Suicide in first-generation Australian migrants, 2006–2019: a retrospective mortality study

BACKGROUND: This study addressed the limited understanding of suicide risk and patterns among migrants in Australia. It examined national-level suicide rates and trends in the Australian population to identify migrant groups which are disproportionately affected by suicide. METHODS: The National Coronial Information System was used to identify suicide cases from 2006 to 2019. Incident rate ratios (IRR) with 95% confidence intervals (CI) evaluated suicide risk for migrant groups compared to Australian-born and migrants from English-speaking countries. Age-standardised suicide rates (ASR) per 100,000 and average annual percentage change (AAPC) were calculated to compare suicide rates and trends. FINDINGS: Compared to the Australian-born population, all migrant males and females had significantly lower suicide risk, except females from Oceania countries. Females from European (IRR 1.28, 95% CI 1.13, 1.14) and Oceanian countries (IRR 1.25; 95% CI 0.95, 1.66) had an elevated suicide risk compared to female migrants from English-speaking countries. Male migrants from Oceania (ASR 20.4, AAPC 1.0 (−3.6, 5.8)) and Africa (ASR 18.0, AAPC −0.4 (−5.5, 4.9)) have high ASR with no significant changes in trend over the study duration. Female African migrants had an ASR of 5.3 per 100,000, which increased by 8% (95% CI 1.4, 15.0) between 2006 and 2019. INTERPRETATION: Migrants from Oceania and African countries are disproportionately affected by suicide mortality compared to other migrant groups in Australia. Further research is needed to identify the risk factors and develop suicide prevention strategies for these groups. FUNDING: 10.13039/501100019998Suicide Prevention Australia, 10.13039/501100000923Australian Research Council.