Suicidality and suicide prevention in culturally and linguistically diverse (CALD) communities: A systematic review

Australia has one of the largest multicultural populations in the world, with cultural and linguistic diversity (CALD) a defining feature. CALD populations have unique identities and experiences of mental health and suicide, with multicultural differences, trauma and experiences of discrimination and stigma pertinent to effective suicide prevention approaches. Very little is known however about suicide and suicidality among this population in Australia. This systematic review explored literature on suicidality and suicide prevention in CALD communities as a means of informing suicide prevention research, policy and practice in the Australian context. Five electronic databases (Medline, PsycINFO, Embase, Emcare, and CINAHL) were searched. Studies were included if they examined factors associated with suicidality or described suicide prevention initiatives in CALD populations, and were conducted in OECD countries. Study quality was assessed using the CASP qualitative checklist for qualitative studies and the Quality Assessment Tool for quantitative studies. Thematic analysis was used to identify key themes in the included studies. Eighteen studies met the criteria for inclusion, including ten qualitative and eight quantitative studies. No Australian studies were identified. Key themes included acculturation difficulties, stigma, the influence of social networks and family, heterogeneity of CALD populations, and suggested prevention strategies. The review found no Australian studies looking at suicidality or suicide prevention in CALD communities. It highlights the need for a greater focus across policy, research and evaluation on suicide prevention in Australian CALD communities.