title: Suicidal Ideation and Mental Health of Bhutanese Refugees in the United States.
abstract: Refugee agencies noticed a high number of suicides among Bhutanese refugees resettled in the United States between 2009 and 2012. We aimed to estimate prevalence of mental health conditions and identify factors associated with suicidal ideation among Bhutanese refugees. We conducted a stratified random cross-sectional survey and collected information on demographics, mental health conditions, suicidal ideation, and post-migration difficulties. Bivariate logistic regressions were performed to identify factors associated with suicidal ideation. Prevalence of mental health conditions were: depression (21 %), symptoms of anxiety (19 %), post-traumatic stress disorder (4.5 %), and suicidal ideation (3 %), significant risk factors for suicidal ideation included: not being a provider of the family; perceiving low social support; and having symptoms of anxiety and depression. These findings suggest that Bhutanese refugees in the United States may have a higher burden of mental illness relative to the US population and may benefit from mental health screening and treatment. Refugee communities and service providers may benefit from additional suicide awareness training to identify those at highest risk.
authors.affiliation: Emergency Response and Recovery Branch, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-22, Atlanta, GA, 30329, USA.
authors.forename: Trong
authors.initials: T
authors.lastname: Ao
authors.affiliation: Emergency Response and Recovery Branch, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-22, Atlanta, GA, 30329, USA.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Emergency Response and Recovery Branch, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-22, Atlanta, GA, 30329, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Sivilli
authors.affiliation: Emergency Response and Recovery Branch, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-22, Atlanta, GA, 30329, USA.
authors.forename: Curtis
authors.initials: C
authors.lastname: Blanton
authors.affiliation: Boston Children's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Ellis
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Geltman
authors.affiliation: Massachusetts Department of Public Health, Boston, MA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cochran
authors.affiliation: Emergency Response and Recovery Branch, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-22, Atlanta, GA, 30329, USA.
authors.forename: Eboni
authors.initials: E
authors.lastname: Taylor
authors.affiliation: Emergency Response and Recovery Branch, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-22, Atlanta, GA, 30329, USA.|LandCow Consulting, Athens, GA, USA.|Department of Infectious Diseases, University of Georgia, Athens, GA, USA.
authors.forename: Emily W
authors.initials: EW
authors.lastname: Lankau
authors.affiliation: Emergency Response and Recovery Branch, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-22, Atlanta, GA, 30329, USA. bhc8@cdc.gov.
authors.forename: Barbara
authors.initials: B
authors.lastname: Lopes Cardozo
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000208:ethnology; D001631:Bhutan / Q000208:ethnology; D003430:Cross-Sectional Studies; D003863:Depression / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health / Q000208:ethnology*; D008875:Middle Aged; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data*; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D014478:Unemployment / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Bhutanese refugees; Mental health; PTSD; Post-migration difficulties; Suicide