Background
-
to assess the suicide mortality rate and the incidence of hospital-treated suicidal behaviour in asylum seekers, and compare it to the Dutch population and the population of The Hague;
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to assess the extent to which health staff were aware of the existence of mental health problems in asylum seekers prior to the date of hospital-treated suicidal behaviour and the extent to which these cases were under mental health treatment prior to the date of the hospital-treated suicidal behaviour;
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to determine which methods were used by cases of suicide death and of hospital-treated suicidal behaviour and what stressors were reported in cases of hospital-treated suicidal behaviour.
Methods
Context of the study
Data sources
Statistical analysis
Results
Burden of suicide death and hospital-treated suicidal behaviour
Sex | Subgroup | Number of person years | Number of suicide deaths | Suicide mortality rate/100 000/year | Mortality rate ratio* | 95% CI |
---|---|---|---|---|---|---|
Males | ||||||
Netherlands | 39 068 490 | 6131 | 15.7 | 1 | ||
Asylum seekers | 125 026 | 32 | 25.6 | 2.00* | 1.37-2.83 | |
Asylum seekers by age group
| ||||||
15-24 | 44 171 | 8 | 18.1 | 2.33 | 1.16-4.70 | |
25-34 | 42 459 | 13 | 30.6 | 2.32 | 1.34-4.01 | |
> = 35 | 38 396 | 11 | 28.6 | 1.58 | 0.88-2.86 | |
Asylum seekers by region#
| ||||||
ME/SW Asia | 40 278 | 7 | 17.4 | 1.28* | 0.51-2.63 | |
WCS Africa | 31 205 | 8 | 25.6 | 2.36* | 1.01-4.63 | |
NEH Africa | 14 284 | 6 | 42.0 | 3.32* | 1.21-7.19 | |
CES Europe | 28 165 | 9 | 32.0 | 2.31* | 1.06-4.38 | |
Females‡
| ||||||
Netherlands | 40 509 314 | 2854 | 7.0 | 1 | ||
Asylum seekers | 74 916 | 3 | 4.0 | 0.73* | 0.15-2.07 |
Sex | Subgroup | Number of person years | Number of hospital-treated suicidal behaviour cases# | Hospital-treated suicidal behaviour rate/100 000/year | Hospital-treated suicidal behaviour rate ratio* | 95% CI |
---|---|---|---|---|---|---|
Males | ||||||
The Hague | 558 762 | 489 | 87.5 | 1 | ||
Asylum seekers | 125 026 | 149 | 119.2 | 1.42* | 1.20-1.66 | |
Asylum seekers by age group
| ||||||
15-24 | 44 171 | 48 | 108.7 | 1.49 | 1.02-2.17 | |
25-34 | 42 459 | 39 | 91.9 | 1.02 | 0.71-1.46 | |
> = 35 | 38 396 | 58 | 151.1 | 1.68 | 1.27-2.22 | |
Asylum seekers by region
| ||||||
ME/SW Asia | 40 278 | 55 | 136.6 | 1.60* | 1.20-2.08 | |
WCS Africa | 31 205 | 22 | 70.5 | 0.88* | 0.55-1.32 | |
NEH Africa | 14 284 | 5 | 35.0 | 0.41* | 0.13-0.96 | |
CES Europe | 28 165 | 57 | 202.4 | 2.37* | 1.79-3.07 | |
Females
| ||||||
The Hague | 595 215 | 947 | 159.1 | 1 | ||
Asylum seekers | 74 916 | 141 | 188.2 | 1.00* | 0.84-1.18 | |
Asylum seekers by age group
| ||||||
15-24 | 22 655 | 34 | 150.1 | 0.51 | 0.36-0.73 | |
25-34 | 24 384 | 46 | 188.6 | 1.18 | 0.86-1.63 | |
> = 35 | 27 877 | 56 | 200.9 | 1.57 | 1.19-2.07 | |
Asylum seekers by region
| ||||||
ME/SW Asia | 21 894 | 55 | 251.2 | 1.40* | 1.06-1.82 | |
WCS Africa | 13 570 | 5 | 36.8 | 0.17* | 0.05-0.38 | |
NEH Africa | 8041 | 3 | 37.3 | 0.19* | 0.04-0.55 | |
CES Europe | 23 992 | 61 | 254.3 | 1.44* | 1.10-1.85 |
Factors that could guide prevention
Mental health problems
% of suicidal behaviour cases for which health staff knew of the existence of mental health problems prior to the reported suicidal behaviour (absolute number of cases)# | Prevalence rate ratio (95% CI) | % of suicidal behaviour cases with known mental health problems that received mental health treatment prior to the reported suicidal behaviour (absolute number of cases)‡ | Treatment rate ratio (95% CI) | |
---|---|---|---|---|
Total
| 78.7 (222) | 73.0 (162) | ||
Sex
| ||||
Male | 74.5 (108) | 1 | 66.7 (72) | 1 |
Female | 83.2 (114) | 1.12 (0.99-1.26) | 78.9 (90) | 1.18 (1.01-1.39) |
Age group
| ||||
15-24 | 64.6 (53) | 1 | 64.2 (34) | 1 |
25-34 | 82.4 (70) | 1.27 (1.06-1.54) | 72.9 (51) | 1.14 (0.98-1.45) |
> = 35 | 85.2 (98) | 1.32 (1.10-1.57) | 77.6 (76) | 1.21 (0.96-1.52) |
Region of origin
| ||||
ME/SW Asia | 78.0 (85) | 1 | 72.9 (62) | 1 |
WCS Africa | 63.0 (17) | 0.86 (0.58-1.53) | 29.4 (5) | 0.41 (0.32-2.05) |
NEH Africa | 75.0 (6) | 0.96 (0.37-1.94) | 33.3 (2) | 0.38 (0.11-2.78) |
CES Europe | 83.8 (98) | 1.06 (0.81-1.21) | 80.6 (79) | 1.14 (0.79-1.23) |
Stressors
Methods used
Method used | Suicide death cases (%)* | Hospital-treated suicidal behaviour cases (%)* |
---|---|---|
Hanging | 5 (25.0) | 8 (2.9) |
Poisoning by drugs | 3 (15.0) | 203 (72.8) |
Moving object | 3 (15.0) | 3 (1.1) |
Poisoning by other means | 2 (10.0) | 12 (4.3) |
Drowning | 2 (10.0) | 2 (0.7) |
Jumping | 2 (10.0) | 6 (2.2) |
Cutting | 2 (10.0) | 39 (14.0) |
Burning | 1 (5.0) | 6 (2.2) |