Abstract
PurposeRefugees, especially minors, who often have experienced traumatic events, are a vulnerable group regarding poor mental health. Little is known, however, of their risk of suicidal behaviour as young adults. We aimed to investigate the risk of suicidal behaviour for young adult refugees who migrated as minors. The moderating role of education and history of mental disorders in this association was also investigated.MethodsIn this register linkage study, all 19–30-year-old Swedish-born (n = 1,149,855) and refugees (n = 51,098) residing in Sweden on December 31st, 2009 were included. The follow-up period covered 2010–2016. Cox models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). The multivariate models were adjusted for socio-demographic, labour market marginalisation and health-related factors.ResultsCompared to Swedish-born, the risk of suicide attempt was lower for all refugees (HR 0.78, 95% CI 0.70–0.87), and accompanied refugee minors (HR 0.77, 95% CI 0.69–0.87), but estimates did not differ for unaccompanied refugee minors (HR 0.83, 95% CI 0.62–1.10). Low education and previous mental disorders increased the risk of suicide attempt in both refugees and Swedish-born, with lower excess risks in refugees. Findings for suicide were similar to those of suicide attempt.ConclusionYoung adult refugees have a lower risk of suicidal behaviour than their Swedish-born peers, even if they have low educational level or have mental disorders. Young refugees who entered Sweden unaccompanied do not seem to be equally protected and need specific attention.
Highlights
The number of forcibly displaced people worldwide is currently record high, and it is believed that 50% of all refugees are refugee children [1]
We aimed to determine the relationship between young refugees, those who came to Sweden as accompanied or unaccompanied refugee minors, and subsequent risk for suicidal behaviour, compared to the Swedish-born population
Young adult refugees and suicidal behaviour. This population-based cohort study showed that refugees aged 19–30 years who came as accompanied minors had a lower risk for suicide attempt and suicide compared to Swedish-born, while the risk for unaccompanied refugee minors did not show statistically significant differences, As there are no previous studies on young adult refugees resettling in a Westernised host country as minors and their subsequent risk of suicidal behaviour, it is challenging to make a direct comparison
Summary
The number of forcibly displaced people worldwide is currently record high, and it is believed that 50% of all refugees are refugee children [1]. Such a pattern of forced migration in recent decades has brought about demographical changes in many European countries, including Sweden. The arrival of unaccompanied refugee minors to Sweden started to increase from 2005 [2]. In 2015, approximately 70,000 refugee minors arrived in Sweden, where about 50% were unaccompanied refugee minors [3]. As mental disorders are important risk factors for suicide attempt and suicide (suicidal behaviour) [11, 12], the risk can be hypothesised to be elevated in refugees.
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