Culturally and Linguistically Diverse Australians: Suicide among refugee and humanitarian entrants and other permanent migrants
'Culturally and linguistically diverse’ (CALD) is a broad term describing the cultural and linguistic diversity of multicultural populations living in Australia (ABS 1999). Refugee and humanitarian entrants, and other permanent migrant Australians are part of the larger CALD communities within Australia.
In 1999, The Australian Bureau of Statistics (ABS) introduced the ‘Standards for Statistics on Cultural and Language Diversity’ (the Standards). The Standards were designed to replace the use of 'non-English speaking background' as the sole indicator of cultural and linguistic diversity. They provide a more holistic, accurate, and consistent measurement of cultural and linguistic diversity in Australia. While the ABS has not revised the Standards since the initial publication, text and formatting were refreshed in 2022 (ABS 2022a).
The Standards comprise indicators related to country of birth (of an individual and their parents), year of arrival in Australia, language(s) spoken, ancestry, religious affiliation, and First Nations status. The AIHW uses ‘First Nations people’ to refer to Aboriginal and/or Torres Strait Islander people in this publication. While CALD terminology as outlined by the Standards is widely adopted within Australia, there is no universally accepted definition of CALD (Pham et al. 2021).
CALD communities and refugees are identified as priority populations under the National Mental Health and Suicide Prevention Agreement (the Agreement) (Cth of Australia 2022). Under the Agreement, Commonwealth and State and Territory governments have a shared responsibility to support priority populations who may be at higher risk of mental ill health and suicide due to vulnerability caused by social, economic, and environmental circumstances. While CALD communities have varied experiences, they may also have some shared experiences that contribute to suicide risk factors. These include difficulties adjusting to a new culture, experiences of stigma, and changes in social and family networks a result of migration (Bowden et al. 2020). CALD Australians who are refugees or humanitarian entrants may experience additional or more pronounced challenges due to past experiences of persecution or human rights abuses within their country of origin, or trauma associated with war or their refugee journey (FASSTT 2017).
Although First Nations people are diverse in language and culture, their experiences as First Nations people are unique. Furthermore, the National Mental Health and Suicide Prevention Agreement (Cth of Australia 2022) identifies ‘Aboriginal and Torres Strait Islander peoples’ as priority populations separate to the identification of ‘culturally and linguistically diverse communities and refugee’ priority populations. As such, First Nations people are considered distinct from CALD terminology used throughout this report. Though it is acknowledged that a person may both identity as a First Nations person and as a person of Cultural and Linguistic Diversity.
Data on suicide among refugee and humanitarian entrants and other permanent migrants
Data presented in this report are drawn from a larger project investigating the health and welfare of Australia’s refugee and humanitarian entrant populations (AIHW 2023a). This larger project was funded by the Department of Home Affairs and involved linking the Settlement Database (Department of Home Affairs 2019) with other datasets available in the Person-level Integrated Data Asset (PLIDA); formally known as the Multi Agency Data Integration Project (MADIP) (ABS n.d.). Linking the Settlement Database to the PLIDA enabled the identification and analysis of migrant status for deidentified individuals appearing within other PLIDA datasets.
The key datasets used in the analysis presented in this publication are the Settlement Database (Department of Home Affairs 2019) and the Causes of Death (ABS 2023) dataset. For full details see technical notes for the ‘Health of refugees and humanitarian entrants in Australia’ report, which was undertaken as part of the larger Department of Home Affairs funded project for details.
Information derived from analysis of linked Settlement Database and Causes of Death dataset data, is limited to the experience of people who have moved to Australia from another country (first-generation migrant Australians). Refugee and humanitarian, and other permanent migrants are part of the broader CALD communities within Australia. Migration status and year of arrival capture a limited number of indicators within ABS ‘Standards for Statistics on Cultural and Language Diversity’. Therefore, data presented should not be considered representative of broader CALD communities within Australia. Instead, this analysis provides robust information about deaths by suicide among first-generation permanent migrant Australians: refugee and humanitarian entrants, and other permanent migrants.
First generation ‘Humanitarian entrants’ and 'Other permanent migrants’ experienced lower rates of suicide compared to the 'Rest of the Australian population’.
The interactive data visualisation below displays deaths by suicide between 2007–2020, by sex and migration group. The age-standardised rates show that:
- Both ‘Humanitarian entrants’ and 'Other permanent migrants’ each experienced lower rates of suicide when compared to the ‘Rest of the Australian population'.
- ‘Humanitarian entrants’ experienced 1.7 times the rate of suicide compared to 'Other permanent migrants’.
- Deaths by suicide were higher for males than females across all three cohorts, with the largest difference in the ‘Humanitarian entrants’ cohort. Among the ‘Humanitarian entrants’ cohort, the age-standardised suicide rate for males (11 per 100,000 population) was more than 3.5 times higher than for females (3.0 per 100,000 population). Among the ‘Rest of the Australian population’ cohort, the age-standardised suicide rate for males (18.8 per 100,000 population) was approximately three times higher than for females (6.1 per 100,000 population).
This bar chart shows the age-standardised suicide rate (per 100,000), crude suicide rate (per 100,000 population) and number of deaths by suicide among by sex and migration group (other permanent migrants and humanitarian entrants), over the years 2007–2020. Migration groups are compared to the rest of the Australian population.
Rates of death by suicide for first generation ‘Humanitarian entrants’ and 'Other permanent migrants’ increased with time since arriving in Australia
The interactive data visualisation below displays deaths by suicide between 2007 and 2020, disaggregated by time since arrival in Australia and migration group. Rates were calculated using person years, which account for the different lengths of time individuals have been living in Australia (and at risk of death by suicide). This enables examination of how these migrant groups are affected by suicide at different times after their arrival in Australia.
The age-standardised rates show that:
- Deaths by suicide were higher for ‘Humanitarian entrants’ compared to ‘Other permanent migrants’ at each period since arrival in Australia. Although, particularly with error bars displayed, the differences between these groups are small.
- Deaths by suicide increased for both ‘Humanitarian entrants’ and ‘Other permanent migrants’ as time since arrival in Australia increased.
This bar chart shows the age-standardised suicide rate (per 100,000), crude suicide rate (per 100,000 population) and number of deaths by suicide among by migration group (other permanent migrants and humanitarian entrants) and age group, over the years 2007–2020. The age group includes ‘<5 years’, ‘5-10 years’ and ‘>10 years’.
What other national suicide and self-harm data available for CALD and refugee communities in Australia?
The AIHW uses the National Mortality Database (AIHW 2023b) and the National Hospital Morbidity Database (AIHW 2023c) to report on key suicide and self-harm statistics in Australia. Information relevant to CALD communities within these databases is limited to country of birth.
The most recent ABS Causes of Death publication (ABS 2023), which presents National Mortality Database data, includes information about suicide by country of birth. This publication found that, between 2018–2022, those born in Croatia, New Zealand and Scotland had a higher age-standardised suicide rate than those born in Australia (ABS 2023). There is no information specific to refugee status within with the National Mortality Database or the National Hospital Morbidity Database.
Linking datasets that contain more comprehensive information about members of CALD communities and/or refugee status and administrative datasets, can provide insight into suicide and self-harm among these communities. For example, while not focused on suicide and self-harm, the AIHW (2022) report “Reporting on the health of culturally and linguistically diverse populations in Australia: An exploratory paper”, investigates the use of PLIDA linked data to report on the health of CALD populations. Linking the Settlement Database to the PLIDA, made the analysis presented within this release possible. Migration status and time since arrival in Australia indicators drawn from the Settlement Database provide additional information regarding the experience of first-generation permanent migrant Australians: refugee and humanitarian entrants, and other permanent migrants.
The National Study of Mental Health and Wellbeing (ABS 2022b) collects information both about cultural and linguistic diversity, and about participants’ lived experience of suicide and self-harm. The ABS conducts this nationally representative survey on an irregular basis, most recently during 2020–2022. Analysis of this survey data may be informative for future work.
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