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Open Access Research article

Suicide death and hospital-treated suicidal behaviour in asylum seekers in the Netherlands: a national registry-based study

Simone Goosen12*, Anton E Kunst2, Karien Stronks2, Irene EA van Oostrum1, Daan G Uitenbroek34 and Ad JFM Kerkhof5

Author Affiliations

1 Netherlands Association for Community Health Services, P.O. Box 85300, 3508 AH Utrecht, the Netherlands

2 Department of Public Health, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, the Netherlands

3 Quantitative Skills, Consultancy for Research and Statistics, Lieven de Keylaan 7, 1222 LC Hilversum, the Netherlands

4 Public Health Service, P.O. Box 2200, 1000 CE Amsterdam, the Netherlands

5 Department of Clinical Psychology, EMGO+ Institute, VU University, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands

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BMC Public Health 2011, 11:484  doi:10.1186/1471-2458-11-484

Published: 21 June 2011

Abstract

Background

Several suicide and suicidal behaviour risk factors are highly prevalent in asylum seekers, but there is little insight into the suicide death rate and the suicidal behaviour incidence in this population. The main objective of this study is to assess the burden of suicide and hospital-treated non-fatal suicidal behaviour in asylum seekers in the Netherlands and to identify factors that could guide prevention.

Methods

We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+). The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization.

Results

The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83). No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07). The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers.

Conclusions

In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour was higher in several subgroups of asylum seekers than that in the reference population. We conclude that measures to prevent suicide and suicidal behaviour among asylum seekers in the Netherlands are indicated.

Keywords:
suicide; suicidal behaviour; migrants; asylum seekers; refugees