Behind the Statistics: What Drives Suicide Risk in Asian American Emerging Adults?

Background and Purpose:
Asian American emerging adults (AAEAs) face significant mental health challenges due to the intersection of cultural and developmental factors (Arnett, 2015; Chu et al., 2010). According to statistics published by the CDC, suicide is the second leading cause of death in AAEAs aged 18–30, and they are disproportionately affected by suicidal thoughts and behaviors (STBs) compared to other age groups (Goodwill & Zhou, 2020; Varma et al., 2021). Although existing research has examined risk factors across individual, interpersonal, family, and societal levels, studies that integrate these multilevel influences remain limited. This study aimed to investigate the combined effects of risk factors at all four levels on STBs among Asian American emerging adults.

Methods:
A national online survey was conducted with 349 Asian American emerging adults, recruited via CloudResearch’s Connect platform. The survey, hosted on Qualtrics, consisted of approximately 170 questions and took an average of 15 minutes to complete. Participants self-identified as Chinese (37%), Vietnamese (18%), Filipino (15%), Indian (12%), Korean (11%), Japanese (4%), or other Asian ethnicity (3%). Gender identities included male (49%), female (47%), and other (4%). The average age was 24.3 years (SD = 3.17). Most participants (81%) had experienced at least one recent stressful life event; 31% reported a mental illness diagnosis, 39% had received mental health treatment, and 5% had been hospitalized for a mental health condition. All variables, except four demographic items, were assessed using validated standardized instruments, including the Suicide Behaviors Questionnaire–Revised, Kessler Psychological Distress Scale, Unbearable Psychological Pain Scale, Asian Parenting Scale, Riverside Acculturation Stress Inventory, Everyday Discrimination Scale, and Interpersonal Needs Questionnaire.

Results:
Hierarchical regression models predicting STBs were built in five steps: demographic factors (step 1), individual-level factors (step 2), interpersonal factors (step 3), family-level factors (step 4), and societal-level factors (step 5). Model fit improved significantly at each step except step 4. Significant predictors in step 1 included being Filipino (vs. Chinese; b = 1.59, p = .002) and identifying as homosexual (vs. heterosexual; b = 1.83, p = .021). In step 2, non-suicidal self-injury (b = 2.35, p < .001), binge drinking (b = –.35, p = .05), smoking (b = 1.02, p = .02), prior mental health treatment (b = .98, p = .01), and psychological pain (b = .87, p < .001) were significant. In step 3, thwarted belongingness was significant (b = .31, p = .03). No family-level variables were significant in step 4. In step 5, everyday discrimination was significant (b = -.50, p = .02). The final model explained 48% of the variance in STBs, with individual-level factors being most significant.

Conclusions and Implications:
This study highlights the multifaceted nature of suicidal thoughts and behaviors among Asian American emerging adults, with individual-level factors such as psychological pain and self-injury contributing most strongly. These findings underscore the need for comprehensive, culturally responsive interventions that address individual distress alongside interpersonal challenges, discrimination, and minority stress. Integrated, multilevel approaches to suicide prevention may be especially effective for this underserved population.