“Please forgive me:” Asian and Pacific Islander Americans’ suicide notes.

Abstract

Suicide notes are an understudied, yet important area of research because they provide insights into what suicide decedents intend to communicate to others in the moments before their tragic death. In this article, the authors report the first known national study to focus exclusively on Asian and Pacific Islander Americans' (APIAs) suicide notes using data from the National Violent Death Reporting System (N = 3,657). About 31% of APIA decedents left suicide notes. Females and youths (below 25 years old) had higher odds of leaving suicide notes than males as well as adults and older adults, respectively. An age by gender moderation effect revealed that female youths had higher odds of leaving a suicide note than female older adults, although there were no age differences in the likelihood of leaving a suicide note among male decedents. A content analysis of APIAs' suicide notes (n = 765) revealed several categories, including addressees of the suicide notes, difficulties described by decedents (e.g., thwarted belongingness), instructions (e.g., disposal of assets), grievances, and conciliatory interpersonal communications (e.g., apologies and expressing love). Apologies were the most frequent sub-category in APIAs' suicide notes. Overall, conciliatory interpersonal communications were more frequently expressed in suicide notes than negative interpersonal concerns (e.g., grievances). APIA youths also had higher odds than APIA adults (aged 25-59 years old) of expressing both negative interpersonal concerns and conciliatory interpersonal communications in their suicide notes. These findings highlight the importance of studying culturally salient protective and risk factors in APIAs' suicide-related outcomes. What is the public significance of this article?This study examined the suicide notes left by Asian and Pacific Islander Americans who died by suicide. The authors found that conciliatory interpersonal communications (e.g., apologies and bidding farewell) were more common than negative interpersonal concerns (e.g., grievances) in their suicide notes.

Impact of Online Racism on Suicide Ideation Through Interpersonal Factors Among Racial Minority Emerging Adults: The Role of Perceived Burdensomeness and Thwarted Belongingness

“…There are several potential reasons for this. First, previous studies on suicide among Asian American adults suggest that perceived burdensomeness may be particularly salient in precipitating suicide ideation in this group as it may be accompanied by shame ( Wong et al, 2022 ). For some Asian individuals, perceiving that they have brought shame to their close friends, family, and their communities may amplify their feelings of being a burden to their loved ones and society.…”

“…For some Asian individuals, perceiving that they have brought shame to their close friends, family, and their communities may amplify their feelings of being a burden to their loved ones and society. In fact, Wong et al (2022) found that among suicide notes left by Asian decedents (from National Violent Death Reporting System), messages asking for forgiveness were commonly observed suggesting that absolving feelings of perceived burdensomeness may have been the main motivator for suicide. Additionally, Tang and Masicampo (2018) found that perceived burdensomeness increased Asian American college students’ suicide ideation and decreased their willingness to seek help.…”

Why did peri‐pandemic suicide death rates decrease among non‐Hispanic white people while increasing among most people of color?

“…The fact that this experience was unique to Black Americans may limit their ability to pull together, as other racial/ethnic minority groups as well as White Americans might have struggled to empathize and build meaningful community. Related constructs of social isolation, thwarted belongingness and trauma impart suicide risk (Polanco-Roman et al, 2021;Van Orden et al, 2010;Wong et al, 2022). Thus, future research should examine if the findings from Curtis et al (2021) extend to other communities of color, and how such findings transmit to risk for suicide.…”

“…Similarly, the literature indicates that among AAPI Americans, facing school-based or general interpersonal violence is related to increased risk for suicide-related thoughts and behaviors (Leung & Lai, 2023). In a qualitative analysis of 2003-2017 data from the National Violent Death Reporting System (NVDRS), thwarted belongingness was a common difficulty reported by AAPI suicide decedents (Wong et al, 2022). More general research on the relationship between racial/ethnic discrimination and suicide risk has found that such relations may be mediated by posttraumatic symptoms such as stress sensitivity and dissociative symptoms (Polanco-Roman et al, 2021); thus, racially-motivated violence in 2020 may have had traumalike impacts on the mental health of people of color.…”