U.S.-born Asian-American women more likely to think about, attempt suicide, study finds

The study shows 15.93 percent of U.S.-born Asian-American women have contemplated suicide in their lifetime, exceeding national estimates of 13.5 percent for all Americans. The finding comes in a study published in the current issue of the journal Archives of Suicide Research. Lifetime estimates of suicide attempts also were higher among U.S-born Asian-American women than the general population, 6.29 percent vs. 4.6 percent.

Data from the study were drawn from the larger National Latino and Asian-American Study and were based on bilingual interviews with almost 2,100 individuals at least 18 years of age. Two-thirds were immigrants from Asia and women made up 53 percent of the respondents. Participants included 600 Chinese, 520 Vietnamese, 508 Filipinos and 467 other Asians, including Japanese, Koreans and Asian Indians.

"It is unclear why Asian-Americans who were born in the United States have higher rates of thinking about and attempting suicide," said Aileen Duldulao, a UW doctoral student in social work and lead author of the study. "There is the theory of the 'healthy immigrant' that proposes immigrants may be healthier on average than U.S-born Americans, because of the selectivity of migration or the retention of culturally-based behaviors. But it is unclear if this theory is the mechanism at work with regard to our findings."

Evidence supporting this idea was previously found among Mexican-American and Latino American immigrants. However, Duldulao said, the health of immigrants tends to decline with the number of years they spend in the U.S. and start adopting behaviors that are less healthy than those found in their homeland.

The suicide data echo a 2006 study that showed Asian immigrants to the U.S. have significantly lower rates of psychiatric disorders than American-born Asians and other native-born Americans. That study's lead author was David Takeuchi, a UW professor of social work and sociology who is also a co-author of the suicide study. Seunghye Hong, who recently earned her doctorate in social work from the UW, also contributed to the suicide study.

The new research also found that:

• The percentage of Asian-Americans who reported thinking about suicide increased the longer they lived in the U.S.
• Young Asian-Americans, between 18 and 34, had the highest estimates of thinking about (11.9 percent), planning (4.38 percent) and attempting suicide (3.82 percent) of any age group
• Asian-Americans who were never married reported the highest lifetime estimates of thinking about (17.9 percent) planning (7.6 percent) and attempting (5 percent) suicide.
• There were few major differences by ethnicity, although Chinese (10.9 percent) and Filipinos (9.76 percent) reported the highest rates of thinking about suicide.

"This study highlights the fact that we may be underserving Asian-American women born in the U.S," said Duldulao. "While there was little evidence of sociodemographic differences in suicidal behaviors among various Asian-American groups, there was some anecdotal data from people working in the community. It is important for service providers, as well as policymakers, to know that U.S.-born Asian-Americans, particularly the second generation, are at high risk for mental health problems and suicidal behavior.

"In most cultures suicide is just as unacceptable as it is here. It is pretty much a taboo. That's why this study is important and why Asian-American communities need to talk more about suicide and mental health," she said.

The researchers used a modified version of a World Health Organization questionnaire to assess whether and at what age people had suicidal thoughts, made suicide plans or attempted suicide.

The research was funded by the National Institute of Mental Health, the Office of Behavioral and Social Science Research at the National Institutes of Health, and the Substance Abuse and Mental Health Services Administration.