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Why More Elderly Asian Women Kill Themselves

Culture * High suicide rate among U.S. immigrants is blamed on depression over social changes.

September 14, 2000|CATHY PASCUAL | TIMES STAFF WRITER

Expecting to find comfort and care during her twilight years, a 78-year-old Hong Kong woman crossed the Pacific to join her adult son in San Francisco. What she encountered was far from what she had hoped.

Her son, who was poor and living in a cramped apartment with his wife and three children, placed her in a rundown hotel room in downtown San Francisco. She was isolated, unable to speak English or to see her family often. She rarely left her room.

It was not until the hotel manager called a local organization for the elderly that the woman received some help. But it was too late. Less than two weeks after she was prescribed antidepressant medication, which she refused to take, she hung herself in her hotel room.

The case, related by a Bay Area social worker, illustrates the fate of a surprising number of elderly Asian women who immigrate to the United States. Asian Americans have the highest suicide rate among women 65 or older, according to the Centers for Disease Control and Prevention. Their suicide rate is four times that of elderly black women, about three times that of elderly Latinas and 65% higher than that of elderly white women.

Although a similar rate was reported by the CDC in 1985, an intensive look at the problem has only begun recently among mental health researchers and providers around the country. "There are a lot of myths and very little analysis," said Stanley Sue, executive director of the National Research Center on Asian American Mental Health at UC Davis. Sue recently joined other experts at a mental health conference in Chicago dedicated to the "public health crisis" of depression among minorities.

Mental health experts blame the high suicide rate among elderly Asian American women on devastating changes in their cultural and social roles that occur after immigrating to the U.S. When elderly women move from a culture that reveres the older generation as wise, experienced decision-makers to one that has far less respect for the elderly, their place in the world is disrupted, said Jeanette Choi, a social worker at the Asian Pacific Family Center in Rosemead.

Asian American women may feel useless when the caretaker roles they've played throughout their lives are no longer necessary. "Relationships are what they've lived for," said Sue. "Children grow up and have their own children. Husbands die earlier. The loss of relationships that are so meaningful to them is devastating."

This loneliness goes beyond the "empty nest" syndrome experienced by most aging mothers. Not able to negotiate the English-speaking world, many elders depend on their families for just about everything. "Elderly immigrants may not have an adequate support network," said Lisa Nguyen, director of the Center for Multicultural and Multilingual Mental Health Services in Chicago.

Elders may feel like a burden, without a purpose in life. Coming from a culture that stresses interconnectedness rather than individualism, some older Asian American women may feel doubly useless if they can no longer contribute to their family or society. "A loss of social relationship means more in a collectivistic society," said Sue. "It cuts away at the very essence of your life."

Although elderly Asian Americans and whites blamed failing health as the main reason for killing themselves, according to a 1994 UCLA study, some suicide notes written by Asian Americans revealed that they felt they were a burden to the family. That reason was not mentioned in any of the notes by white suicide victims.

The method of suicide also varied by ethnicity. Asian Americans used hanging significantly more than firearms, which were most common among whites. Some experts say that hanging sends an accusatory message of anger and resentment to the children. According to traditional Chinese belief, "the ghosts of those who die by hanging returned to torment the living in a particularly persistent and vicious manner," stated one researcher.

Other experts say the act of suicide itself serves as a message to those closest to the victim. For elderly Asian American women, suicide may be the only way to express unhappiness or anger over the way they are treated by the family, said Doris So, mental health counselor in San Francisco. "Traditionally Chinese women have no power in the family. They are considered a possession of the husband," said So. "They think no one will listen to them if they complain."

Although Asian Americans tend to be lumped together into one monolithic group, differences in cultural tolerance of suicide exist.

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