Suicide and Self-Harm: A Qualitative Study of Korean American Women's Experiences during Adolescence

Background and Purpose:

Contrary to their perceived academic and financial markers of adjustment, the National Alliance of Mental Health (NAMI) indicates that Asian American girls, ages 15-24, have the highest suicide mortality rates across all racial/ethnic groups (Africa & Carrasco, 2011). However, little is known about ethnic sub-groups of Asian Americans adolescents, specifically on the etiology of suicidal ideations and moreover, self-harm by cutting. This qualitative study sought to understand the unique experiences of Korean American young adult women, who either experienced suicidal ideations/attempts or made non-suicidal self-injuries to themselves during adolescence. In particular, this qualitative research study asks: 1) What are the experiences of Korean-American girls that led them to participate in self-destructive behaviors such as cutting or suicidal thoughts during adolescence? 2) What types of supports did they seek, if any; and 3) What was the role of friends, peers, family, or churches/organizations during their experiences with self-harm or suicidal thoughts?

Methods:

IRB approval was obtained for this qualitative study. Participants were recruited from three large metro areas across the United States. Women were included in this study if they identified as Korean-American (were either born or moved to the U.S. before the age of 5) and were over the age of 18 (N = 6). In-depth, semi-structured interviews were completed by phone or in person on topics of family relationships, peers, help-seeking behaviors and their general experiences of suicidal thoughts, attempts or self-harm during adolescence. Transcripts were coded using a constructivist, grounded theoretical approach and emic themes were analyzed.

Results:

Five of the six participants experienced suicidal thoughts. The other participant used self-harm by cutting, only. Two women experienced both suicidal thoughts and cutting and of those who only reported having suicidal thoughts, one individual tried to self-harm by cutting but did not continue beyond her first try. For all individuals, the age of onset for these experiences ranged from 7^th-9^th grade (13-15 years old). Four common themes emerged from coding the interviews: 1) poor relationship with at least one parent; 2) lack of understanding of one’s experience during the time of their suicidal thoughts/self-harm, 3) academic excellence despite difficulties with mental health; and 4) help-seeking, or the lack, thereof.

Conclusions and Implications:

This research studied the experiences of Korean American women who endured suicidal thoughts and/or self-harm by cutting during their adolescence. Common themes from interviews conducted with six Korean American women reflect issues with parent and peer relationships, lack of mental health understanding, perfectionism, and no help-seeking. Many of the participants indicate they suffered through these difficulties on their own. This study, though small in size, has implications for practitioners, counselors and other school personnel in understanding the intricate family dynamics that affect this demographic of adolescents. Additionally, future research should examine the role of school counselors and administrators in working together with parents to help students struggling with these topics.