Suicide rates high among Asian-Americans

SAN FRANCISCO, CA: An ambitious young woman with two Harvard degrees and a promising career that had taken her from Hong Kong to California, 30-year-old newlywed Susie Bin-Su Barron seemed to have it all.

But in reality, things were far from perfect. In 2004, Barron lost her two-year battle with depression and was found dead in her San Francisco Bay Area garage from self-inflicted carbon monoxide poisoning. A note stuck to the windshield had just two words scrawled on it: “I’m sorry.”

Stories such as Barron’s are not uncommon in America today. According to the 2009 report of the Centers for Disease Control and Prevention (CDC), suicide is the ninth leading cause of death among Asian-Americans, higher than the national average of 11th. For young adults between 15 and 34, suicide is the second leading cause of death for Asian-Americans and the third for the general population in the US, where more than 9,000 people committed suicide in 2008, the last full year statistics were available from the CDC.

On college campuses across the country, suicide is cited as the second leading cause of death, and Asian-Americans and international students from Asia often make up a disproportionate number of total self-inflicted fatalities. At Cornell, 13 out of the 21 suicides that occurred between 1996 and 2006 were Asian-Americans, who made up 14 percent of the total student population during that same time. Most recently, three Caltech students — all Asian or Asian-American — were found dead between May and July in individual cases that were all pronounced suicides.

While the reasons behind these cases remain unclear and varied, anecdotal evidence often points to pressures in many Asian-American families to succeed in the US. Also, among many Asian cultures there is a lack of understanding of mental health issues. Countries such as China, Korea, and Japan have relatively high suicide rates, according to the World Health Organization (WHO).

International students, whose families may often pour life savings into their educations, face added pressure to succeed and maintain a family’s honor.

“Growing up, Susie was always the alpha type,” said Christine Lu, Barron’s younger sister. “She was on the varsity swim team, she ran for student government, she was in the choir — her life almost read like a checklist.”

The pressures of perfection

Stanley Sue, a professor at the University of California (UC) Davis focusing on mental health and psychological issues among Asian-American communities, said the pressure on these immigrants is often intense.

“(International students) are expected to do well in school and when they don’t, there’s a tremendous loss of face … their families save up money to give them an overseas education, and (if) they fail, it particularly affects the well-being of the immigrant.”

At UC Davis, where nearly 40 percent of the student population is Asian or Asian-American, Sue cites overbearing parents and extreme shyness as the two major factors.

“Students should always feel like they have options … you want them to achieve but not feel like there’s only one way,” said Sue. “You need to tell them to work hard but give them choices.”

At campuses such as UC Davis, administrators have tried to address this issue through various Asian-American issues focused programs, such as healthy living groups, where students can discuss issues in a safe environment.

“A lot of students find that their problems are not unique — we try to have students help each other solve issues,” said Sue. “Students are able to help each other and relieve a lot of issues they used to bottle inside.”

Despite these efforts, some students who have gone through similar programs question how effective they are. A UC Berkeley alumnus who lived in the school’s Asian-Pacific-American Theme House (APATH), a dormitory hall dedicated solely to exploring Asian-American issues, found that his experience consisted of little more than touching upon some general issues.

“The panels never really went into issues like domestic violence among Asian families or really sensitive issues like that,” said the student, who asked to remain anonymous.

Even for those who have achieved academic success, the pressure then moves on to their personal and professional lives. Lu recalled how this was the case with her eldest sister, who started suffering from depression shortly after taking a job with software company Oracle in 2002.

While Barron had already established herself as a capable business professional at two global consulting powerhouses, Lu recounts how difficult it had been for Barron to work in a technology company where she did not always understand the technical jargon involved in her daily work as a project manager.

Although Barron sought out medical help, something that many Asian-Americans have difficulty doing, Lu thinks it may have only added to her frustration.

“(For someone) used to overachieving and being in a position of control all your life, I imagine it must have become a very frustrating experience to all of a sudden find yourself needing mental help,” Lu said. “The very same brain that got you straight As, got you into Harvard, that got you the job that everyone wished they could have … it’s the same brain that is now dependent because you find yourself staring at your desk every day not being able to work.”

Eliza Noh, an assistant professor at California State University at Fullerton who has studied suicide rates among Asian-American women for much of her academic career, said that these pressures came up often during her interviews with Asian-American women.

“It’s something that wasn’t unique to any one generation,” said Noh, who interviewed women from first generation to fourth generation Asian-American women. For Noh, a second-generation Asian-American with a Korean and Vietnamese heritage, this is an issue that hits especially close to home, having lost a sister to suicide when she was in college.

“Even after all these years, it’s still a very painful topic to talk about,” she said.

Higher risk for Asian-Americans

Historically, statistics have suggested that Asian-American women are more susceptible to depression and suicide than virtually any other group in the US. While WHO studies have suggested that suicide rates in East Asian countries are among the highest in the world, the majority of suicides recorded by WHO are committed by men instead of women.

According to a study published last month by the University of Washington, Asian-American women contemplate suicide at higher rates than the general US population.

“Women have a lot of choices in the US, and sometimes having too many choices can lead to a great deal of conflict which can be reflected in suicide thoughts and attempts,” said Sue.

While it is still unclear why US-born Asian-American women are more prone to thinking about suicide, researchers suspect that it may be because immigrants tend to be more resilient and mentally healthier individuals. “Perhaps immigrants are just healthier people. They’re the ones that succeed and are more risk-taking,” said Sue. But not enough data was available to draw any real conclusions, she added.

Noh, however, also points to potential contradictions between this study and prior research, which showed that lower acculturation, which is most prevalent among first-generation immigrants, leads to higher risk of depression and suicide.

In her study, Noh also found that while many first- and second-generation Asian-American women are ambivalent or resistant to conventional methods such as therapy and medication, some have been able to find solace through alternative means such as faith, meditation, or support networks.

“There needs to be acknowledgement of the role traditional medicine plays, and the role of creating support groups for Asian-Americans – things that go beyond the traditional model because Asians don’t seek clinical care at high rates … we need to think of diverse and creative ways to do outreach and give therapy,” said Noh.

In a research seminar last year, Noh presented some of the findings from the interviews she conducted. One of the women surveyed, a 30-something Japanese-American woman, recalls the helplessness she felt as an Asian-American woman in depression. “… It’s hard enough to be empowered as an Asian-American woman. But to be an Asian-American woman who’s depressed, I felt I had no power whatsoever, no control,” she said.

More research needed

Although a number of theories attempt to discover what leads to depression and suicide among Asian-Americans populations and generational groups, Sue, Noh, and Aileen Alfonso Duldulao, who led the University of Washington stduy, all agree that more research is needed.

As Asian-American studies continue to develop and garner additional interest, Sue said that researchers are only at the cusp of understanding behavior patterns among Asian-American communities.

It was the lack of research in this area that drove Noh and Duldulao to devote their academic careers to this field.

“When (suicide) happened to my family, I decided to do a little bit more research and when I did it, I realized there was nothing there,” said Noh. “At the time, it was focused primarily on suicide among white populations … there was virtually nothing on minorities.”

Dulduldao, who had worked extensively with low-income communities in Los Angeles and the Bay Area, also noticed the lack of data available during her work.

“Service providers, including myself, knew that suicidal behaviors were a problem among the Asian-American community,” she said. “But there was no empirical evidence to back up this claim.”

In addition to the need for added time and funding, Sue said “culture bound syndromes” that are not typically considered mental health issues are difficult to pinpoint. Sue points to a condition found among Chinese people called neurostemia where they have fatigue, somatic complaints and so on, “There’s no equivalent we have in the main association,” he said

In the meantime, researchers and those affected by suicide agree that one of the most important things is to raise awareness of this issue and to encourage discussion about it.

“I hope (my) study will serve as a wake-up call that we need to do something about this issue in our community,” said Dulduldao. “Because our second-generation and subsequent generations are severely at risk.” (China Daily)


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