Journal of Immigrant and Minority Health

, Volume 18, Issue 4, pp 828–835 | Cite as

Suicidal Ideation and Mental Health of Bhutanese Refugees in the United States

  • Trong Ao
  • Sharmila Shetty
  • Teresa Sivilli
  • Curtis Blanton
  • Heidi Ellis
  • Paul L. Geltman
  • Jennifer Cochran
  • Eboni Taylor
  • Emily W. Lankau
  • Barbara Lopes Cardozo
Original Paper


Refugee agencies noticed a high number of suicides among Bhutanese refugees resettled in the United States between 2009 and 2012. We aimed to estimate prevalence of mental health conditions and identify factors associated with suicidal ideation among Bhutanese refugees. We conducted a stratified random cross-sectional survey and collected information on demographics, mental health conditions, suicidal ideation, and post-migration difficulties. Bivariate logistic regressions were performed to identify factors associated with suicidal ideation. Prevalence of mental health conditions were: depression (21 %), symptoms of anxiety (19 %), post-traumatic stress disorder (4.5 %), and suicidal ideation (3 %), significant risk factors for suicidal ideation included: not being a provider of the family; perceiving low social support; and having symptoms of anxiety and depression. These findings suggest that Bhutanese refugees in the United States may have a higher burden of mental illness relative to the US population and may benefit from mental health screening and treatment. Refugee communities and service providers may benefit from additional suicide awareness training to identify those at highest risk.


Bhutanese refugees Suicide Mental health PTSD Post-migration difficulties 



We gratefully acknowledge the following individuals and organizations for their invaluable contribution to this study: Office for Refugee Resettlement (Eskinder Negash, Marta Brenden, Makda Belay, Essey Workie); Arizona Department of Health Services (Ken Komatsu, Carrie Senseman, Markay Adams); Texas Department of State Health Services (Jessica Montour); Georgia Department of Public Health (Monica Vargas); New York State Department of Health (Eric Cleghorn; Cheryl Brown; Stephanie Anderton); Resettlement agencies and Bhutanese Community Leaders of: Atlanta, Georgia, Buffalo and Syracuse, New York, Dallas/Fort Worth and Houston, Texas, Phoenix and Tucson, Arizona; CDC Students and Fellows (Cathy Baroang, Jaya Kannan, Karren Lamay, Sonia Hegde, Colin Basler, Navit Robkin, Ashley Hagaman, Ugonna Ijeoma); Psychological Autopsy Interviewers (Markay Adams; Mike Gronostaj; Jeff McCollum; Dulces Morales; Amy Peterson; Loren Rodgers; Gigi Rose; Maria Said; Laura Vonnahme); CDC Collaborators (DGMQ/IRHMB, DGDDER/IERHB, Division of Injury Prevention—Alex Crosby, M.D., Thomas Niederkrotenthaler; Pathways to Wellness—Michael Hollifield, M.D., Boston Children’s Hospital—Alisa Miller, Ph.D.).

Compliance with Ethical Standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer Science+Business Media New York (Outside USA) 2015

Authors and Affiliations

  • Trong Ao
    • 1
  • Sharmila Shetty
    • 1
  • Teresa Sivilli
    • 1
  • Curtis Blanton
    • 1
  • Heidi Ellis
    • 2
    • 3
  • Paul L. Geltman
    • 3
    • 4
  • Jennifer Cochran
    • 4
  • Eboni Taylor
    • 1
  • Emily W. Lankau
    • 1
    • 5
    • 6
  • Barbara Lopes Cardozo
    • 1
  1. 1.Emergency Response and Recovery Branch, Center for Global HealthCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Boston Children’s HospitalBostonUSA
  3. 3.Harvard Medical SchoolBostonUSA
  4. 4.Massachusetts Department of Public HealthBostonUSA
  5. 5.LandCow ConsultingAthensUSA
  6. 6.Department of Infectious DiseasesUniversity of GeorgiaAthensUSA

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