"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.
Evan R Polzer, Carly M Rohs, Christe'An D Iglesias, Joseph Mignogna, Lauren S Krishnamurti, Ryan Holliday, Lindsey L Monteith
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引用次数: 0
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.
期刊介绍：
Injury Epidemiology is dedicated to advancing the scientific foundation for injury prevention and control through timely publication and dissemination of peer-reviewed research. Injury Epidemiology aims to be the premier venue for communicating epidemiologic studies of unintentional and intentional injuries, including, but not limited to, morbidity and mortality from motor vehicle crashes, drug overdose/poisoning, falls, drowning, fires/burns, iatrogenic injury, suicide, homicide, assaults, and abuse. We welcome investigations designed to understand the magnitude, distribution, determinants, causes, prevention, diagnosis, treatment, prognosis, and outcomes of injuries in specific population groups, geographic regions, and environmental settings (e.g., home, workplace, transport, recreation, sports, and urban/rural). Injury Epidemiology has a special focus on studies generating objective and practical knowledge that can be translated into interventions to reduce injury morbidity and mortality on a population level. Priority consideration will be given to manuscripts that feature contemporary theories and concepts, innovative methods, and novel techniques as applied to injury surveillance, risk assessment, development and implementation of effective interventions, and program and policy evaluation.
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