Abstract
BackgroundThere 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.MethodsCohort 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.ResultsThe 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.ConclusionsThis 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).
Highlights
There are an estimated 258 million international migrants worldwide
The annual suicide attempt rate was higher in migrant (577 per 100,000, 95% Confidence interval (CI) 513, 649 per 100,000) than non-migrant households (325 per 100,000, 95% CI 310, 340 per 100,000)
Living in a female migrant household was associated with a 60% increased risk of attempted suicide, whereas there was no statistical evidence of an elevated risk in male migrant households (Table 2)
Summary
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. Dramatic increases have been observed in international migration from LMIC, with an estimated 164 million international migrants worldwide from this part of the world out of 258 million migrants globally [1]. Migration is an important driver for development in LMICs through the provision of foreign remittances. This migration occurs within the context of stringent migration policies (e.g. restrictions on the migrant’s family accompanying them), which has led to a growing number of transnational families, with millions of left-behind children in countries of origin when parent(s) migrate for temporary (2–3 years) work abroad [2, 3]. Many of the women who migrate in this way tend to be young mothers
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