Planning for suicide prevention in Thai refugee camps: Using community-based system dynamics modeling

Abstract

Suicide and associated behaviors represent a significant health disparity among refugees and displaced persons. Despite this burden, evidence for prevention programing in these populations is limited. This study aimed to inform the selection and implementation of suicide prevention strategies in refugee camps in Northwestern, Thailand - camps that had experienced recent spikes in suicides and suicide attempts at the time of the study. We leveraged Community Based System Dynamics modeling through a series of four workshops with key local stakeholders and suicide prevention experts, to build a qualitative systems model that accounts for complexities and is aimed at assisting local partners with selecting the most promising strategies for implementation and evaluation. The process expanded local understanding of the causes and consequences of suicide and resulted in selection of priority interventions aimed at reducing suicide in this context. Our research illustrates the application of a novel methodology that aims to account for the complexities of suicide prevention in the context of displacement and helps to optimize local suicide prevention efforts.

Keywords: Refugees; Suicide Prevention; System Dynamics; Systems Thinking.

Figure 1.

Preliminary causal loop diagram of suicidal behaviors in refugee populations

Figure 2.

Initial form for the stock and flow diagram of suicide behaviors in refugee populations

Figure 3.

Expansion of the portion of the model for suicide behaviors and recovery

Figure 4.

Final form for the stock and flow diagram of suicide behaviors in refugee populations