Evaluating a Video-Based Approach to Mental Health Awareness and Suicide Prevention Among Bhutanese Refugees Resettled in the United States: A Mixed Methods Study

Abstract

The annual suicide rate amongst Bhutanese refugees was found to be 24.4 per 100,000, which was close to the suicide rates in the refugee camps in Nepal (20.7 per 100,000), but very high when compared to the US annual suicide rate of 12.4 per 100,000 2. High suicide rates and the dynamics around them have been well documented amongst Bhutanese refugees in a number of studies conducted in the United States 3 4 5. We conducted an initial set of 6 focused group discussion (FGDs) to design and create a video best suited for the Bhutanese refugee community. Then, a mixed methods intervention design was used to measure the change in perceptions and describe ideas and beliefs post-intervention. This study indicates that a video-based intervention is a potentially effective tool to create awareness on suicide and mental health topics. It also helps in addressing certain non-structural issues like family integration, encouragement to seek education and attempt to diminish stigma within the community. The video appeared to offer a basic level of psychoeducation on mental health services and the prevention of suicide. However, the video cannot have an impact on improving structural problems such as lack of obtaining citizenship, financial difficulties, and problems with the English language. Policies and programs should be put in place to address these broader structural problems while at the same time continuing to promote psychoeducation, through videos and other means, related to suicide prevention in this high-risk community.