Data Disaggregation, Asian American College Students, and Suicidality — Uncovering Southeast Asian Student Needs

Every 2—3 days, a young Asian American adult dies from suicide [1]. Suicide rates among young Asian Americans in the United States (US) in the past 2 decades have increased dramatically [2]. Asian Americans represent over 20 unique origin groups [3], and understanding of the variation of mental health symptoms and needs among these unique subgroups is needed to direct appropriate care.

In this issue in the Journal of Adolescent Health, Sevillano and Conner undertake an important effort to assess variation in suicidality and mental health risk and protective factors across 412,981 college students in the US, which included 67,105 Asian American students, comparing those from East Asian (e.g., Chinese, Japanese, and Korean), South Asian (e.g., Indian, Nepalese, Pakistani, or Sri Lankan), and Southeast Asian (e.g., Cambodian, Filipino, Hmong, and Vietnamese) backgrounds [4]. They found that Southeast Asian students had significantly higher rates of suicidal thoughts and psychological distress compared to East and South Asian students, and that Southeast Asian students’ rates were similar to non-Asian students’. These findings align with recent studies showcasing how Vietnamese and Filipino young adults have higher suicide rates and suicidality compared to other Asian subgroups [1,5]. As Asian youth are often overlooked in mental health investments due to low collective rates of suicide among adolescents, data disaggregation in this study reveals a need to prioritize suicide prevention care for Southeast Asian students. The authors also identify that psychological distress, discrimination, loneliness, substance use, and resilience are all significant determinants of suicidality.

Disaggregation of Asian American college students from 2019 to 2024 in this study into subgroups underscores the importance of understanding connections between psychological distress and suicidality, which is salient for Southeast Asian college students. The Southeast Asian young adults in these data are likely the descendants of families who migrated to the US post-1975 in the years following the wars in Vietnam, Cambodia, and Laos, representing the largest waves of US refugee resettlement in history. These are children of parents from the diaspora, many of whom experienced multiple traumas premigration (war, torture, and genocide), during migration (displacement, piracy, and languishing in first asylum nations and camps), and/or postmigration trauma (family separation, violence, and discrimination) [6]. In addition, the Southeast Asian students in this study reflect children and grandchildren of the mass migration of Filipinos to the US in the early 20th century. Research studies in the 2000s on who would likely be the parents of the students reflected in this data demonstrate the need to further disaggregate data to understand determinants of mental health.

The effects of trauma exposure on Southeast Asian refugee communities have been studied with mixed findings concerning lasting impact. A study in 2005 showed that more than 20 years after resettlement, Cambodian refugees in Long Beach, California experienced high levels of post-traumatic stress disorder and depression [7]. This contrasts to a 2007 study in the US showing that Vietnamese women had relatively lower rates of depression and anxiety compared to Chinese women [8]. Among Filipino American adults in the late 1990s, depression and substance use disorders were predictive of suicidal ideation, while social connectedness with family was an important protective factor [9]. While identification of mental health conditions among Asian Americans may have evolved with time, the mental health of Southeast Asian young adults today reflect a culmination of transmission of generational trauma [10], acculturative stress [11], internalization of the model minority myth [12], and racial discrimination [13], including implicit lack of acknowledgment from other underrepresented groups [14]. Higher psychological distress among Southeast Asians may be connected to lower rates of educational attainment and English proficiency and higher rates of poverty compared to other groups [15]. Finally, mental health stigma is a known barrier to needed care for Asian Americans as a whole [16], yet cultural perceptions of using mental health services likely vary by Asian American subgroup [17]. Taking these elements together, the psychological stressors that Southeast Asian college students face may contribute to higher overall rates of suicide risk, ideation, and attempt.

Several policy implications should be considered to address the growing need for suicide prevention care and mental health investment for Southeast Asian college students. First, this study highlights the variation in suicidality among Asian subgroups and demonstrates the critical need to disaggregate data among racial groups. Efforts to improve data disaggregation nationally among Asian American data advanced in 2024, when the US Office of Management and Budget updated standards to collect and present race and ethnicity data through Statistical Policy Directive No. 15 [18]. With these changes, individuals completing federal data collection could select from the 6 largest Asian American origin groups (Chinese, Asian Indian, Filipino, Vietnamese, Korean, and Japanese) or other. Unfortunately, efforts to advance data disaggregation have been thwarted by more recent federal modifications of critical data sets, such as the National Survey on Drug Use and Health, which for the first time this year removed information about race and ethnicity [19]. Erasing race and ethnicity from data inhibits our ability to understand the differences in mental health access and outcomes for these unique groups.

Second, this study reveals the higher psychological distress of Southeast Asian young adults, which we suspect may be exacerbated today due to threats from deportation and family separation. Deportations from the Immigration and Customs Enforcement have reached nearly 200,000 between January and July of 2025, on course to reach new records of deportations in the last 10 years [20]. Some Southeast Asian communities have historically intersected with carceral and deportation systems in the US stemming from gender and racial disparities, socioeconomics, and trauma [21] In some communities currently, Southeast Asians are being deported up to 5 times the rate of other groups [22], which heightens anxiety, trauma, and psychological distress. Reducing Immigration and Customs Enforcement deportations and instead diverting resources towards mental health supports would alleviate distress of communities at risk, including Southeast Asian families.

Third, this study accentuates the need to develop and test more culturally responsive solutions for Asian American youth and young adults, where existing offerings do not keep up with rising needs [23]. As Asian American youth have among the highest unmet mental health-care needs compared to other groups [24], cultural adaptation of evidence-based therapies for Asian American students, and in particular, Southeast Asians, may have high potential for impact [25]. Culturally and ethnic concordant mental health providers positively influence decisions to access care for some Southeast Asians [26], yet Filipino, Vietnamese, and other Southeast Asians have among the lowest numbers of psychologists in the US compared to other Asian subgroups, and even far fewer than non-Asian groups [27]. Promoting positive childhood experiences (PCEs), including supportive family relationships, the ability to talk about feelings and feel heard and accepted by family members, a sense of belonging, and peer and community support, could help protect and nurture the mental health. PCEs have been associated with better relationships and less mental health issues during adulthood [28]. Suicide prevention efforts are needed for Asian American college students, including promoting PCEs and leveraging adolescent self-esteem and family connectedness in Asian Americans, which can lead to improved mental health [29]. Culturally adapted interventions that help activate these resiliency factors for Asian American students and their families may help attenuate psychological distress and other risk factors for suicide [30,31].

Finally, further research and research investment to the pipeline to improve mental health therapies are required for Asian Americans and specific subgroups, such as Southeast Asians. Although Asian Americans make up 7% of the US population, Asian American, Native Hawaiian, and Pacific Islander communities receive less than 1% of both philanthropic funds [32] and federal research investment [33]. The model minority stereotype further chokes funding and workforce development to address Asian American health disparities [34]. Disaggregated data reflecting subgroup-specific commitment and investment in Asian American research are currently lacking, limiting the ability to assess targeted support within this already underfunded area. However, advancing health equity for Asian American communities—especially those at greater risk—requires a multifaceted approach: expanding representation within the Asian American health workforce, integrating Asian American research study findings into professional training, and increasing funding for health and mental health research focused on these populations [35]. These efforts are essential to addressing the persistent disparities that affect both the broader community and its diverse subgroups.