Suicide among psychiatric patients who migrated to the UK: a national clinical survey

Su-Gwan Tham*, Isabelle Hunt, Pauline Turnbull, Louis Appleby, Nav Kapur, Duleeka Knipe

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)

Abstract

Background
Within the UK, limited research has examined migration and suicide risk. To assist with tailoring mental health care to the needs of different migrant groups, it is important to identify the clinical profile and antecedents to suicide.

Methods
We focussed on two groups of migrants: those resident in the UK for less than 5 years (recent migrants) and those seeking permission to stay in the UK. Data on mental health patients who died by suicide in the UK between 2011 and 2019 were obtained as part of the National Confidential Inquiry into Suicide and Safety in Mental Health.

Findings
13,948 patients died by suicide between 2011 and 2019: 593 were recent migrants with 48 seeking permission to stay in the UK. The overall suicide rate between 2011 and 2017 for patients seeking to stay was 23.8/100,000 (95% CI 17.3–32.1). There was some uncertainty around this estimate but it appeared higher than the general population suicide rate of 10.6/100,000 population (95% CI 10.5–10.7; p = .0001) for the same period. A higher proportion of migrants were from an ethnic minority group (15% recent migrants vs. 70% seeking to remain vs. 7% non-migrants) and more were viewed as at low long-term risk of suicide (63% recent migrants vs. 76% seeking to remain vs. 57% non-migrants). A higher proportion of recent migrants died within three months of discharge from psychiatric in-patient care (19% vs. 14%) compared to non-migrants. Proportionally more patients seeking to remain had a diagnosis of schizophrenia and other delusional disorders (31% vs. 15%) and more had experienced recent life events compared to non-migrants (71% vs. 51%).

Interpretation
A higher proportion of migrants had severe or acute illness at the time of their suicide. This may be linked to a range of serious stressors and/or lack of connection with services that could have identified signs of illness early. However, clinicians often viewed these patients as low risk. Mental health services should consider the breadth of stressors migrants may face and adopt a multi-agency approach to suicide prevention.
Original languageEnglish
Article number 101859
JournalEClinicalMedicine
Volume57
DOIs
Publication statusPublished - 26 Feb 2023

Bibliographical note

Funding Information:
The Healthcare Quality Improvement Partnership.This study was carried out as part of the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) and we would like to thank: Alison Baird, Lana Bojanić, James Burns, Huma Daud, Jane Graney, Julie Hall, Saied Ibrahim, Rebecca Lowe, Nicola Richards, Cathryn Rodway, Professor Jenny Shaw and Phil Stones. This research was supported by the Healthcare Quality Improvement Partnership (HQIP NCA 2069, Mental Health Clinical Outcome Review Programme). The study was carried out as part of the National Confidential Inquiry into Suicide and Safety in Mental Health. DK was supported by the Wellcome Trust through an Institutional Strategic Support Fund Award to the University of Bristol [204813] and the Elizabeth Blackwell Institute for Health Research, University of Bristol.

Funding Information:
This research was supported by the Healthcare Quality Improvement Partnership (HQIP NCA 2069, Mental Health Clinical Outcome Review Programme). The study was carried out as part of the National Confidential Inquiry into Suicide and Safety in Mental Health. DK was supported by the Wellcome Trust through an Institutional Strategic Support Fund Award to the University of Bristol [ 204813 ] and the Elizabeth Blackwell Institute for Health Research, University of Bristol .

Publisher Copyright:
© 2023 The Authors

Structured keywords

  • SASH

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