The risk of committing suicide is lower for the overarching group labeled “Asian youth” compared to non-Asian peers (9.17 deaths per 100,000 compared to 10.77 per 100,000). But researchers at Seattle Children’s Research Institute’s Center for Child Health, Behavior and Development say lumping all Asian kids into a single group leads to missing the trees for the forest. 

According to new institute research, Asian youth suicide rates differ among ethnic subgroups, including Chinese, Filipino, Indian, Korean, Vietnamese, Indian, Japanese, and others. The new study, published in JAMA Pediatrics and led by Seattle Children’s Anthony L. Bui, MD, MPH, found, for example, that Indian and Chinese youths showed the lowest rate of suicide while Korean and Vietnamese teens showed higher rates. 

Increased stressors

Averaging data across all subgroups, says Bui, reduces the urgency around providing mental health research and services aimed at understanding and supporting Asian American youth. 

“The increase in Asian American youth suicide rates coincides with events we’ve seen in our communities and read on the news over the past few years. We know this is playing out locally here in Seattle,” Bui says. “The experience of being Asian has been more stressful. There are more incidents of anti-Asian [sentiment] and xenophobia, including violence, threats and verbal abuse, bullying, and hate incidents. ”

Many cultures, not one group

Asian ethnic groups are some of the fastest-growing and diverse populations in the nation and state. Each one, Bui points out, has its own language, culture, and other social characteristics. 

In Washington, Asian communities make up between 10% and 13% of the state’s population. According to the Washington State Commission Asian Pacific American Affairs, there are 48 district sub-ethnic cultures under the Asian American or Pacific Islander overall groupings. 

Most of those residents live in Puget Sound, with King County having the highest population.

Anti-Asian sentiments contribute to youth mental health challenges

A study by The Asian American Foundation found that 40% of Asian people in Seattle experienced anti-Asian hate in the past year. 

“The stress from racism and anti-immigrant sentiment is likely a large cause of why there are higher rates of mental illness and suicide among Asian American youth,” Bui says.

This new research pushes against the singular “model minority” stereotype of Asians, especially for kids. 

“That is a dangerous and harmful stereotype that continues to persist in our communities and likely has contributed to increased rates of mental illness and suicide among Asian American youth,” Bui says. “This stereotype generalizes Asians to be academically gifted, hardworking, and well-adjusted. The stereotype creates unfair and unrealistic societal pressures on Asian youth to achieve constantly, and it also results in poorer recognition of mental health conditions among Asian youth.” 

Further, it places pressure on Asian youth to avoid seeking help for mental health struggles.

“It’s no surprise that Asian youth have the lowest rates of mental healthcare use compared to other racial groups,” Bui says. “Studies have shown that stigma against mental health contributes to this. As a result, many Asian youth do not get the care they need to treat their mental health conditions.” 

Washington youth suicide numbers

More broadly, an average of 2.6 young people between the ages of 10 and 24 end their lives each week in Washington State according to Harborview Injury Prevention & Research Center. An average of 17 adolescents are admitted to the hospital with non-fatal suicidal behavior. Seattle-Tacoma has the second highest suicide attempt rate out of the 33 largest metropolitan areas in the United States.

The new study from Seattle Children’s is a step toward teasing out the ethnicity-related nuances that impact youth rates.

“Few public health studies currently divide Asian Americans into more specific ethnic categories,” Bui says. “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.”

He adds,“This study adds to the evidence that Asians are not a monolith, but instead a composition of many diverse ethnicities, cultures, languages, and people with differing historical experiences that brought them or their families to the U.S.”

A hope: Providing support where it’s needed

Bui is hopeful his more inclusive and specific approach to research will lead to positive change. 

“We know that Vietnamese youth have disproportionately higher rates of suicide compared to other Asian groups,” he explains. “Knowing this, one of our next questions is, of course – what can we do about this? We know that Vietnamese and other Southeast Asian groups have the lowest use of mental healthcare services. I am currently working on a study supported by Seattle Children’s, the Academic Pediatric Association, and the American Board of Pediatrics Foundation to interview Vietnamese American families and understand why that is.”

The end goal of the new research project? “We hope this information will help us build culturally tailored solutions to better connect Vietnamese youth to the care they need,” Bui says. Looking forward, he hopes to continue to work on projects that partner with communities to reduce youth mental health disparities, including among underserved youth of immigrant origin.

New Help for Seattle tweens and teens

A new mental health program is now providing free virtual therapy services for ages 13 to 24 in Seattle. Launched this week, the program is the result of a $14.55 million partnership between the Seattle Department of Education and Early Learning and Seattle Public Schools. It will allow teens and young adults to access Talkspace, an online behavioral health company, to connect and communicate with Washington-licensed mental health providers for free. It will also give them access to a self-guided mental health program aimed at helping users cope with life stresses, anxiety, depression and other challenges.

The program is now open and teens can go to www.talkspace.com/seattle to sign up for therapy.

Seeking families for research

Bui is recruiting Vietnamese teenagers ages 12 to 18 in Washington or their parents or guardians for his current research. If you are interested in participating in a study, email Bui’s lab at BuiLab@seattlechildrens.org.

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