Intersectional Stigma, Belongingness, and Suicide: A Novel Approach for Minority Mental Health.

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PROJECT SUMMARY A critical barrier to progress in the fields of suicide research and minority mental health disparities is the lack of appropriate conceptualization of at-risk groups. Past research indicates that immigrant generation is a more meaningful measure of suicidality than racial/ethnic categorization. Based on comprehensive findings from the National Latino and Asian American Study, suicide is a growing concern particularly among second-generation immigrants. Half of all second-generation immigrants are racial/ethnic minorities, namely Latinos and Asians. Asians are the only racial/ethnic group for which suicide is the leading cause of death among early adults age 18-24. Among racial/ethnic minorities, suicide remains a top five leading cause of death until age 55 only in Asians. Despite this disparity, there is a severe dearth of evidence-based research initiatives targeting suicide through an identity-based approach in racial/ethnic minority groups. Past evidence from minority stress theory suggests strong associations between identity-based stigma and suicide. However, minority stress theory lacks an intersectional stigma perspective incorporating multiple minority identities. Adapting this theory to include intersectional stigma enhances its applicability to racial/ethnic minorities, many of whom identify with multiple stigmatized subgroups. Moreover, merging the interpersonal theory of suicide to minority stress allows scientists to investigate the pathway of belongingness to suicide from an intersectional stigma perspective. The proposed study signifies a pressing research opportunity to uncover new insights on understanding suicide through this innovative theoretical framework in a subgroup of Asians. This will be implemented in a pilot study using a novel study design integrating complex methods from multi-level national, community, and individual data. The study purpose is to better understand belongingness as it relates to suicide from the complex perspective of intersectional stigma, particularly in early adult Asians who identify with multiple stigmatized subgroups (ethnicity, immigrant, faith), through the following aims: Aim 1: To test the potential mediating effect of belongingness to intersectional stigma and suicide-related outcomes (stress, depression, suicidal ideation) in a national sample of Asians with multiple stigmatized identities; Aim 2: Identify identity-specific (ethnicity, immigrant, faith) risk and resilience factors of suicidality in an Asian community; Aim 3: Explore the meaning of belongingness from the lived experience of intersectional stigma through in-depth interviews with Asian individuals. The fellowship research objective is to conduct a hypothesis-generating pilot study on the risk and resilience factors of suicide using a novel approach that is especially relevant to racial minorities. The fellowship training goals are to: (1) gain proficiency in advanced methodological skills for mental health and health disparities research; (2) enhance expertise in conducting suicide and mental health research in immigrant racial/ethnic minority groups; and (3) Publish 5 first author peer-reviewed manuscripts to advance an independent research career. The proposed study responds to NIMHD’s recent calls to produce innovative approaches for minority health disparities.