HEAL Study: Suicidal Thoughts, Behaviors, and Quality of Life among Suicide Bereaved Asian Americans

Each suicide affects approximately 15 to 30 people, including immediate and extended family members with nearly 100 people when friends and co-workers are considered. Suicide-bereaved families face higher risks of suicidal thoughts and behaviors (STBs), complicated grief, and diminished quality of life, often characterized by poor mental and physical well-being. Despite these profound impacts, there has been no investigation specifically focused on Asian Americans (AAs) to explore their unique experiences, risk factors, and the association between these factors, STBs, and quality of life. This is particularly concerning given that suicide rates among AAs have increased over the past two decades, with AAs also representing the fastest-growing population in the U.S. Our HEAL (Hope and Empowerment of Asian American Loss) study fills a critical gap by investigating the lived experiences of AAs who have lost family members to suicide. This study will examine whether cultural constructs, such as “loss of face” unfulfilled family roles, beliefs about protecting family members, and cultural attitudes toward death, alongside individual grief and family cohesion/adaptation, influence STBs and quality of life among suicide-bereaved AAs. To our knowledge, no studies have investigated the effects of suicide loss among AAs. Using a mixed-method approach, HEAL will recruit 75 AA family members (ages 18 and older) across nine states to address the following Specific Aims: Aim 1A: Qualitatively explore the experiences of loss, mental health, and quality of life among 20 suicide-bereaved AA family members through in-depth interviews. Aim 1B: Refine and adapt quantitative instruments to ensure cultural relevance and sensitivity based on insights from Aim 1A. Aim 2A: Quantitatively describe the multi-level risk factors and outcomes (STBs and quality of life) among 75 suicide-bereaved AA family members. Aim 2B: Assess the associations between individual, family, and socio-cultural risk factors and outcomes (STBs and quality of life). The long-term goal of HEAL is to use these findings to inform the development of culturally specific, evidence-based interventions for suicide-bereaved AA families. This work aims to ultimately reduce STBs and improve the quality of life in this vulnerable population by addressing the unique challenges they face and by providing insights for urgently needed interventions for AA mental health.