RESUMO
BACKGROUND: Several suicide and suicidal behaviour risk factors are highly prevalent in asylum seekers, but there is little insight into the suicide death rate and the suicidal behaviour incidence in this population. The main objective of this study is to assess the burden of suicide and hospital-treated non-fatal suicidal behaviour in asylum seekers in the Netherlands and to identify factors that could guide prevention. METHODS: We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+). The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization. RESULTS: The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83). No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07). The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers. CONCLUSIONS: In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour was higher in several subgroups of asylum seekers than that in the reference population. We conclude that measures to prevent suicide and suicidal behaviour among asylum seekers in the Netherlands are indicated.
Assuntos
Hospitalização , Refugiados/psicologia , Ideação Suicida , Prevenção do Suicídio , Suicídio , Adolescente , Adulto , Feminino , Humanos , Masculino , Países Baixos/epidemiologia , Sistema de Registros , Suicídio/etnologia , Adulto JovemRESUMO
OBJECTIVE: To analyse whether specific attention is needed for the improvement of health for pregnant asylum seekers by producing an overview of obstetric outcomes, risk factors and expressed health needs of asylum seekers in the Netherlands and other Western host countries. DESIGN: Literature study. METHOD: A search was performed in Medline, Embase and PsycInfo for empirical studies about pregnancy and delivery specifically among asylum seekers in Western host countries and published since 1995. Picarta and the authors' literature collections were used to find Dutch studies. Google was used to find grey literature. RESULTS: Published empirical studies on pregnancy outcome indicators specific for asylum seekers were scarce and limited to the Netherlands. The studies found revealed an increased risk of perinatal and maternal mortality and severe maternal morbidity. These studies, however, were based on small numbers of cases. Qualitative studies revealed that pregnant asylum seekers expressed the following needs: a) information about pregnancy and about healthcare in the host country, b) healthcare professionals who pay attention to their problems and c) mothers' groups for social contacts and information exchange. CONCLUSION: Specific attention must be paid to improving the care for pregnant asylum seekers, since the limited number of studies suggest that asylum seekers are at increased risk of perinatal mortality, maternal mortality and severe maternal morbidity. More studies are needed into risk factors and quality of care for pregnant asylum seekers. The publications studied contain recommendations for an improved matching of the care with the needs expressed. The recommendations concern provision of information, cultural competencies of care providers, identification of risk factors, health networks approach, continuity of care and organising mother's groups.
