Disparities in Suicidality Among East, South, and Southeast Asian College Students: Unmasking the Hidden Mental Health Crisis

Background and Purpose: Suicide is the leading cause of death in Asian American (AA) youth. One study found that 22% of AA emerging adults reported suicidal ideation–double the national average of 11% among non-Asian identifying youth. To examine heterogeneity in suicidality and related factors among East, South, and Southeast Asian students using data from the American College Health Association National College Health Assessment survey.

Methods: Data came from 412,981 college students including 67,105 East, South, and Southeast Asian students (M_age = 23.2, SD = 6.3). Mean comparisons between East, South, and Southeast Asians versus other racial/ethnic groups were conducted using independent samples t-tests, assuming unequal variances due to group size differences. The dependent variables in these analyses were the summed scores of the indicators of the latent variables used in the structural equation modeling. Structural equation modeling was used to conduct invariance testing of a model positioning discrimination, loneliness, psychological distress, psychological well-being, resilience, as latent predictors of a suicidality latent variable. After initial model fitting, models for East, South, and Southeast Asian were constrained to equality and tests of configural, metric, and scalar invariance. Next the structural elements were constrained to determine if relations between the latent variables were invariant across groups.

Results: One-way ANOVAs. Examining effect sizes revealed that the only mean differences with greater than a trivial effect size were for Suicidality and Psychological Distress. Post-hoc analyses indicated that Southeast Asian students (M = 5.9, SD = 3.7) reported significantly higher Suicidality than their East (M = 5.4, SD = 3.4) and South Asian (M = 4.8, SD = 3.2) peers. Similarly, post-hoc analyses indicated that Southeast Asian students (M = 9.4, SD = 5.5) reported significantly higher Psychological Distress than those in the East (M = 8.8, SD = 5.1) and South Asian (M = 8.6, SD = 5.6) groups. Results of Invariance Testing. The results of the invariance testing of the measurement model revealed that the model failed the configural, metric, and scalar invariance tests. Across all groups, Discrimination, Loneliness, Psychological Distress, Resilience, and Substance use were significant positive predictors of Suicidality.

Conclusions and Implications: Suicide is considered to be preventable, yet it remains poorly understood, particularly in AA youth. Using pooled data from a national dataset, this study highlights the heterogeneity of suicidality risk among AA groups. This underscores the need for social work practitioners and educators to prioritize culturally-responsive suicide prevention and intervention efforts, with particular emphasis on how to address the impact of discrimination, loneliness, and psychological distress on suicidality. Additionally, results suggest that social work training and interventions should leverage the protective influence of psychological well-being factors such as resiliency.