ABSTRACT
Women of Turkish descent in Germany show higher rates of suicidal behavior compared to their host populations and men of Turkish descent. This indicates a demand for a better understanding of suicidality in this group. Nine focus groups ( N = 61) were conducted to assess explanatory models including patterns of distress, perceived causes, course/consequences of and reactions towards a suicidal crisis, help-seeking behavior, and potential intervention and prevention strategies. All participants were of Turkish descent living in Berlin, Germany. The focus groups included two with professionals such as psychiatrists or psychotherapists, two with Community Mothers, three with women from the community (ages: 18 -34, 35 -49, 50+), and of three suicide attempters (ages: 18 -33, 38 -66). Data were analyzed using the methodology of thematic analysis. Results show that suicide-related behaviors, attitudes, and help-seeking behavior have gender and culture-specific characteristics. Two central themes were identified: the impact of family and community and the impact of German society. Participants stated that they believe that family and community pressures as well as discrimination and lack of acceptance cause social isolation. Fear of stigmatization and dishonoring themselves or their family, as well as shame and self-stigma decrease the likelihood of reaching out for help. Recommended strategies are community and family interventions, promotion of integration and social inclusion, awareness campaigns to destigmatize suicidality and the use of mental health services, empowerment of women, as well as the improvement of cultural sensitivity and competency of services.
Subject(s)
Emigrants and Immigrants/psychology , Models, Psychological , Patient Acceptance of Health Care , Social Stigma , Suicide, Attempted/psychology , Adolescent , Adult , Aged , Cultural Competency , Female , Focus Groups , Germany/epidemiology , Humans , Interviews as Topic , Male , Middle Aged , Risk Factors , Sex Factors , Socioeconomic Factors , Turkey/ethnology , Young AdultABSTRACT
PURPOSE: Discrimination is linked to various health problems, including mental disorders like depression and also has a negative effect on the access to mental health care services. Little is known about factors mitigating the association between ethnic discrimination and mental distress. METHODS: The present study examined the extent of the relationship between perceived ethnic discrimination and psychological distress among women of Turkish origin residing in Berlin, and explored whether this association is moderated by acculturation strategies while controlling for known predictors of distress in migrant populations. RESULTS: A total of 205 women of Turkish origin participated in the study. 55.1% of the participants reported some degree of ethnic discrimination. The degree of reported discrimination varied according to acculturation. The highest level of ethnic discrimination was found in the second generation separated group and both generations of the marginalized group. Further, the results indicate an association between ethnic discrimination and distress while adjusting for known socio-demographic predictors of distress, migration-related factors, and neuroticism (B = 5.56, 95% CI 2.44-8.68, p < 0.001). However, the relationship did vary as a function of acculturation strategy, showing an association only in the separated group. CONCLUSIONS: The findings highlight the effects of ethnic discrimination beyond the influence of known risk factor for psychological distress in migrants, such as unemployment, being single, having a limited residence permit or the presence of personality structures that may increase vulnerability for stress responses and mental disorders.
