Why Are Young Asian Americans Killing Themselves?

Social Pressures, Identity Issues and Mental Health Taboos Play Roles

Katherine Tong sat in the church pew listening to a eulogy delivered by a father who lost his son to suicide. She thought, "Thank God our family is OK."

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What she didn't expect was that six months later, her stepson Evan Tong ended his life in his own room saturated with carbon monoxide. He was only 17.

She knew he was depressed, but quickly dismissed any worries that he would take his own life. "No, he will never do that," the mother told herself the moment when the idea flashed through her head.

For the Tong family, like so many in the Asian community, suicide and mental illness had been far away from them. In fact, they didn't talk about it.

But the silence is costing young lives. While Asian young people don't have a higher suicide rate than the overall national rate, the number gradually went up, from 2011 to 2015, according to mortality data from the National Centers for Disease Control and Prevention.

Suicide Growth

At the same time, suicide was the leading cause of death among Asian American young people, ages 20 to 24, in 2015. Suicide accounts for about one-third of deaths in this age group, the highest for all races. By comparison, the number of white people, ages 20-24, who died from suicide was 19 percent; Latino males, 15.3 percent; Latino females, 16.2 percent; and blacks, 8.1 percent.

Asian American Young People Suicide Data

Social science experts and educators blame the high number on cultural stigmas and social pressures, which start at home but are spread across society.

Asian American young people have long been labeled as one of the most well-educated and high-achieving groups in the United States. Besides the anxiety to gain academic and professional achievements, they suffer from insecure feelings about their identity, discrimination and conflicts between traditional Eastern and the Western perspectives.

At the same time, cultural stigmas and lack of understanding about mental health in Asian families and the community prevent young people from seeking help.

Asian American experts and mental-health advocates are trying to educate the Asian community about suicide prevention and overcoming a reluctance to seek help.

"Mental Health should not been seen any differently than physical health," said psychological therapist Sandra Yi-Lopez who provides Korean language counseling services in Los Angeles.

Larissa Lam talks about the identity issue that many Asian Americans are facing.

I was torn apart

Eric Lu was a typical "golden" child in Asian parents' mind before sliding into a deep depression and harboring suicidal thoughts in 2014. He studied at Harvard University, earned admission to the medical school, and appeared ready to embark on a promising career as a doctor.

Lu was born in Taiwan and moved to Texas with his parents when he was 3 years old. Like many other second-generation Asian American children, he learned traditional Asian values from his family that conflicted with American perspectives he gained from his peers at school and society. "I don't think growing up I really tried to develop my own sense of identity until much later." Luke said. He said he tried to be flexible and "learned to just fit into whatever the prevailing mindset was." And that strategy usually worked, whether home with his family or at school, which was predominantly white.

Eric Lu. (Photo Courtesy of Eric Lu)

Neither he nor his immigrant parents expected this "dual identity" would one day lead him to a severe depression or even an ideation to abandon his life.

It was in his first year at Harvard Medical School that he first started to develop his "own self:" He found out his passion - film making, and decided to take a leave from medical school to pursue his goal of becoming a filmmaker.

His parents fiercely pushed back. They could not accept that their son would take the chance to abandon the glory he already achieved and bet on an unstable career. During Eric's two years' leave of absence in Los Angeles, the family had "two to three hours' fight every day" about his career choice. His parents, he said, threatened to kick him out of the family and cut off financial support. "I felt very torn ... very sad, very angry, very conflicted, very devastated."

"The only one time I was disobedient to them and went against them was this time," the Ivy League graduate said. "I've always been very obedient. I played the violin, I did well at SAT and I went to Harvard. Every step of the way, I check off the box they were holding me to."

He finally gave in to his parents and returned to Boston to continue his studies at the medical school in 2014. Soon after that he slipped into deep depression. He shut himself in his room, started failing classes. And things got worse. For more than a month, he kept thinking about jumping off the balcony of his 17th-floor apartment.

Though extreme, Lu's experience represents common anxieties among Asian American students to gain professional achievements. The book, "Battle Hymn of the Tiger Mother," by Amy Chua, a Chinese American mother, gained wide attention for her Asian-style obsessive parenting methods that pushed her children to high levels of achievements. Now, some seven years after the Tiger Mom fever, young Asians still suffer mental stress caused by the pressure to be academically outstanding.

A recent study by psychology scholars at Indiana University compares circumstances before suicides among Asian Americans and whites. It found that school problems are twice likely to be the contributing factor for suicides among Asian American and Pacific Islanders under age 25, than for white young people.

Professor Y. Joel Wong, who led the study, said the result is related to a "family perfectionism," meaning parents and children place high expectations on academic success.

Many times, however, the pressures come from not only the Asian community, but from the outside world.

The "model minority" myth, which perceives Asian people as hard-working, best-educated and well-paid achievers among their peers in other ethnic groups, is one of the most prevalent stereotypes facing Asian Americans, especially second-generation, young Asians. Such labels are also tied to Asian students as being quiet, obedient and weak in dealing with social relations.

"It became a thing that you're never allowed to fail. Even when you do succeed, nobody thinks you're worthy of a celebration." said George Qiao, a Harvard senior and Chinese American mental health advocate. He believes the model minority prejudice fosters tensions and self-doubt among Asian American young people, like him and his Asian friends.

Qiao was a straight-A student in a public high school in Los Angeles, where his extraordinary achievements were thought to be a "predestined" by his race. "When I was in high school, I didn't feel proud of anything," said Qiao, "Because people will say like, 'Oh, you aced all tests? It's because you're an Asian.' Then what are you supposed to be proud of?"

The experience resonates with Katherine Xie, a senior at Cornell university who had depression and suicidal attempts during her high school years. Xie said she came through a lot of exterior mental pressures, from the perspectives from her non-Asian peers and portraits by the media: "We're almost like robot in a way" - extremely smart, extremely hard-working, but not being able to share or even have their personal emotions.

The preconceived, wrongly shaped "identity" can be fragile and destructive. Once an individual doesn't succeed in academics or realizes scholarly accomplishments alone do not establish value in the society, a sense of self and identity are shattered. "That became more devastating to Asian students than white Americans," said Wong.

Amid the identity mist and stereotypes, many young Asian Americans feel a strong sense of isolation and insecurity that distances them from the society.

"It's common for Asian Americans to feel insecure ... There is a wall separating me from the white Americans. At the same time, I have abandoned a lot of the heritage that I should have had," Qiao said.

Larissa Lam, a Chinese American singer and a host for a motivational talk show, UTalk, with programming that encourages young adults in the U.S. to discuss life issues, said she saw many Asian American teenagers suffering emotional distress from the loneliness. "Feeling the pressure of both sides of not being quite American enough and not being quite Asian enough." Lam said: "The loneliness, or not fitting in, or belonging, place in their mental health."

A scene from the movie "Looking for Luke," which follows a death of a Harvard Chinese American student.

A Deep Silence

When Xie overdosed and ended up in the hospital four days before her high school graduation, she had already endured four years of depression. She wasn't conscious of the possible consequence at that time, "I didn't really think that I'm gonna die," she said, "I just didn't have any healthy way to cope with these extreme feelings at that time."

She remembers first telling parents about her internal distress, as a 14 year old. She asked for their permission to get medical treatment, but the thought of it irritated her parents.

"It's not real. Get over it." The Chinese immigrant couple told her. They were angry and disappointed that their child could not handle challenges and hardship on her own.

The family never spoke of her mental health problems again. Instead, Xie tried her best to control her emotions, as her parents suggested. She disguised herself well in front of others. She maintained a 4.0 GPA in school, won national awards and got admitted to Cornell University. But the depression persisted. She cut herself as a way to transfer emotional pain to physical pain and turned to dependence on pills that nearly took her life.

Xie shared her story in the Mighty, an online magazine, in 2016. Her article got more than 2,000 likes and young Asians left comments about their struggles engaging their families in productive conversations.

Mental Health educator Christopher June is doing outreach in Los Angeles' Koreatown.

"How many times have I brought up needing help and have only shown signs of struggling and I'm met with, 'Oh you'll be fine,'" one comment read.

The reluctance to discuss mental health and to seek professional treatment is prevalent within Asian families and the community.

"If this is culturally unacceptable to talk about, it is very dangerous," said Sandra Yi-Lopez, a psychological therapist of Didi Hirsch Mental Health Services, a non-profit organization that offers mental health support in the United States. She says it's common for young people to rely on drugs and alcohol to cope with mental problems when they are unable to express their feelings. "Especially when drinking is appropriate in a culture; for example, the Korean culture."

The refusal to listen and attempt to understand a child's mental struggles is not a simple case of a distant parent-child relationship. Rather it's a sign of a taboo deeply rooted in values shared by the Asian American community.

Asians' Silence on Mental Health

A mother who lost her son to suicide and a community educator try to break the silence that takes away young lives. (If your video does not display, click here.)

The silence is a coping mechanism of Asian immigrants who sacrificed a great deal to come to the United States and overcame hardships. Their experiences reinforce the values of endurance and resilience. "Seeking mental health treatment is regarded as a kind of character flaw." Xie said.

The "saving face" culture, a ubiquitous desire to gain social respect in the Asian community, is another reason for silence. "Don't air your dirty laundry in the public" is a warning many Asian children hear from their parents. It is considered rude to share negative feelings and mental distress as well as to ask about an Asian's mental health, which causes someone to "lose face."

What's more devastating is the strong shame and stigma that suicide sticks to Asian culture.

Katherine Tong, the Chinese mother, said the family lost friends ever since her son Evan killed himself. "They just didn't want to associate with us, because they think this problem could rub off on their family."

As a result, many families and individuals hide the feelings. They don't go to a counseling or get professional treatment. For young people who are suffering mental distress, this is fatal.

Do you feel anyone around you is not feeling well?

Is your loved one experiencing hopelessness or significant changes in behavior, like withdrawing or unexpected high-efficiency, or showing signs of self-harm?

Check out more information here:

Talk with the person. It is hard, but you need to ask explicitly: "Are you thinking about hurting or killing yourself?"
Show your understanding.
Thank him/her for being open to you.
Most important:
Ask whether the person is willing to seek professional help!
This response is what often times you will get. It's tough to admit one's suicidal thoughts.
But they DO need someone to talk about their feelings!
Ask "How are you feeling?"

It is always no hurt to say "Do you want me to accompany you?"
Let his/her know it will be a long battle. And you will always be there.
Don't push them. Let them know you are here and you are listening:
"What do you think you need?"
When they are being more open to you, ask about seeking mental health again.

That prompted Lu, who already became a filmmaker in 2015, to direct a documentary about suicides in Asian American families. He came across the story of Luke Tang, a Harvard sophomore who surprised all his family and friends by killing himself in September, 2015. Lu said he had much in common with Tang. "Every part, really to every part," he said. "That's why I wanted to tell the story, because I knew that there are a lot of people out there who are like Luke or me. They might not make it out of their suffering."

In the 26-minute documentary, "Looking for Luke," Tang's parents endeavored to understand why this happened to their beloved son. By talking to Tang's close friends and reading his journals, the parents gradually realized signals of depression in the last stage of their son's life that could have been identified and treated earlier.

Lu hopes with this movie, he can open up a conversations and "give permission or space for people," especially children and their parents, "to talk about deeper, underlined mental distress."

Christopher June found Asian young people more open to mental health topics than their parents' generation.

A Slow Progress

Since April 2017, the documentary "Looking for Luke" has been brought to at least 19 screenings in 14 cities across the country. Each screening is followed by a discussion and professional counseling services for the community.

Mental health education fliers in Korean language.

As Lu expected, the movie helped many Asian American young people and their families to take their first step to cope with mental health and suicide issues. "A lot of them asked me: 'What is depression? How can I help my child with his depression?'" He's planning to bring the movie to more places and even Asian countries like China where suicide is also a hidden secret.

Christopher Jun keeps doing one-on-one talks in Koreatown every week. "The Korean community is slowly opening up," Jun said. "Especially for young people."

Following Jun's lead, the Didi Hirsch Mental Health Services plans to offer more suicide prevention services in Chinese, Vietnamese and Japanese to fill the need for resources in the Asian American community.

The Tong family and the Toh family are working with American Foundation of Suicide Prevention and local suicide prevention groups. They hope that their story can inspire Asian families to cope with mental health with their children.

"It is very important that parents express their love. Parents should tell their kids that: I hope you to work hard and do your best as you can, but regardless of how you do, I still love you." Wong suggests.

For young Asian Americans, Lam, as a second-generation Chinese American, advises that they embrace both their American-side and the Asian-side identities. "Think of it as a strength not a weakness. Growing up I realized ... we have something special that defines us. I can be a bridge to cultures."

And most important, Jun said: "When you are not feeling well, seek help!"

If you or someone you know needs help, here are resources:

General Crisis Lines:
• National Suicide Prevention Hotline (24-hour): 800-273-TALK or 800-273-8255
• Crisis Text Line (24-hour): Text TALK to 741-741

For Asian Americans:
Asian LifeNet Hotline: 877-990-8585
(Mandarin, Cantonese, Japanese, Korean and Fujianese speakers are available)

Southern California Resources:
• Didi Hirsch Mental Health Services provides multilingual suicide support and mental healthcare. For more information, call 1-888-807-7250 (8:30 a.m. to 5 p.m., Monday-Friday).
• Find support groups for suicide attempters and survivors of suicide loss near you: https://afsp.org/find-support/ive-lost-someone/find-a-support-group/