Asian American Suicide 1
Kathleen Del Rosario
GE Cluster 20CW: Interracial Dynamics
Race and Health, Jennifer Garcia
June 7, 2011
Asian Americans and Adolescent Suicide
Suicide claims the lives of 30,000 Americans each year and is currently the eleventh
leading cause of death in the United States. The act of committing suicide is an action taken by
an individual to purposely end his or her own life. People who contemplate suicide are those who
find themselves in situations so difficult to cope with that death seems like their only way out.
These situations often involve feelings of shame, guilt, victimization, loneliness, and being a
burden to others. Suicidal thoughts are also common among individuals suffering from mental
illnesses such as bipolar disorder, schizophrenia, and depression. As researcher Hicks states
(1990), among the different age groups, the rate of suicide tends to increase most rapidly among
adolescents ages fifteen to twenty-four (p. 9). Between the different racial groups within this age
category, Asian Americans are the group most likely to attempt suicide due to pressures faced by
the “model minority” myth, challenges that lead to the underutilization of mental health services,
and the effects of acculturation into American society. These factors validate the need for public
health professionals to focus on outreaching to the Asian American youth population, possibly
through student ethnic support groups, and also educating them about their resources and about
the problem of suicide.
Causes and Risk Factors of Adolescent Suicide
According to researcher Davis (1983), a common misconception about the period of
adolescence is that it is the time for a person to live freely and have as much fun as they possibly
Asian American Suicide 2
can when in actuality, it is the time for an individual to learn how to maintain their
responsibilities. It is for this reason that adolescence is viewed as a stressful period for both
parents and adolescents themselves (p. 10). This stressful period gives rise to stressful situations,
which may result in an adolescent’s suicidal thoughts. Studies show that teens who live in
disorganized families or feel unwanted by their parents are more likely to commit suicide. Drug
and alcohol addictions also contribute to suicidal thoughts due to the fact that they only provide
temporary relief (p. 26). College students, particularly undergraduates, are more likely to commit
suicide than the general population of the same age group (p. 33) not only due to stress involved
with academic performance but also due to separation from their homes and their loved ones (p.
37). Social isolation of an individual, portrayals of suicide in the media, and even gloomy
weather are among other factors that may lead to suicide attempts. Though mental illness is
strongly correlated to suicide, it is not proven that an individual has to be diagnosed with one to
be suicidal.
There are several warning signs that may determine if an adolescent is at risk of
committing suicide. Hicks explains that those who have previously attempted to kill themselves
are more likely to become victims of suicide (p. 29). Battin (1995) further explains that 10-20%
of people who have attempted suicide in the past will go on to complete one (p. 158). Youth who
are at-risk may give off verbal signs involving both direct and indirect statements about death or
dying. Direct statements may include comments similar to, “‘I wish I were dead’” or “‘I don’t
want to go on living,” and indirect statements may include, “‘Why is there so much unhappiness
in my life?’” or “You don’t have to worry about me anymore,’” (Hicks, 1990, p. 31). Exhibiting
certain behaviors, such as giving away valued belongings or having sudden mood-swings
without reasonable explanations (p. 32), is also a sign that an adolescent is contemplating
Asian American Suicide 3
suicide. Other characteristics of an at-risk suicide victim are signs of depression, including sleep
disturbances, loss or increase in appetite, low self-esteem, lack of energy, and feelings of
isolation (p. 33). Being put through tough, life-changing situations, for example, the loss of a
parent or a break-up with a significant other, poses another signal of an individual being an atrisk suicide victim.
Adolescent Suicide among Asian Americans
Suicide rates vary across different racial groups, for example, between Asian Americans
and European Americans. The highest rate of suicide among Asian Americans occurs within the
high-risk fifteen to twenty-four-year-old age group. The same goes for European Americans,
however, Asians within this age group are more likely than European Americans within the same
age group to attempt suicide (Leong, Leach, & Gupta, 2008, p. 118). Leach (2006) reports that
from 1970 to 1980, the rate at which Chinese ages fifteen to twenty-four committed suicide more
than doubled, putting them in a high-risk category (p. 129). Studies also show that most of the
world’s suicides occur in Asian countries (p. 118). According to Leach, rates of suicide among
Asians in Asia are higher than rates of suicide among Asians in the United States, but the rank in
rates are consistent between the two geographic regions (p. 128). This notes that there are
cultural influences on suicide rates among Asian Americans such as the belief that committing
suicide will rid the community from further shame (p. 132), claiming that suicide is acceptable
and an “honorable behavior” (Tse and Bagley, 2002, p. 11).
In general, less is known about explanations of suicide among other ethnic groups in
comparison with European Americans, including Asian Americans. Information on suicide
among Asian Americans is limited due to the fact that most data is based on groups that have
been present in the United States for a longer period of time, such as the Chinese, Japanese, and
Asian American Suicide 4
Filipino Americans. Leong et. al. (2008) argue that the misrepresentation of Asian Americans in
studies of suicide is “misleading because Asian Americans [do] display varying suicide rates and
reasons for suicide, depending upon a variety of within-group factors such as age, acculturation,
religious orientation, and sexual orientation,” (p. 118). Much of what is known about suicide
among Asian Americans is from studies using university students as participants, proving that a
large number of deaths occur among Asian American adolescents as a result of suicide (p. 118).
Causes of the Disparity
One factor that leads to the high rate of suicide among Asian American adolescents is
stress faced by the “model minority” myth, which is the idea that Asians are the most successful
minority. Zhou (2004) cites that Asian Americans continue to achieve both economically and
educationally, according to the 2000 U.S. Census (p. 33). This factor affects Asian American
youths both within their families and within society. Within their families, Asian Americans are
faced with high expectations and pressures to be successful. Asian American college students
seem to be “more perfectionistic and concerned about external, often parental, criticisms, and
also reported higher hopelessness scores than European Americans” (Leach, 2006, p. 134).
Failure lowers their self-esteem, which may lead to depression and suicidal thoughts due to the
belief that they are not living up to par. Within society, Asian Americans are faced with pressures
to succeed because they hold the status of being a more superior race, yet they are also criticized
by other minority groups for their advancement in the racial hierarchy. According to Leong et.
al., Asian American youths in turn have to deal with the stresses involved with adolescent
development in addition to the “model minority” myth (p. 122). Not only are they faced with
pressures to be successful, but they have to deal with those pressures in addition to problems
Asian American Suicide 5
with self-identity (p. 122). These concurrent pressures are likely to overwhelm Asian
adolescents, leading to suicidal behavior as their escape.
Another factor that leads to the high rate of suicide among Asian American adolescents is
the underutilization of mental health services. Leong et. al. note that Asian Americans are the
group least likely to seek mental health treatment (p. 118). Asian American adolescents tend to
have higher rates of suicide compared to European American adolescents due to the fact that they
are amongst the “‘hidden ideators’” (Leong et. al., 2008, p. 118). This implies that they are less
likely than their European counterparts to admit to having suicidal thoughts, resulting in their
reluctance to access mental health services. Researches Lau and Leong (2001) make note of the
barriers that prevent Asian Americans from seeking mental treatment; they feel that having
mental health problems is shameful and will cause them to be looked down upon, contradicting
their superiority according to the “model minority” myth. Because of this, they don’t feel
comfortable discussing their problems with mental health professionals. As a result, Asian
Americans don’t receive help when they need it, and by the time they do, they may have already
reached a state of “intense distress, discomfort, and hopelessness” (Leong et. al., 2008, p. 118).
There is also a lack of knowledge about available mental health services within Asian
communities (Lau and Leong, 2001, p. 205). Not being educated about their resources is another
factor that contributes to the resistance of Asian Americans to seek mental treatment. Their
reluctance leaves their poor mental health status untreated, possibly leading to suicidal behavior.
The high rate of suicide among Asian American adolescents also results from the effects
of their acculturation into American society. Acculturation is “a complex, multidimensional
process associated with negotiating two or more cultures when one enters a new dominant
culture after leaving a perceived less valued culture” (p. 126). Leong et. al. report the distinction
Asian American Suicide 6
between a “‘national culture’” and a “‘host culture’” (p. 126); the “national culture” is the culture
that is left behind, and the “host culture” is the one being adopted. In this case, the national
cultures are Asian cultures, and the host culture is American culture. Zhou and Gatewood (2007)
claim that American culture is “highly exclusive” and that the “melting pot” doesn’t fully accept
non-European immigrants (p. 132). Asian American adolescents are faced with pressures to let
go of their traditional culture and adapt to American ways of living. For example, based on
interviews with members of the Japanese student club at Berkeley, Peterson (1966) mentions that
because they are aware of their status as a minority, Japanese American students are “seeking a
means both of preserving elements of the Japanese culture and of reconciling it fully with the
American one,” (p. 40). Studies show that there is a relation between acculturation and
depression (Leong et. al., 2008, p. 126), and students who are more acculturated report fewer
issues with their mental health (p. 127). Among Asian American college students, those who
were more adapted to the American culture were less likely to have suicidal thoughts, and those
who identified more with their native culture were more at-risk. Acculturation also refers to
parent-child relationships among Asian Americans. Traditional Asian values include respect
toward parents and traditions, but influence of American culture leads to rebellion and an
“immense amount of stress associated with intergenerational family conflict and parent-child
relationships,” (p. 127). According to Leong et. al., Asian adolescents who exhibit high parentchild conflicts are more likely to engage in suicidal behavior.
Levels of Prevention
When studying public health, it is important to understand that there are three levels to
consider when focusing on preventative measures: primary, secondary, and tertiary. The primary
level concentrates on what can be done to prevent the risk behavior from happening in the first
Asian American Suicide 7
place. In the case of suicide among Asian American adolescents, the primary level involves
educating the Asian American community about resources and about the dangers of suicide. In
order to decrease the chances of Asian American youths attempting to commit suicide, they
would have to know where they can go if they need to talk to someone and who they can talk to.
Not only do these resources include medical facilities or psychological health services, but they
may also include student ethnic support groups on high school and college campuses. Since the
focus is on Asian American adolescents who are most likely students, knowing there are Asian
ethnic student groups on campuses will help them gain stronger support systems because they
will be comfortable around peers who are more understanding, making it less likely for them to
feel alone or depressed and also less likely to even think about attempting suicide. These support
groups may also be able to reach out and educate Asian American youths about the disparity,
making them less prone to encounter risk factors as well.
The secondary level focuses on what can be done to eliminate the risk of experimenting
with the behavior. With suicide among Asian American adolescents, this level involves
counseling sessions, whether it be psychological or among peers. Speaking to a psychologist will
help determine effective ways to deal with troublesome situations. Psychologists offer assistance
to patients by listening to their thoughts and feelings and determining ways they can make
changes in their lifestyle in order to better themselves. However, Asian Americans often don’t
feel comfortable expressing their feelings to others. Going back to the explanation that Asian
Americans are “‘hidden ideators’” (Leong et. al., 2008, p. 118), more help lines and mental
health facilities specifically for Asian Americans will contribute to a higher level of comfort.
Better yet, for Asian American adolescents, peer counseling and/or mentorships within ethnic
support groups on campus will also be helpful in dealing with tough and stressful situations.
Asian American Suicide 8
Having a peer counselor will not only help them maintain good academic standing, but it will
also allow them build a bond with a peer who is there to help and support them, also allowing
them to feel more comfortable expressing their thoughts and feelings. Mentorships will provide
Asian American youths with advisers who they can look up to, seek advice from, and build a
relationship with as well. Having these people to talk to and forming relationships with them will
encourage Asian American youths to be more open and gain more support, decreasing their
chances of attempting suicide.
The tertiary level focuses on what can be done to reduce the risk behavior. Since the
behavior cannot be reduced once suicide is already committed, this pertains to attempted suicide
and suicidal behavior among Asian American adolescents. This level involves emergency
counseling and referral to a psychiatrist who may diagnose a mental illness and provide
treatment and medication; it is crucial to the status of mental health among Asian American
adolescents who have attempted to commit suicide because adequate treatment is needed for atrisk adolescents in order for their mental health to improve.
Recommendations
Upon examining the research on suicide among Asian American adolescents, I came
across two interesting points pertaining to the authors’ publications. First, the authors appear to
understand that race is a socially constructed aspect of our world, thus, using the term “ethnic
group” when referring to Asians and Asian Americans and not referring to them as a “race.”
Second, the causes of suicide among the Asian American youth population proposed by the
authors seem to be more based on internal factors. In other words, suicide among Asian
American youths isn’t a direct result of discrimination, but it is a result of how Asian American
adolescents shift their mentalities in response to the way they are viewed and treated in American
Asian American Suicide 9
society. Because of this, public health professionals should put more focus on the primary level
of prevention, which is what can be done to prevent suicidal thoughts from occurring.
The first cause, the “model minority” myth, is the idea that Asians are the superior ethnic
minority group because they seem to be the most successful. Zhou mentions that this myth has
been in existence since the mid-1960s, which was the peak of civil rights and ethnic
consciousness movements (p. 32). As an argument for a cause of suicide among Asian American
adolescents, it is the most valid because of the history of its existence and how it is still used in
reference to Asian Americans today. Asian Americans, especially adolescents, are faced with
pressures to excel far above their peers both from home and from society in general. Feelings of
failure will lead to more stress, which leads to a higher risk of mental illness and suicide attempts
because they will feel like they aren’t good enough and have failed their families and/or society.
In response, public health professionals should focus on outreach from student ethnic groups. In
order to not crack under the pressures they face from the “model minority” myth, Asian
Americans need a strong support network that will help boost their self-esteem. Students of the
same ethnicity will be the most understanding because there is a high chance they will be facing
the same pressures, helping Asian American adolescents realize that there are people out there
who support them and making it less likely for them to become suicidal.
The second cause, the underutilization of mental health services, is a result of Asian
American adolescents not being comfortable about sharing suicidal thoughts. This argument
makes sense because, being seen as a “model minority,” they feel that it’s shameful to be
suffering from poor mental health, and they shouldn’t make it known. If they are not willing to
admit how they are feeling, and if they don’t take initiative to get help when they need it, the
problem will never be solved. Mental illnesses will persist, and the risk of suicide attempts will
Asian American Suicide 10
increase. In response, public health professionals need to focus on providing education to the
Asian American youth population. Asian American adolescents are in need of knowing where
their resources are located and their rights to accessing them. Not only does education pertain to
education of resources but also to education about the disparity itself. If they are more educated
about the consequences of suicide among Asian American adolescents in addition to being
educated about available resources that provide mental health services, there is a high chance
they will feel more comfortable with expressing their feelings, leading to an increased level of
utilization, which is one of the first steps toward eliminating this public health disparity.
The third cause, acculturation into American society, is the concept that Asian American
youths are torn between holding onto their native roots and assimilating into American culture.
Asian American adolescents who are more acculturated are less likely to suffer from mental
illnesses and are thus less likely to attempt suicide than Asian American adolescents who identify
more with their native culture. This is another valid argument because Asian American
adolescents who are more engaged in their Asian culture might have feelings of being
“outsiders” when faced with American culture, leading to tension in the household due to their
desire to rebel against their traditional customs in order to “fit in.” Stress and feelings of not
being wanted will arise among the youth, causing them to break down and suffer from poor
mental health, which may lead to suicide. In response, public health professionals should, again,
focus on outreach from student ethnic groups on campuses to promote unity among themselves.
Ethnic groups may take on a cultural approach rather than a medical one, but they will reassure
Asian Americans that there are groups of people they can relate to and that they are not alone.
Feelings of unity within a support system of peers who share the same cultural values will help
Asian American Suicide 11
uplift their mentalities and drive them away from thinking that the best way to solve their
problems is by taking away their own lives.
Conclusion
Among youths ages fifteen to twenty-four, suicide appears to be a continuing public
health issue. In comparison with European Americans, Asian Americans are more likely to
attempt suicide within this age category. Causes of this disparity involve pressures faced by the
“model minority” myth, challenges that lead to the underutilization of mental health services,
and the effects of acculturation into American society. The primary, secondary, and tertiary levels
of prevention should be applied when proposing methods to eliminate the disparity, but the
authors’ explanations establish the need for public health professionals to focus more on the
primary level, which concentrates on what can be done to prevent suicidal thoughts from
occurring. All three causes collectively presume that more outreach should be done toward
adolescents of the Asian American community, preferably through student ethnic support groups
on campuses, and that more efforts should be made to further educate them about their resources
and about the problem of adolescent suicide.
Asian American Suicide 12
References
Battin, Margaret P. (1995). Ethical Issues in Suicide. Englewood Cliffs, New Jersey: Prentice
Hall.
Davis, Patricia L. (1983) Suicidal Adolescents. Springfield, Illinois: Charles C. Thomas
Hicks, Barbara B. (1990). Youth Suicide: A Comprehensive Manual for Prevention and
Intervention. Bloomington, Indiana: National Education Service.
Leach, Mark M. (2006). Cultural Diversity and Suicide. New York, NY: The Haworth Press, Inc.
Leong, Frederick T.L., & Lau, Anna S.L. (2001). Barriers to Providing Effective Mental Health
Services to Asian Americans. Mental Health Services Research, 3(4), 201-214.
doi:10.1023/A:1013177014788
Leong, Frederick T.L., Leach, Mark M., & Gupta, Arpana. (2008) Suicide among Asian
Americans: A Critical Review with Research Recommendations. In Leong, Frederick
T.L. & Leach, Mark M. (Ed.), Suicide Among Racial and Ethnic Minority Groups. New
York, NY: Routledge Taylor & Francis Group.
Petersen, William. (1966, January 9). Success Story, Japanese-American Style. The New York
Times Magazine, 20-21, 33, 36, 40-41, 43.
Tse, John W.L., & Bagley, Christopher. (2002). Suicidal Behaviour in Chinese Youth: Search for
Cases and Risk Factors. In Tse, John W.L. & Bagley, Christopher (Ed.), Suicidal
Behaviour, Bereavement and Death Education in Chinese Adolescents (pp. 1-18).
Burlington, VT: Ashgate Publishing Company.
Zhou, Min. (2003). Are Asians Becoming “White?” Contexts, 3(1), 29-37.
Zhou, Min & Gatewood, J.V. (2007). Transforming Asian America: Globilization and
Contemporary Immigration to the United States. In Zhou, Min & Gatewood, J.V. (Ed.),
Asian American Suicide 13
Contemporary Asian America: A Multidisciplinary Reader (2nd ed.) (pp. 139-157). New
York, NY: New York University Press.