PS19 - Suicide-Related Behavior in Vulnerable Populations: From Community to Clinical Settings
Deliberate Self-Harm and Suicide in People With Immigration BackgroundTranscountry migration has led to large demographic changes in many countries including Norway, but what consequences this may have for the validity of our current knowledge on suicide and deliberate self-harm in different segments of the population are still understudied. While previous research has shown inconsistent results, rare study has examined how reason for immigrating to the host country differentiates the risks. This presentation aims to provide insights into suicide and deliberate self-harm (DSH) among peopel with immigration background. Norwegian registers were interlinked to identify all individuals who died by suicide in 1992-2018 and who received emergency treatment for non-fatal DSH in 2008-2018, and via a nested case-control design to assess rates and relative risks of suicide and DSH according to immigration background, country of birth and reasons of immigration, and in the context of personal socioeconomic status. The data shows that rates of both suicide and DSH were highest in people born abroad with two Norway-born parents (mean rate: 19.4/100 000 for suicide and 280.9/100 000 for DSH) and lowest in the second-generation immigrants. Compared with the native Norwegians, suicide risk was significantly higher for those foreign-born with two Norway-born parents (HR=1.50) and those born in Norway with 1 one foreign-born parent (HR=1.20), while significantly lower for the first- and second-generation immigrants. The associated risks remained almost unchanged when the data were adjusted for personal differences in education, marital status, income and place of residence in Norway. The analyses on DSH exhibited similar patterns of results as for suicide, although the estimated reduced risks in the first- and second-generation immigrants is somewhat smaller. Evidently, the risks for suicide and DSH varied significantly by reason of immigration and country of origin. Immigrants coming for education had the lowest risks for suicide and DSH, and those coming for work the second lowest. The risks for immigrants coming for family unity were lower than the natives, but higher than counterparts coming for job or education. Among immigrants coming to Norway as a refugee or asylum seeker, the risk of suicide was comparably high as those coming for work, but the relative risk for DSH was significantly higher, especially the refugees from Afghanistan, Iran, Sri Lanka and Syria. The increased risks associated with the mixed immigration background tended to be slightly higher in females than in males, and were likely confined to adoptees from South Korea and Columbia. Clearly, suicide and DSH in people with an immigration background differs significantly by reason of immigration and country of origin. The findings should be taken into account in efforts of mental healthcare and suicide prevention targeting people with immigration background.