Risk and Protective Factors for Suicidal Thoughts and Behaviors Among Asian American Young Adults: A Systematic Review

Background: Asian American (AA) young adults, including AA college students, may experience more suicidal thoughts and behaviors (STBs) compared to other racial and ethnic groups of the same age. To the best of our knowledge, this study is the first systematic review of the risk and protective factors for STBs with a focus on AA young adults. Methods: Informed by the social-ecological perspective and the cultural model and theory of suicide, this study systematically reviews the risk and protective factors for STBs among AA young adults. Based on 22 research articles published between 1998 and 2023, we analyzed and discussed the effects of 37 risk and 15 protective factors at the individual, relationship, community, societal, and cultural levels. Results: Most risk factors are at the individual level (e.g., depressive symptoms and hopelessness), followed by factors at the cultural level (e.g., acculturation and acculturative stress), the relationship level (e.g., family problems and romantic relationship problems), the community level (e.g., verbal threats on campus), and the societal level (e.g., public stigma about mental health). Also, most protective factors are at the individual level (e.g., self-reliance and fear of suicide), followed by the relationship level (e.g., social support and family responsibilities), the community level (e.g., religious affiliations), and the cultural level (desire not to burden others). Conclusions: This systematic review emphasizes the need for future research to explore cultural factors, subgroup differences, and longitudinal designs, while advocating for culturally specific prevention and intervention strategies to improve mental health outcomes for AAYAs.