Detecting Unseen Suicide Risks Among Asian American Youth
September 13, 2024 – New research examining disparities in Asian American youth and young adult suicide rates have revealed previously uncovered risks for various ethnic subgroups. The study, recently published in JAMA Pediatrics and led by Anthony L. Bui, MD, MPH, at Seattle Children’s Research Institute’s Center for Child Health, Behavior and Development, found that grouping all Asian Americans together when examining youth and young adult suicide rates hides opportunities for support, because it overlooks how some Asian American ethnic subgroups may have statistically higher rates compared to others.
Mental health conditions commonly go unseen and can be compounded by genetic, societal and cultural factors that vary by age group. In Asian American youth, stigma around seeking mental health support remains a concern and can contribute to recent statistics showing suicide as the leading cause of death for Asian American youth.
“I am hoping to better explore reasons why mental illness are more prevalent in some of the subcommunities within the Asian American population, including differences on how these communities seek out mental healthcare.” Dr. Bui said.
Dismantling Stereotypes
Asian Americans are one of the fastest growing and diverse populations in the U.S. This population includes a wide range of ethnic subgroups throughout East and Southeast Asia, India and the Pacific, each with their own unique languages, cultures and other social characteristics. Historical erasure of culture, marginalization and oppression has led to poor institutional supports for these different communities and, despite the many identified differences between ethnic groups, researchers broadly label these individuals as “Asian” or “Asian American.”
Dr. Bui, who is also a primary care pediatrician and an acting assistant professor at the University of Washington School of Medicine, recognizes the importance of uplifting racial and ethnic minoritized groups, especially within broad, and in his view, sometimes dismissive generalizations.
In an invited JAMA Network Open commentary published earlier this year with University of California, Los Angeles psychology professor Dr. Anna Lau, Dr. Bui touches on various factors that contribute to poor mental health support for Asian Americans and Pacific Islanders, including the dangers of the “model minority stereotype” that imbues these populations. This stereotype generalizes Asian American and Pacific Islander youth as academically exceptional, well adjusted and socially mobile. Such cultural stereotypes leave little room for community vulnerability, identification of societal needs and help for mental health conditions such as depression, anxiety and alarmingly, high rates of suicide and suicidal ideation.
Hidden Disparities Revealed
“Few public health studies currently divide Asian Americans into more specific ethnic categories. While we know that suicide is a leading cause of death for Asian American youth and young adults, this research is one of the first attempts to understand how these rates differ across Asian ethnicities.”
Dr. Bui and colleagues examined suicide rates from 2018 to 2021 among youths ages 15 through 19 and young adults from 20 through 24 years. Data representing five specific subpopulations —Chinese, Filipino, Indian, Korean and Vietnamese — were collected, as well as data categorized as “all other,” which included Bangladeshi, Bhutanese, Burmese, Cambodian, Hmong, Indonesian, Japanese, Malaysian and Pakistani, to name a few.
Findings revealed that the overall suicide rate for Asian Americans was 9.17 deaths per 100,000, which is lower in comparison to the 10.77 per 100,000 seen in non-Asian American youth. However, upon closer look, Dr. Bui found the generalized data masked other groups within this population.
Indian youths, followed by Chinese youths, showed the lowest rate of suicide in comparison to Vietnamese and Korean groups, who trend much higher. Averaging data across all subgroups decreases not only the reported numbers, but also the urgency for community-focused mental health research for Asian American populations.
Providing Mental Health Care Where It Is Most Needed
While the findings raise concerns, Dr. Bui is hopeful his more inclusive and specific approach to research can jumpstart positive, nuanced change. Understanding how suicide rates differ among distinct Asian American communities can help providers, community health workers, mental health professionals and even families prioritize prevention and treatment efforts for the groups who most need it.
Building on this research, Dr. Bui aims to study what promotes and constrains the use of mental healthcare among Vietnamese American communities and ultimately hopes to build culturally tailored programs to better support underrepresented Asian American communities.
Collaborators on this study include Seattle Children’s researchers Tumaini R. Coker, MD, MBA, and Frederick P. Rivara, MD, MPH; and UW psychiatric epidemiologist Isaac C. Rhew, PhD, MPH.
While completing this work, Dr. Bui, who is a member of the Health Equity Alliance Lab, was supported by Seattle Children’s Research Institute’s Excellence in Research New Investigator Award and the University of Washington Department of Pediatrics.
— Empress Rivera-Ruiz
About the Center for Child Health, Behavior and Development
Researchers at Seattle Children’s Center for Child Health, Behavior and Development work with families, communities and healthcare providers to address the mental, physical and behavioral health of children globally. The center’s multidisciplinary researchers focus on a broad range of areas related to child health and development, providing insights into improving children’s well-being. Learn more.