Are left-behind families of migrant workers at increased risk of attempted suicide? – a cohort study of 178,000+ individuals in Sri Lanka
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 pr...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-01-01
|
| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12888-018-2000-8 |
| _version_ | 1819034435905912832 |
|---|---|
| author | Duleeka Knipe Helen Lambert Melissa Pearson Michael Eddleston Shaluka Jayamanne Kolitha Wickramage Keith Hawton Flemming Konradsen Chris Metcalfe David Gunnell |
| author_facet | Duleeka Knipe Helen Lambert Melissa Pearson Michael Eddleston Shaluka Jayamanne Kolitha Wickramage Keith Hawton Flemming Konradsen Chris Metcalfe David Gunnell |
| author_sort | Duleeka Knipe |
| collection | DOAJ |
| description | 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). |
| first_indexed | 2024-12-21T07:33:42Z |
| format | Article |
| id | doaj.art-71db54bd18b241089cb59e04e8506358 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-21T07:33:42Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-71db54bd18b241089cb59e04e85063582022-12-21T19:11:30ZengBMCBMC Psychiatry1471-244X2019-01-011911810.1186/s12888-018-2000-8Are left-behind families of migrant workers at increased risk of attempted suicide? – a cohort study of 178,000+ individuals in Sri LankaDuleeka Knipe0Helen Lambert1Melissa Pearson2Michael Eddleston3Shaluka Jayamanne4Kolitha Wickramage5Keith Hawton6Flemming Konradsen7Chris Metcalfe8David Gunnell9South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of PeradeniyaPopulation Health Sciences, Bristol Medical School, University of BristolSouth Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of PeradeniyaSouth Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of PeradeniyaSouth Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of PeradeniyaMigration Health Division, International Organization for Migration, UN Migration Agency, Migration Health CentreCentre for Suicide Research, Department of Psychiatry, University of OxfordSouth Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of PeradeniyaPopulation Health Sciences, Bristol Medical School, University of BristolPopulation Health Sciences, Bristol Medical School, University of BristolAbstract 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).http://link.springer.com/article/10.1186/s12888-018-2000-8MigrationLeft-behind childrenSri LankaAsiaSuicide |
| spellingShingle | Duleeka Knipe Helen Lambert Melissa Pearson Michael Eddleston Shaluka Jayamanne Kolitha Wickramage Keith Hawton Flemming Konradsen Chris Metcalfe David Gunnell Are left-behind families of migrant workers at increased risk of attempted suicide? – a cohort study of 178,000+ individuals in Sri Lanka BMC Psychiatry Migration Left-behind children Sri Lanka Asia Suicide |
| title | Are left-behind families of migrant workers at increased risk of attempted suicide? – a cohort study of 178,000+ individuals in Sri Lanka |
| title_full | Are left-behind families of migrant workers at increased risk of attempted suicide? – a cohort study of 178,000+ individuals in Sri Lanka |
| title_fullStr | Are left-behind families of migrant workers at increased risk of attempted suicide? – a cohort study of 178,000+ individuals in Sri Lanka |
| title_full_unstemmed | Are left-behind families of migrant workers at increased risk of attempted suicide? – a cohort study of 178,000+ individuals in Sri Lanka |
| title_short | Are left-behind families of migrant workers at increased risk of attempted suicide? – a cohort study of 178,000+ individuals in Sri Lanka |
| title_sort | are left behind families of migrant workers at increased risk of attempted suicide a cohort study of 178 000 individuals in sri lanka |
| topic | Migration Left-behind children Sri Lanka Asia Suicide |
| url | http://link.springer.com/article/10.1186/s12888-018-2000-8 |
| work_keys_str_mv | AT duleekaknipe areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka AT helenlambert areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka AT melissapearson areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka AT michaeleddleston areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka AT shalukajayamanne areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka AT kolithawickramage areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka AT keithhawton areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka AT flemmingkonradsen areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka AT chrismetcalfe areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka AT davidgunnell areleftbehindfamiliesofmigrantworkersatincreasedriskofattemptedsuicideacohortstudyof178000individualsinsrilanka |