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Asian-American young adult suicide has been a hot topic among college campuses lately. Research showing high depression and anxiety rates for Asian-Americans and Asian immigrants, but little access to health care or involvement to receive medical treatment or help, show big problems for the Asian-American community. My paper analyzes information from various sources on Asian-American suicide rates and what is being done in prevention, mental health and depression concerns for Asian-Americans, specific problems that concern Asian-American women and the need for change to encourage these women to seek help, and if health services are accessible and why Asian-Americans are not utilizing them. Fong touches on a few of these topics, including depression and suicide, so I will confirm or contradict what items relate to his arguments.

Mental health and depression in Asian-Americans.

There is not a lot of research done on mental health issues in the Asian-American community. (NAMI, p. 1) It is interesting to note that he word ‘depression’ does not translate over to certain Asian languages, because it doesn’t exist in their vocabulary –ie. Chinese. (NAMI, p.1) Stress often results from the adjustments and conflicts that are inevitable when migrating to a new country, and this stress is often connected to psychological disorders, lowered self-esteem, isolation, and changes in appetite and behavior. (Barnes, p. 12) Isolation is dangerous, when it leads to feelings of alienation from the majority, because individuals who feel they do not fit in a group tend to feel ostracized and suicidal. Immigrants or American-born Asians may experience racism, which is unique, so they may suffer from feelings of self-consciousness, difficulties in relationships, and more isolation. (Barnes, p. 13)

There is not enough research on Asian Americans or Pacific Islanders to determine guidelines for suicide prevention. Trends between foreign-born and US-born Asian-Americans have not been analyzed, and the report data on specific Asian ethnic groups is not accurate enough to show or understand any trend. (Barnes, p. 14)

Asian-American suicide prevention.

Often those who need the most help do not ask for it, minority status aside. College officials have begun to notice that many students prone to self-injury and suicide never go near the counseling centers and reveal anything about their experience before attending college. (Arenson, p. 1) Due to this, and highly publicized suicides injuring college reputations and prompting litigation, colleges are working harder to find vulnerable students and get them into treatment. Colleges are even going as far as forcing students to leave school temporarily, but some wonder if that is really the answer.

Suicide is the second-biggest cause of death among college students. (Arenson, p. 1) One study based on a dozen universities in the 1980’s, found that the rate of suicide was about 7.5 per 100,000 students, representing about 1,100 suicides a year for the entire college population. (Arenson, p. 1) Most health experts believe that rate has remained constant.

The best way of prevention for college student suicide is unclear, but sometimes the intervention is unwelcome. NYU student, Sue Schaller, was forced to withdraw in 2004, because she had been briefly hospitalized for depression and had suicidal thoughts. She said she felt much better after returning from the hospital, and being on campus, so she wanted to stay in school, but the university wouldn’t let her. Perhaps pushing students out of the university to aid them out of depression only causes more problems. Is the answer really, “Go away and come back when you’re all better?” This can lead to students being overly cautious, scared of being sent home again, and not wanting to open up with professionals to begin with. Many colleges, including Duke and MIT, are asking faculty and staff members and students to be on the look out for students who are showing signs of depression or potential suicide. (Arenson, p. 3)

Cornell University has made it an issue to reach out to Asian and Asian-American students. Of 16 students who committed suicide from 1996 to 2004, nine of them were of Asian descent. (Arenson, p. 3) Cornell found that those of Asian descent were not using the counseling services as the same rate as their other non-Asian classmates. (Arenson, p. 3) Some students plan to contact counseling services on campus, but often forget or do not “get around to it.” (Arenson, p. 4) Students, who attempt to be candid, open and honest to university psychologists, are not treated with the same courtesy. University psychologists work for the school, not the students, and even have students sign documents saying that they understand that it is only for the university’s evaluation purposes. (Arenson, p. 4)

Current data on suicide in Asian-American communities is highly underreported, and many think that suicide may be prevalent to a greater degree. The statistics are startling. In the year 2000, suicide ranked as the second leading cause of death among Asian-American and Pacific-Islander males ages 15-24 in the US. (Barnes, p. 9) Asian-American women, ages 5-24, have a slightly higher rate of suicide than Whites, Blacks, and Hispanics in the same age group. (Barnes, p. 9) Asian-American children and adolescents are considered by mental health providers to be highly prone to depression, but Asian-American children receive less mental health care than Whites, Blacks and Hispanics. (Barnes, p. 9)

Many Asian-Americans may not attempt to get help, because of cultural beliefs. It is difficult for health care providers who must understand the psychosomatic origins of various symptoms and provide adequate care, because mental illness often manifests itself with physical symptoms. Mental illness is seen in some Asian-American’s eyes as “manifestations of evil” and they do not want to run the risk of being labeled a “bad” person. (Barnes, p. 11) The lack of understanding and knowledge motivates many Asian-American individuals and families to hide and symptoms of mental illness and delay seeking appropriate help. (Barnes, p. 11)

Sometimes it is even more difficult for a community to understand mental illness or what leads someone to suicide. Gene Kan, an Asian-American male, was known as an icon of peer-to-peer computer movement. Yet, his larger than life persona overshadowed his longstanding bouts with depression, something he sought treatment with. After he was found in July 2002, with a bullet hole through the head, it was ruled as a suicide. Yet, many Asians congregated online to say that it wasn’t true. (Goldsea, p.1) A few believed that Kan fell victim to a mob hit, and that a conspiracy occurred to cover it up. An autopsy reported that it was indeed suicide, but many still wonder, or perhaps the Asian-American just cannot accept that a smart, successful Asian-American male was unhappy enough to take his own life.

Sex and age matters.

The differences between men and women are not just restricted to gynecology and urology. Biologically, men and women are very different in every way. Such as, the risk of diabetic coma being higher among women than in men, but the amputation rate is lower. (Szegedy-Maszak, p. 3) Diabetes is at least two to four times more common among minority groups such as African American, Latino, American Indian and Asian-Pacific-Islander women than among white women. (Szegedy-Maszak, p. 3) Among the older women of all ethnic or racial groups, Asians have the highest suicide rate. (NAMI, p. 1)

Asian-American adolescent girls have the highest rates of depressive symptoms of all racial or ethnic ad gender groups. (KCCEB, p. 1) Conflicting cultural values seem to impact Asian-American women’s sense of control over their life decisions. They often feel responsible but unable to meet impossible standards set by families and society, and it contributes to their low self-esteem issues. Asian-American women also learn by example. Since many of their families are quiet about their depression, they continue to maintain the silence. The most surprising is that Asian-American women fear stigma not only for themselves, most more so for their own families, so they keep quiet. (KCCEB, p. 1)

Asian-American women have most recently been organizing for reproductive freedom, but their efforts are the lease visible. (Silliman, p. 157) They have had to work hard to tear down the “model minority myth” and work against persistent racist and sexist stereotypes about API women. (Silliman, p. 163) Other pitfalls include the stereotype that all Asians are well off economically and socially. Asian women’s health are not identified as “research priorities.” (Silliman, p. 163)

Access to proper health care?

Immigrants from Southeast Asia suffer from particularly high rates of depression and post-traumatic stress disorder and exhibit more than twice the need for outpatient mental health services than the general Asian population. (NAMI, p. 2) In a study of young Cambodian immigrants, who survived Pol Pot’s concentration camps, nearly half experienced post-traumatic stress disorder and 41% suffered from depression 10 years after leaving Cambodia. (NAMI, p. 2)

There are around 70 Asian-American providers available for every 100,000 Asian-Americans in the US, when there are 173 providers per 100,000 Caucasians. (NAMI, p. 2)

Asian-Americans have an extremely low utilization of mental health services relative to other US ethnic groups. In the Chinese American Psychiatric Epidemiologic Study, only 17% of Chinese-Americans experiencing problems sought medical care. (NAMI, p. 2)

Some Asian-Americans are even being targeted in health care scams –Like the case currently in San Francisco. Filipino seniors have been targeted and exploited in an elaborate Medicare scam. (McCormick, p. 1) Seniors received wheelchairs, which were more like motorized scooters, hospital beds, and other useless material –all billed to Medicare’s tab. (McCormick, p. 3) Seniors said they were confused; many never saw doctors, and ones placed in a sleep study rooms had wires connected to all parts of their bodies without attaching the wires to any connections. (McCormick, p. 4) Numbers like 20 seniors a day rode vans six days a week for almost a year. (McCormick, p. 4) Afterwards, everyone received $100 for participating –A great incentive for those on small Social Security incomes. (McCormick, p. 10)

Among the Asian-American elderly, attitudes toward Western-style doctors is mixed. Many may not visit doctors, because they do not want to complain. (Zhan, p. 132) Yet, also, minorities have a greater need and reap less benefit from mental health services. (Jones, p. 5) Because of cultural differences the traditional methods of treatment are inadequate for ethnic patients. Doctors tend to underestimate ethnic patients’ strengths and overemphasize their weaknesses. (Jones, p. 6) Needless to say, there is a desperate need for minority professionals in the medical field.

Relation to Class Material

Fong’s textbook briefly talks about Asian-American anxiety and depression, drawing to the same conclusions that I have found in other research materials.

Asian-American college suicide rates have been a part of class discussion. The conclusion drawn from class was that we knew little of cause of depression and suicide, but perhaps it was stress from family obligations and personal goals that were set too high.

Health care for Asian-Americans is a very important topic. With few bilingual translators available, and the cultural differences that perhaps doctors do not have the patience or time to truly understand, it seems difficult for Asian-Americans to receive proper healthcare. Also, due to cultural and social stigma, it is sometimes difficult for Asian-Americans to ask for medical help, until things have severely worsened.

Though Fong’s book was highly factual with many statistics and number charts, and class discussion based mostly on personal thoughts and experiences, I found my additional outside research to help aid what I learned from the class.

Bibliography

Arenson, Karen W. “Worried Colleges Step Up Efforts Over Suicide.” New York Times 3 Dec. 2004: 1-4. http://http://www.nytimes.com/2004/12/03/education/03suicide.html.

Barnes, Donna Holland. “Cultural Competency: Developing Strategies to Engage Minority Populations in Suicide Prevention.” National Organization for People of Color Against Suicide 2003/2004: 1-25.

Goldsea. “Gnutella Hero Gene Kan: Suicide or Murder?” Asian Air 30 Jan. 2003: 1-4.

Jones, Enrico E. Minority Mental Health. New York: Praeger Publishers, 1982.

KCCEB. “Empowering Avenues for Community Action: The National Collaborative for Asian American Women’s Mental Health.” NAWH. 5 May 2005

McCormick, Erin. “Elderly immigrants used in Medicare scam.” San Francisco Chronicle 17 Apr. 2004: 1-12. http://sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/04/17/MNGA0CADR81.DTL.

NAMI Multicultural & International Outreach Center. “Asian American and Pacific Islander Communities (AA/Pis) Mental Health Facts.” Did you know… Arlington, VA: Colonial Place Three, 2001. 1-3.

Silliman, Jael. Undivided Rights: Women of Color Organize for Reproductive Justice. Massachusetts: South End Press, 2004.

Szegedy-Maszak, Marianne. “A distinct science.” Los Angeles Times 19 May 2005: 1-4. http://www.latimes.com/features/health/la-he-unique9may09,1,230….

Zhan, Lin. Asian Voices: Asian and Asian-American Health Educators Speak Out. Toronto, ON: Jones and Bartlett Publishers, 1999.