Polzer Evan R, Rohs Carly M, Iglesias Christe'An D, Mignogna Joseph, Krishnamurti Lauren S, Holliday Ryan, Monteith Lindsey L
VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO, United States of America.
Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America.
Inj Epidemiol. 2025 Jan 20;12(1):5. doi: 10.1186/s40621-025-00560-6.
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.
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.
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.
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.
美国退伍军人的自杀率一直居高不下，在亚裔美国人和太平洋岛民（AAPI）退伍军人中增长尤为显著。对于与AAPI退伍军人打交道的临床医生而言，在自杀预防方面的考虑因素的相关知识有限，然而具有文化适应性的策略往往最为有效。为了填补这一空白，我们试图阐明主题专家对于AAPI退伍军人自杀预防考虑因素的看法。
2023年，我们对14名关键信息提供者（如临床医生、研究人员）进行了定性访谈，以了解他们在美国大陆预防AAPI退伍军人自杀的经验和建议。访谈记录通过主题分析采用归纳法进行分析。
关键信息提供者讨论了AAPI群体的异质性，并强调在对AAPI退伍军人进行自杀预防时，需要平衡文化敏感性和文化谦逊。害怕给家人带来耻辱被描述为一个因素，这可能会阻止AAPI退伍军人透露心理健康问题和自杀风险，也可能会阻止他们获得心理健康和自杀相关的医疗服务。AAPI退伍军人的自杀风险被认为是由羞耻感和家庭集体的核心地位所塑造的，家庭既赋予了抵御自杀的保护作用，也带来了自杀风险。关于自杀的文化规范和信仰被认为与AAPI退伍军人的自杀有关，包括关于在应对痛苦时坚持的信念以及在特定情况下对自杀的容忍。躯体习语被描述为AAPI退伍军人表达痛苦和自杀倾向的一种方式，关键信息提供者讨论了这可能如何影响治疗和外展工作。
关键信息提供者访谈为概念化和解决AAPI退伍军人自杀风险的文化因素提供了重要见解。这些发现可用于为该人群制定量身定制的自杀预防措施，重点是解决心理健康污名化问题，考虑痛苦的躯体习语，并考虑家庭在自杀风险和预防中的作用。
