With an estimated suicide rate of 24.4 per 100,000, Bhutanese refugees who have resettled within the United States are experiencing a mental health crisis–this rate is nearly twice that of the general U.S. population which was 14.1 per 100,000 in 2021.1,2 Over 100,000 ethnic-Nepali citizens were forcibly removed from Bhutan in the 1990s.3 Many lived in Nepali refugee camps for 15-20 years and faced natural disasters and many other stressors.3 Since 2008, over 90,000 Bhutanese refugees have relocated to the U.S.3 Participants of this literature review were over the age of 18, both men and women, both healthy and mentally ill, and had resettled to the United States. As a result, a total of six studies were included in this review using PubMed. The prevalence rate of suicidal ideation varied across the four studies which included the statistic. One study reported a rate of 3.1% while the other three reported rates of 6.0%, 6.7%, and 7.7% respectively.4,7,6,5 Many risk factors associated with suicidal ideation were identified but only one protective factor. Researchers found that those who reported having suicidal ideation had 0.85-fold reduced odds of reporting low perceived social support (95% CI 0.78-0.93).8 Those who reported symptoms of anxiety in the last four weeks reported an AOR 38.1 (95% CI 7.9-185.1).4 Participants who had experienced increased familial conflict post-resettlement reported an AOR of 22.6 (95% CI 5.5-92.6) .4 Those who reported symptoms of distress reported an AOR of 15.0 (95% CI 3.9-57.1).4 Participants who reported symptoms of depression had an AOR of 11.2 (95% CI 2.9-42.1).4 Participants who reported symptoms of PTSD had an AOR of 9.3 (95% CI 2.1-41.0).4 More generally, those with a prior mental health diagnosis reported an AOR of 8.7 (95% CI 1.7-43.9).7 These were the most notable risk factors identified in the literature.
Author(s): Andrew Denman, Saruna Ghimire, PhD, and Paul Flaspohler, PhD
Advisor(s): Saruna Ghimire, Department of Microbiology
Paul Flaspohler, Department of Psychology
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