Characteristics of individuals from ethnic minority backgrounds who die by suicide: A systematic review

We aimed to estimate the prevalence of clinical and modifiable sociodemographic characteristics of individuals from ethnic minority backgrounds who died by suicide and, where possible, compare them to the majority population. Databases were searched for studies published between 01/01/2000-19/12/2023. Absolute and relative prevalence estimates of characteristics were reported by minority group (Indigenous; migrant; other ethnic minority) then stratified by continent and, where applicable, migrant sub-type and ethnicity. A narrative synthesis was conducted with moderate-high quality studies. We identified fifty-seven studies across 16 countries; the majority from North America, Europe and Oceania. When examining moderate-high quality evidence, there were generally limited numbers of studies reporting the prevalence of each characteristic by ethnic minority status, especially for social factors. Based on the available data, we found a high prevalence mental health problems among people who died by suicide from Indigenous (20.8-60.7 %), migrant (37.2-42.9 %) and other ethnic minority (29.9-37.3 %) backgrounds. However, people from Asian/Pacific Islander, Black and Hispanic backgrounds were less likely to have mental health problems reported compared to majority populations. Indigenous people and migrants generally had lower contact with mental health services compared to majority groups. We also found evidence of a lower prevalence of depression and higher prevalence of alcohol and substance use problems among Indigenous compared to non-Indigenous individuals, and greater levels of economic disadvantage among migrants compared to non-migrants. Our findings highlight differences in the characteristics of people who die by suicide based on ethnicity and migration status and identify potential targets for research and suicide prevention strategies.