Mental health, migration stressors and suicidal ideation among Latino immigrants in Spain and the United States.
Immigration stress appears to augment the risk for suicide behaviors for Latinos. Yet, specific risk factors that contribute to suicidal ideation (SI) among diverse Latino immigrant populations are not well established.



Data were collected in Boston, Madrid and Barcelona using a screening battery assessing mental health, substance abuse risk, trauma exposure, demographics, and sociocultural factors. Prevalence rates of lifetime and 30-day SI were compared across sites. Logistic regression modeling was used to identify sociodemographic, clinical, and sociocultural-contextual factors associated with 30-day SI.



Five hundred and sixty-seven Latino patients from primary care, behavioral health and HIV clinics and community agencies participated. Rates of lifetime SI ranged from 29-35%; rates for 30-day SI were 21-23%. Rates of SI were not statistically different between sites. Factors associated with SI included exposure to discrimination, lower ethnic identity, elevated family conflict, and low sense of belonging (P<0.01). In the adjusted model, higher scores on depression, posttraumatic stress disorder, and trauma exposure were significantly associated with 30-day SI (OR=1.14, 1.04, and 7.76, respectively). Greater number of years living in the host country was significantly associated with increased odds of having SI (OR=2.22) while having citizenship status was associated with lower odds (OR=0.45).



Latinos suffering depression, trauma exposure, and immigration stressors are more likely to experience SI. Despite differences in country of origin, education, and other demographic factors between countries, rates of SI did not differ. Recommendations for prevention and clinical practice for addressing suicidal ideation risk among Latino immigrants are discussed.
Boston University Medical School, Boston Medical Center, Child and Adolescent Psychiatry, 850, Harrison Avenue, Dowling Building, 7th Floor, Boston, MA 02118 USA; Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA.
L R
LR
Fortuna
Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA.
K
K
Álvarez
Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA.
Z
Z
Ramos Ortiz
Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA.
Y
Y
Wang
Hospital Universitari Vall d'Hebron, Paseo de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
X
X
Mozo Alegría
Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, 1035, Cambridge Street, Cambridge MA 02141 USA.
B L
BL
Cook
Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA 02114 USA. Electronic address: malegria@mgh.harvard.edu.
M
M
Alegría
D000328:Adult; D003863:Depression / Q000208:ethnology / Q000523:psychology*; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D004641:Emigration and Immigration; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013030:Spain; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D013315:Stress, Psychological / Q000208:ethnology / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology; D059020:Suicidal Ideation; D014481:United States
Addiction; Posttraumatic stress disorder; Social and cross-cultural psychiatry; Suicide; Unipolar depression