Suicide behaviors and role of family characteristics, school difficulties, unhealthy behaviors, and mental health among multi-cultural students.

Background: School is a multi-cultural setting where students are trained for community participation, especially at adulthood. But some students experience suicidal behaviors and the risk may be exacerbated among immigrant students because of their living conditions. In an early adolescence context, this study assessed of risk for suicide behaviors among European and non-European immigrants and the roles of family characteristics, school difficulties, unhealthy behaviors, and mental health. Methods: Questionnaires were completed by 1559 middle-school adolescents from north-eastern France (mean age 13.5 (SD 1.3) years) including: sex, age, family structure, nationality, father’s occupation, unhealthy behaviors (last-30-day consumption of tobacco/alcohol/cannabis/hard drug, no regular sports/physical activities), repeating a school year, low-school-performance (<10/20), and quittingschool-
thinking, depressive symptoms, victim of violence or sexual abuse, implication in violence, and
suicide behaviors. Data were analyzed using logistic models. Results: Last-12-month suicidal ideation (SI) and lifetime suicide attempts (SA) affected 11.7% and 9.9% of students. The risk for SI was higher for European immigrants (gender-age-adjusted odds ratio ORa 2.06) and non-European immigrants (2.60) compared with French. Further adjustment for father’s
occupation and family structure reduced the ORs to 1.76 (28%) and 2.43 (11%) respectively. Further adjustment for unhealthy behaviors, school difficulties, depressive symptoms, victim of violence or sexual abuse, and implication in violence reduced the ORs to 1.50 (53%) and 2.23 (23%) respectively. The risk for SA was higher for European immigrants only (ORa 2.21). Further adjustment for father’s occupation and family structure reduced the OR to 2.03 (15%), and further adjustment for other covariates reduced it to 1.59 (51%). Conclusion: Immigrant students have a higher risk for suicidal ideation or suicide attempts depending on their origin. The risk is strongly mediated by family characteristics, school difficulties, unhealthy behaviors, and mental heath. Public policy may focus on these issues. This should promote school achievement and community participation.