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Mental health, migration stressors and suicidal ideation among Latino immigrants in Spain and the United States

Published online by Cambridge University Press:  23 March 2020

L.R. Fortuna ,
K. Álvarez ,
Z. Ramos Ortiz ,
Y. Wang ,
X. Mozo Alegría ,
B.L. Cook  and
M. Alegría
L.R. Fortuna
Affiliation:
Boston University Medical School, Boston Medical Center, Child and Adolescent Psychiatry, 850, Harrison Avenue, Dowling Building, 7th Floor, Boston, MA02118USA Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA, 02114, USA
K. Álvarez
Affiliation:
Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA, 02114, USA
Z. Ramos Ortiz
Affiliation:
Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA, 02114, USA
Y. Wang
Affiliation:
Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA, 02114, USA
X. Mozo Alegría
Affiliation:
Hospital Universitari Vall d’Hebron, Paseo de la Vall d’Hebron, 119-129, 08035, Barcelona, Spain
B.L. Cook
Affiliation:
Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, 1035, Cambridge Street, CambridgeMA02141USA
M. Alegría*
Affiliation:
Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 50, Staniford Street, Suite 830 Boston, MA, 02114, USA
*
⁎Corresponding author. malegria@mgh.harvard.edu
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Abstract

Background

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.

Methods

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.

Results

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).

Conclusion

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.

Keywords

SuicideUnipolar depressionPosttraumatic stress disorderSocial and cross-cultural psychiatryAddiction
Type
Original article
Information
European Psychiatry , Volume 36 , August 2016 , pp. 15 - 22
Copyright
Copyright © European Psychiatric Association 2016

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