Brian Greenfield(1), Londa Daniel(2) and Bonnie Harnden(2)
1. McGill University Faculty of Medicine and Montreal Children’s Hospital, Montreal, Quebec, Canada
2. Concordia University, Montreal, Quebec, Canada
Immigration and Mental Health: Stress, Psychiatric Disorders and Suicidal Behavior Among Immigrants and Refugees. Hauppauge, New York: Nova Science Publishers, 2010, 350 pages.

Introduction: The assessment of patients contemplating suicide requires a specific skill set. When immigrants are involved, the complexity increases. Method: This article presents an overview of cultural issues concerning suicide, examining cultural differences among several countries of origin and tracking the impact of those disparities as immigrants adapt to the host culture through the first and subsequent generations. Results: Although suicide may be universally considered a final common pathway of distress, its acceptability, manifestations and execution vary widely across cultures. When individuals from disparate cultures immigrate to a host country, their suicide rates and methods gradually assume a profile similar to those of the host culture, mediated by acculturative stress, the process of acculturation and by risk factors (eg never having been married, drug use and rejection by the host culture) and protective elements (eg maintenance of traditional family relationships, belonging to an ethnic community, living in a large city and being married). Consideration is given to the Canadian Inuit, faced with problematic integration into the mainstream culture and particularly high suicide rates, to provide perspective on similar challenges and therapeutic matters in relation to suicidal immigrants. A case example highlights some of these characteristics. Conclusion: Although commonalities can be found between cultures in their attitudes toward suicide and the stresses associated with immigration, assessment of immigrants who are suicidal must be considered on an individual basis and superimposed on a sound clinical interview.