ASIAN AMERICAN COLLEGE STUDENTS’ PERCEPTIONS ON SUICIDE

Friday December 4, 2009Loyola University Chicago

Lake Shore Campus Regis Hall Seminar Room

AGENDAWelcome/Introduction

Jae Jin Pak, AASPI Board President

Focus group findings

Jessy Wilt, MSW student, LUC

Caleb Kim, Ph.D., Professor, LUC

Aruna Jha, Ph.D., VAMC, MIW

Closing

Asian countries: similar cultures, similar risks

Asian Americans and Suicide

There is a lack of information in the literature on suicide pertaining to Asian Americans

Much of the knowledge about suicide draws from theories or frameworks that are based on dominant European American culture

Leong & Leach, 2008

Funded by Mental Health America of Illinois

• Sample Population– Snowball sampling– From 8 Universities

• Five focus groups– 1st, 5 participants– 2nd, 1 individual interview– 3rd, 6 participants– 4th, 8 participants– 5th, 8 participants

• Focus group questions:

1. What is your general perception of death?

2. What is your general perception of suicide?

3. What do you feel your ethnic community perceives about suicide?

4. What are the risk factors? 5. What are the protective

factors? 6. What services would you

suggest to help support those who are may be suicidal?

Male Female TotalParticipants 13 15 28

Ethnicity

Asian Indian 2 3 5

Chinese 7 7 14

Filipino 1 2 3

Korean 2 3 5

Vietnamese 1 0 1

Religion

Christian/Catholic 5 8 13

Hinduism 0 1 1

Buddhism 4 0 4

Islam 0 1 1

Unknown/None 0 2 2

Other 4 3 7

Perceived Social Class (average) Middle Middle Middle

Language Spoken at Home

Native 7 5 12

English 2 5 7

Combination 4 5 9

Born in the United States 7 14 21

Average # of Years in U.S. 17.3 20.6 19.07

Average level of acculturation Mod.Close to U.S. Mod.Close to U.S. Mod.Close to U.S.

Themes from Perceptions of Death

“expected”“good”“sad”

“part of life” “celebrated”

“religion provides comfort”

Themes from Perceptions of Death

“I mean death is a good thing, I would say, because you get to go to heaven and be with god.” –Chinese Male

“And because I am Chinese and Vietnamese, there’s a lot of celebration in death, because death is another step closer to a better life.” -Male

“I think death is inevitable and it’s just something you have to accept.” – Filipino Female

Themes from Perceptions of Suicide

“shocking”“selfish”“weak”“taboo” “shame”

“embarrassment”“anger”

Themes from Perceptions of Suicide

“I think it’s selfish because they only care about their own lives.” –Chinese Female

“I think my initial thoughts were ‘come on it can’t be that bad.’ I feel like he was being a little selfish, or that he was being a little weak.” –Filipino Male”

“I think that family, especially if you are Asian, I think that family would probably be embarrassed.” –Pakistani Female

Themes from Perceptions of Suicide

“guilt”“empathy”

“supportive to survivors”“increased awareness”

Themes from Perceptions of Suicide

“If they were someone close to me I would probably feel guilty…because you didn’t know about it, you could have helped or prevent it.” –Chinese Female

“I think I would empathize more with the person than anything, But of all those things I would feel guilty the most.” –Chinese Male

Perceived Risk Factors for Suicide

• Purposes1. Compare the similarities and differences of

risk factors between general populations and Asian American college students.

2. Identify the risk factors from ecosystem perspective.

3. Develop culturally sensitive suicide prevention and intervention strategies.

Identify Risk Factors from Ecosystem Perspective

1. Individual Level• Psychological and social loneliness

2. Family Level • Intergenerational Conflict between

– Parent’s (and extended family member’s) pressure on academic and non-academic success

– Student’s responsibility of not disappointing his/her parent’s expectation and sacrifice

• Stress in Acculturation Process – Strict family and cultural rules– No support from family and from professionals

3. Social and Cultural Level• Identity Crisis • Pressure on Model Minority Myth

Individual Level: Loneliness and Isolation

• I think people usually commit suicide because they think no body cares about them or they think they are the only person that is going through what they are going through. (Chinese female)

• Being left out from certain groups of friends, (which) you thought that they were your true friends but later on you find that they weren’t. --- That’s the reason to people being more depressed and then --- you are broken down, be more depressed, and be more anti-social and leads you to avoid people [and] will play a factor to suicide. (Korean male)

Family LevelIntergenerational Conflict

• If we are first generation* American, we have a big responsibility coming from our parents because we are living out our parents’ hopes and dreams because there is a lot that they have sacrificed. So there’s a lot of extra pressure, because every mistake we make is not just for myself, but it’s for our family. That is a lot of weight and it’s hard because it’s on you to grow up quickly and be balanced and learn how to balance your parents’ feelings and your own lifestyle. (Asian Indian female)

*This is generally called 2nd generation, who were born and raised in the US.

• My friend that wanted to commit suicide, she felt love from her father [is] conditional. She has to achieve more for him to [make him] love her and she said that is fearful that she would disappoint him….. I think that’s the Chinese American mind, it’s that you know, we brought you over from China, over wherever, over to America and you have all of this college and we’re banking on you to make our family proud, and I think that’s a very big pressure. (Chinese female)

• It’s like the trophy thing, you know, you always want your trophy to shine the best, you know, like blinding shining. (laughs from group) (Asian Indian male)

• I think maybe it’s not just my parents, but some other people in the family, like aunts and uncles, are like “so are you going to be a doctor or lawyer?” Maybe that person can’t deal with those things or meet those standards, and then feel inadequate. (Chinese female)

• [My parents] wanted me to be a doctor or a lawyer or something that paid pretty well. And like, they put a lot of pressure on me for that and when you don’t achieve, that disappointment bears down on you. (Chinese male)

• We don’t want to let our parents down or disappoint them in anyway. So we try our best and we kind of kick ourselves if we can’t reach that certain goal, or reach their expectations. (Korean male)

Stress in Acculturation Process

• I feel like Asian parents, they can’t relate to us because they don’t understand why we can’t get certain grades. We can’t get 4.0. They think that they sacrifice so much for us, give so much for us and give everything to us and then we need to do is study, but there are a lot of more things to worry about, not just study itself. (Korean male)

• Parents keep wanting more and more for you, and obviously it’s because they just want the best future for you, because they’ve strived so much just to raise you in America, but then it kind of created this dichotomy where you are not accepted in your own community, your own age group, and neither are you accepted from your parents. (Filipino female)

Strict Family Rules• There’s some families that are super strict…like gender roles

and it’s like how girls should be and how guys should be and like when and how your life should be carried out for you. Like my grandparents have my life planned out for me. I have to get married by this age, and I have to have grand kids for them at this age, so before they’re dead they [should have] seen their great grand kids. (Korean Female)

• There’s just purity complex [in Asian women]…especially with our religion. There’s just the idea like “marriage, marriage, marriage” and “[do] what your husband will want from you” and I think the reality is that most girls, I mean most girls anywhere, but especially if you are growing up in America, you are going to meet boys and date. And I think the pressure from parents on girls and boys and dating, it’s something that shouldn’t be such a big deal.------ And I think any immigrate personality where we are upholding our name here or you are shamed, and there’s a lot of pressure for girls and guys. (Asian Indian Female)

No support from family and professionals

– [In abusive situation] you don’t want to call the cops on your parents, you know, because it’s like a disgrace to your family, so you might want to get yourself out of that situation and you might run away, or you might kill yourself. But you’re not going to call the cops on your parents, I know like White kids would…. (Pakistani female)

– I had cousins that were suicidal and I think it’s because Asian parents aren’t as emotionally open with their children and it forces them battle up their emotions. And because of that it leads to self-mutilation, [and suicide]. (Filipino Female)

Social and Cultural Level

• Identity Crisis

– …maybe strive to fit in [mainstream]…, when you are growing up as an Asian girl or boy, you’re not like the other American kids in your neighborhood and you kind of feel out-casted sometimes. And I mean, that could be one of the factors that make you to want to commit suicide…I mean it seems kind of drastic, but when you grow older and you start to be even more out-casted because you are placed in a big high school where you don’t know anyone, or in college where you don’t know anyone, you kind of stick out and you kind of feel lonely. (Filipino/Chinese female)

• My perception of people who are suicidal, it’s not just academic pressure, it’s pressure in life in general. There are some people who become worn down from their horrible situation, and their family situation is horrible, and these combined factors pressure them to find a way to release that tension, I guess, that mental tension. And one solution is suicide. So maybe Asian community, the academic pressure could be one factor in creating that pressure, but other factors effect, like family situation and social situation. (Chinese Male)

• Myth of Model Minority• It’s not only that going to school is enough it’s that you

uphold your image for your parents. I think a lot of Asian kids, the stereotype is that we are good at science and math, and I think there is pressure if you are not interested in that, or if you are homosexual, or if you are something that is not normal then that is going to be something that is ten times harder to do. (Asian Indian female).

• Being Asian American and if you have grown up in a white community, people think “Oh you’re smart, you’re Asian, you play violin, or piano” and all this other super child kind of thing and if you don’t meet that specific stereotype, then you feel almost out of the loop or not as good as you possibly can be. And that put almost more pressure. And I think that’s almost like an element of control, like if you can’t meet that, then you feel like you can’t achieve anything and that might lead you to be depressed or whatever negative emotion you are going to have. (Filipino female)

Although Asian American college students shared similar risk factors of suicide with the general population such as loneliness, depression, family conflict, and identity crisis, most significant risk factors in Asian American college students are:

1. culturally bound. • Parent’s pressure and intergenerational conflict resulted

from collectivistic values such as keeping family reputation, obey parental hierarchy, filial responsibility, harmony rather than confront, strict family/cultural rules on gender and no open communication

2. associated with stress in acculturation process. • Not accepted by parents and isolated from mainstream • Negatively impacted by stereotype (i.e. model minority)

Asian American’s suicide can be considered as a ‘social act’ which is understood in the context of relationship and cultural values.

Asian American Students’ Opinions about:

Protective Factors for Suicidal Behavior

Aruna Jha., Ph.D.•Research Assistant Professor,

University of Illinois at Chicago

•Suicide Prevention Coordinator,Zablocki VA Medcal Center, MIW

Outline

• Religious beliefs and practices• Family values and attitudes• Social Support

– Religious Communities– Friends and family

• Resources• Clinical Implications

05/01/2023 28Aruna Jha, Ph.D.

Religious beliefs and practices• Religion makes you think twice• Religion provides hopeful options• Religion prohibits suicide

05/01/2023 29Aruna Jha, Ph.D.

Religion makes you think twice…………..

• It’s not that religion makes you think like “no I can’t kill myself,” but it makes you think I shouldn’t and then you might think it through. I think sometimes people don’t think it through and they just kill themselves, they just do it in an instant, but I think that if you think about your religion you might take a second and look at it and maybe decide I do have other options.

(Pakistani Femaile Participant)

05/01/2023 30Aruna Jha, Ph.D.

Religion provides hopeful options………………….

Ok…in my religion, it’s personal, but I feel if some things are going bad in your life you usually find options to deal with it

(Pakistani Female Participant)

05/01/2023 31Aruna Jha, Ph.D.

Religion provides hopeful solutions……….

• Being a Christian, there’s other fellow brothers and sisters in Christ who are there for you, to help encourage you and help you through that certain situation. It’s not the end of the world. If it seems like your world is falling apart; you just need to deal with it. Just get through it. There’s always light at the end of the tunnel.

(Korean Male Participant)05/01/2023 32Aruna Jha, Ph.D.

Religion prohibits suicide

• I’m not sure if I could use my friend to generalize for all the people, but he was saying kind of the only thing keeping him from committing suicide was knowing that it was…it would be totally be disobedient to his faith.

(Chinese Male Participant)

05/01/2023 33Aruna Jha, Ph.D.

Religion teaches you to value life

• I’m pretty sure (in) most religions…. If you have morals, you know, where you don’t kill yourself….. maybe most religions would cherish their lives.

(Chinese Male Participant)

05/01/2023 34Aruna Jha, Ph.D.

Family Attitudes and Beliefs

• Acceptance• Assimilation• Suicide Stigma

05/01/2023 35Aruna Jha, Ph.D.

Acceptance of student: Unconditional love

• Generational differences: culture• Academic choices• Dating vs. mate selection• Students’ desire to satisfy parents

05/01/2023 36Aruna Jha, Ph.D.

Assimilation of family in U.S.

• Because I think the longer you stay here the more Americanized you get. And when that happens, your parents, their priorities are different. They are very much less likely to pressure you about your job or finding a good career. And when that happens, your problems change. (Chinese Male Participant)

• I’m sure like, your kids, second generation kids, they have a lot less pressure than the first generation……...they won’t have the same worries. Like that will change the direction of suicide in the future.

(Chinese Male Participant)05/01/2023 37Aruna Jha, Ph.D.

Suicide stigma

• From what I’ve gotten from my parents, you just don’t do it, you don’t talk about, because then, hopefully, it’s shameful and you’ll bring shame to your family; then if you think it’s shameful, you won’t do it because they brought you up and you are going to waste your life.

(Chinese Female Participant)

05/01/2023 38Aruna Jha, Ph.D.

Suicide not okay……..• The only way you can sort of help…they, well,

my mom, she has depression and she didn’t even want to see someone and it was like family members have to step up and be like, ‘if you keep this in it’s gonna make you go crazy.’

(Chinese female participant)

05/01/2023 39Aruna Jha, Ph.D.

Social Support

• I think it’s about support structure. Like, when I was younger I knew some friends who contemplated this and I think what they lacked compared to other friends was close friends that they could share with and that would help them to be someone to vent to or someone to help them to see reason sometimes.

(CHINESE MALE PARTICIPANT )

05/01/2023 40Aruna Jha, Ph.D.

Social support

• Religious communities• Friends and family• Internet

05/01/2023 41Aruna Jha, Ph.D.

Religious Communities• I definitely agree. I feel like church, and not just

church but the people within the church. People who have credibility and cherish their lives. People who have credibility, knowing that they are a loving person. They actually care about you, so then you can be able to up to them and share openly in confidence. Without feeling shame or like it’s a taboo.

(Chinese Male Participant)

05/01/2023 42Aruna Jha, Ph.D.

Friends and family

• Mentors and stuff. I mean if you really think about it the people who commit suicide are usually the ones who are by themselves, and they’re the ones who are bullied and such…… someone that is trustworthy and you can count on when anything is wrong.

(Chinese female participant)

05/01/2023 43Aruna Jha, Ph.D.

Internet• I think from a generational point of view, we are so

connected with the internet and so your community becomes so much bigger and if you don’t like one particular group, I guess, you can find some other forum or website. I mean that’s also a good outlet for people who are suicidal I think. If you don’t have friends to talk toand you can’t talk to your parents, why don’t you talk to people at this forum or website.

(Filipino Male Participant)

05/01/2023 44Aruna Jha, Ph.D.

Resources

• Adequate• Appropriate• Timely

05/01/2023 45Aruna Jha, Ph.D.

Students’ Recommendations

• Indirect approaches (life skills training)– Psycho-educational seminars– Culturally competent counselors– Parent education– Youth pastors

• Hotlines• More communication

05/01/2023 46Aruna Jha, Ph.D.

Students’ Recommendations

I know Loyola has sent out pamphlets once throughout my three years here, about statistics on suicide, but and they tell you to watch out for signs, but they don’t really tell you what those signs are or they are not very informative or how to help out. They give you a hotline, but that’s the end of the information.

– (Chinese Female Participant)

05/01/2023 47Aruna Jha, Ph.D.

Students’ Recommendations:• Sometimes you want to de-stress by like talking

to someone and also you may want to keep your privacy too- so you want to talk to someone like a stranger you may not want to talk again- so its one way to open up easily, de-stress, and also talk about your problems…I guess that’s how psychologists and therapists work.

(Korean Male Participant)

05/01/2023 48Aruna Jha, Ph.D.

Students’ Recommendations

• CHINESE MALE PARTICIPANT: You have to let your parents know that if you don’t have pressure you probably won’t have any problems…so I don’t know, not necessarily get the word out to not pressure your kids to do better, just do it in a way that’ll make them happy too.

05/01/2023 49Aruna Jha, Ph.D.

Students’ Recommendations

• So I think that we should talk about it. And as Asians sometimes we don’t talk about a lot of things, but now we are in the Western countries, we should be able to open ourselves up if you want to feel. I think it’s a good thing to talk about it……….

(French Chinese Male Participant)

05/01/2023 50Aruna Jha, Ph.D.

To Summarize

• Asian countries have the highest rates of suicide in the world

• Asian immigrants inherit these cultural risks

• Focus group participants discussed several risk and protective factors

• Focus group participants gave many recommendations for suicide prevention

05/01/2023 Aruna Jha, Ph.D. 51

Clinical Implications: Students’ Recommendations

Let us discuss!

05/01/2023 52Aruna Jha, Ph.D.

Questions/Comments

05/01/2023 53Aruna Jha, Ph.D.