deterioration

“…The core interpersonal components of suicidal ideation for asylum seekers is a feeling that they cannot continue with prolonged uncertainty, flooding of traumatic experiences and an overwhelming sense of burdensomeness to oneself and to others (Ellis et al . ). Prolonged uncertainty and ongoing re‐traumatization impacts on a range of cognitive and social attributes, interpersonal confidence and autobiographical memory.…”

“…Available options for supporting people in such states are limited by the scale of re‐traumatisation and aloneness (Ellis et al . ). The immediate family and sociocultural group is becoming a diminishing protective factor against deteriorating mental health (Ellis et al .…”

“…The immediate family and sociocultural group is becoming a diminishing protective factor against deteriorating mental health (Ellis et al . ). Without changes to current policy settings, which would allow the legacy caseload access to permanent protection visas, the mental health of refugees and asylum seekers living in the Australian community are likely to deteriorate even further.…”

“…An additional complexity in this situation is thwarted purpose and identity (Ellis et al . ; Hashem & Dudman ). This adversely impacts upon relationships between, for example, husband and wife, and among siblings, friends and others who are also under significant strain (Al‐Modallal ; Vijayakumar ).…”