“You wished the ground would open and swallow you up”: Expert opinions on shame, the collective, and other cultural considerations for suicide prevention among Asian American and Pacific Islander veterans
Abstract Background Rates of suicide remain elevated among U.S. Veterans and have increased disproportionately among Asian American and Pacific Islander (AAPI) Veterans. Knowledge is limited regarding suicide prevention considerations for clinicians working with AAPI Veterans, yet culturally respons...
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| Format: | Article |
| Language: | English |
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BMC
2025-01-01
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| Series: | Injury Epidemiology |
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| Online Access: | https://doi.org/10.1186/s40621-025-00560-6 |
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| author | Evan R. Polzer Carly M. Rohs Christe’An D. Iglesias Joseph Mignogna Lauren S. Krishnamurti Ryan Holliday Lindsey L. Monteith |
| author_facet | Evan R. Polzer Carly M. Rohs Christe’An D. Iglesias Joseph Mignogna Lauren S. Krishnamurti Ryan Holliday Lindsey L. Monteith |
| author_sort | Evan R. Polzer |
| collection | DOAJ |
| description | Abstract Background Rates of suicide remain elevated among U.S. Veterans and have increased disproportionately among Asian American and Pacific Islander (AAPI) Veterans. Knowledge is limited regarding suicide prevention considerations for clinicians working with AAPI Veterans, yet culturally responsive strategies tend to be most effective. To address this gap, we sought to elucidate subject matter experts’ perspectives regarding suicide prevention considerations for AAPI Veterans. Methods Qualitative interviews were conducted with 14 key informants (e.g., clinicians, researchers) in 2023 to understand their experiences with, and recommendations for, preventing suicide among AAPI Veterans in the Continental U.S. Interview transcripts were analyzed through thematic analysis, with an inductive approach. Results Key informants discussed the heterogeneity of the AAPI population and emphasized the need to balance cultural sensitivity and cultural humility in suicide prevention with AAPI Veterans. Fear of bringing shame and dishonor upon one’s family was described as a factor which may prevent AAPI Veterans from disclosing mental health concerns and suicide risk and which may prevent them from accessing healthcare services for mental health and suicidality. Suicide risk among AAPI Veterans was viewed as being shaped by shame and the centrality of the family-collective, with family conferring both protection against and risk for suicide. Cultural norms and beliefs regarding suicide were considered pertinent to suicide among AAPI Veterans and included beliefs about perseverance in coping with distress to permittance of suicide in specific circumstances. Somatic idioms were described as a means by which AAPI Veterans may communicate distress and suicidality, with key informants discussing how this may impact treatment and outreach. Conclusion Key informant interviews provided crucial insights into cultural factors salient to conceptualizing and addressing AAPI Veterans’ risk for suicide. These findings can be utilized to inform tailored suicide prevention for this population, with emphasis on addressing mental health stigma, considering somatic idioms of distress, and considering the role of family in suicide risk and prevention. |
| format | Article |
| id | doaj-art-3f6f02e38b714d298e4c125343d888fb |
| institution | Kabale University |
| issn | 2197-1714 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Injury Epidemiology |
| spelling | doaj-art-3f6f02e38b714d298e4c125343d888fb2025-01-26T12:09:57ZengBMCInjury Epidemiology2197-17142025-01-0112111210.1186/s40621-025-00560-6“You wished the ground would open and swallow you up”: Expert opinions on shame, the collective, and other cultural considerations for suicide prevention among Asian American and Pacific Islander veteransEvan R. Polzer0Carly M. Rohs1Christe’An D. Iglesias2Joseph Mignogna3Lauren S. Krishnamurti4Ryan Holliday5Lindsey L. Monteith6VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionAbstract Background Rates of suicide remain elevated among U.S. Veterans and have increased disproportionately among Asian American and Pacific Islander (AAPI) Veterans. Knowledge is limited regarding suicide prevention considerations for clinicians working with AAPI Veterans, yet culturally responsive strategies tend to be most effective. To address this gap, we sought to elucidate subject matter experts’ perspectives regarding suicide prevention considerations for AAPI Veterans. Methods Qualitative interviews were conducted with 14 key informants (e.g., clinicians, researchers) in 2023 to understand their experiences with, and recommendations for, preventing suicide among AAPI Veterans in the Continental U.S. Interview transcripts were analyzed through thematic analysis, with an inductive approach. Results Key informants discussed the heterogeneity of the AAPI population and emphasized the need to balance cultural sensitivity and cultural humility in suicide prevention with AAPI Veterans. Fear of bringing shame and dishonor upon one’s family was described as a factor which may prevent AAPI Veterans from disclosing mental health concerns and suicide risk and which may prevent them from accessing healthcare services for mental health and suicidality. Suicide risk among AAPI Veterans was viewed as being shaped by shame and the centrality of the family-collective, with family conferring both protection against and risk for suicide. Cultural norms and beliefs regarding suicide were considered pertinent to suicide among AAPI Veterans and included beliefs about perseverance in coping with distress to permittance of suicide in specific circumstances. Somatic idioms were described as a means by which AAPI Veterans may communicate distress and suicidality, with key informants discussing how this may impact treatment and outreach. Conclusion Key informant interviews provided crucial insights into cultural factors salient to conceptualizing and addressing AAPI Veterans’ risk for suicide. These findings can be utilized to inform tailored suicide prevention for this population, with emphasis on addressing mental health stigma, considering somatic idioms of distress, and considering the role of family in suicide risk and prevention.https://doi.org/10.1186/s40621-025-00560-6SuicideVeteranAsian AmericanPacific IslanderCulture |
| spellingShingle | Evan R. Polzer Carly M. Rohs Christe’An D. Iglesias Joseph Mignogna Lauren S. Krishnamurti Ryan Holliday Lindsey L. Monteith “You wished the ground would open and swallow you up”: Expert opinions on shame, the collective, and other cultural considerations for suicide prevention among Asian American and Pacific Islander veterans Injury Epidemiology Suicide Veteran Asian American Pacific Islander Culture |
| title | “You wished the ground would open and swallow you up”: Expert opinions on shame, the collective, and other cultural considerations for suicide prevention among Asian American and Pacific Islander veterans |
| title_full | “You wished the ground would open and swallow you up”: Expert opinions on shame, the collective, and other cultural considerations for suicide prevention among Asian American and Pacific Islander veterans |
| title_fullStr | “You wished the ground would open and swallow you up”: Expert opinions on shame, the collective, and other cultural considerations for suicide prevention among Asian American and Pacific Islander veterans |
| title_full_unstemmed | “You wished the ground would open and swallow you up”: Expert opinions on shame, the collective, and other cultural considerations for suicide prevention among Asian American and Pacific Islander veterans |
| title_short | “You wished the ground would open and swallow you up”: Expert opinions on shame, the collective, and other cultural considerations for suicide prevention among Asian American and Pacific Islander veterans |
| title_sort | you wished the ground would open and swallow you up expert opinions on shame the collective and other cultural considerations for suicide prevention among asian american and pacific islander veterans |
| topic | Suicide Veteran Asian American Pacific Islander Culture |
| url | https://doi.org/10.1186/s40621-025-00560-6 |
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