Suicide and Suicide Attempts Among Asylum-Seekers in Denmark

Abstract

Objective

There are concerns that asylum-seekers are at increased risk of suicide attempt and suicide mortality. Yet, largescale nationwide studies are limited. Our aim was to examine whether asylum-seekers in Denmark had higher rates of suicide attempt and suicide when compared to the general population.

Methods

A retrospective cohort design was used. Data on asylum-seekers and the general population living in Denmark during 2009–2019 were obtained from the Immigration services and national registers. Indirect standardization was applied to adjust for differences with respect to age group and sex and Incidence Rate Ratios (IRR) with 95% confidence intervals were calculated.

Results

In a population of 78,666 asylum-seekers, a total of 601 suicide attempts and 9 suicides were recorded. The rate of suicide attempt was 842.0 per 100,000 person-years for asylum-seekers and 92.3 per 100,000 person-years for the general population. When adjusting for differences related to age group and sex, an IRR of 8.5 (95% CI: 7.6−9.5) was found for suicide attempt between 2014-2019. The IRR for suicide attempt unaccompanied minors between 2015 and 2019 was 5.8 (95% CI: 4.3−7.5) when adjusting for age group. We did not find an elevated rate of suicide among asylum-seekers (IRR: 1.6, 95% CI: 0.6−3.5).

Conclusions

Asylum-seekers were found to have higher rates of suicide attempt than the general population in Denmark. This also applied to unaccompanied minors. Our study emphasizes the need for awareness and preventive measures targeting mental health and suicidal behavior among asylum-seekers.

HIGHLIGHTS

• Asylum-seekers had an 8-fold higher rate of suicide attempt than the general population.

• The suicide attempt rate for asylum-seekers reached its lowest levels during recent years.

• Unaccompanied minors had a 5-fold higher frequency of suicide attempt when compared to peers in the general population.

• We did not find elevated rates of death by suicide among asylum-seekers. No suicide deaths were recorded among unaccompanied minors

Keywords:

• All ages
• asylum seeker
• attempted suicide
• minors
• suicide

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

AUTHOR NOTES

Daniel Khan Amiri, Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark. Trine Madsen, PhD, Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen, Denmark. Marie Norredam, DM Sc, Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, Department of Public Health, University of Copenhagen. Svend Erik Brande, Danish Red Cross, Asylum Department, Denmark. Ellenor Mittendorfer-Rutz, PhD, Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden. Merete Nordentoft, DM, Sc, Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Annette Erlangsen, PhD, Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen, Denmark; Center of Mental Health Research, Australian National University, Canberra, Australia; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

DATA AVAILABILITY STATEMENT

Aggregate data from the study may be obtained from the first or last author. No additional data sets are available for this project.