BMC Psychiatry
Volume 19, Issue 1, 2019

Are left-behind families of migrant workers at increased risk of attempted suicide? - A cohort study of 178,000+ individuals in Sri Lanka (Article) (Open Access)

Knipe D.* , Lambert H. , Pearson M. , Eddleston M. , Jayamanne S. , Wickramage K. , Hawton K. , Konradsen F. , Metcalfe C. , Gunnell D.
  • a South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, United Kingdom
  • b Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, United Kingdom
  • c South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
  • d South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, United Kingdom
  • e South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, Faculty of Medicine, University of Kelanyia, Kelanyia, Sri Lanka
  • f Migration Health Division, International Organization for Migration, UN Migration Agency, Migration Health Centre, Manila, Philippines
  • g Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
  • h South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
  • i Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, United Kingdom
  • j Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, United Kingdom, National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, United Kingdom

Abstract

Background: There are an estimated 258 million international migrants worldwide. In Asia low-skilled workers often emigrate on a temporary basis (2-3 years) without their families. There is significant concern over the mental health and wellbeing of left-behind families in this region. No previous study has examined whether the risk of suicidal behaviour is elevated in left-behind family members. Methods: Cohort study using baseline data from a large randomised controlled trial in Sri Lanka (n = 178,730 participants; 8% households had a current temporary foreign migrant) and prospective hospital presentations of suicide attempts. Using multilevel Poisson regression models, we compared the risk of attempted suicide in households with left-behind and non-left-behind family members. We also investigated whether the sex of the migrant or the age/sex of the household member left behind altered any associations. Results: The risk of an attempted suicide was elevated in female migrant households (IRR 1.60 95% CI 1.38, 1.85), but not male migrant households (IRR 1.01 95% CI 0.76,1.36)) with strong evidence that risk differed for female vs. male migrant households (p-value = 0.005). We found no evidence that the age or sex of the left-behind household member altered the association observed. Conclusions: This analysis suggests that members of households with a temporary female foreign migrant are at an increased risk of attempted suicide, but these findings must be interpreted with caution. The increased risk of suicidal behaviour in these households may be due to factors that were present before the migration and persist post-migration (e.g. household violence, poverty). © 2019 The Author(s).

Author Keywords

Migration Asia Suicide Sri Lanka Left-behind children

Index Keywords

educational status household poverty human sex difference risk assessment middle aged suicide attempt family coping controlled study Sri Lanka family study Young Adult migrant worker school child Adolescent Domestic Violence male female Article suicidal behavior major clinical study adult age cohort analysis Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85059941663&doi=10.1186%2fs12888-018-2000-8&partnerID=40&md5=1995267af66d653537eddcc46c645d85
DOI: 10.1186/s12888-018-2000-8
ISSN: 1471244X
Original Language: English