Researchers: Camillia K. Lui, PhD, Nina Mulia, DrPH
Understanding the complex interplay between mental health, substance use, and identity among adolescents is crucial for effective prevention and intervention. Recent research highlights significant disparities in suicidal ideation, substance use, and mental health risks among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) youth, as well as other racial and ethnic groups. While certain subgroups face heightened risks, broad data aggregation often obscures these disparities, underscoring the need for disaggregated data to inform targeted support. Additionally, early-life adversity and polysubstance use emerge as critical factors influencing long-term mental health outcomes, emphasizing the urgency of culturally responsive and equity-driven public health strategies.
Key Takeaways
- Suicidal ideation rates vary widely among AANHPI subgroups, with Filipino adolescents at the highest risk (21.2%) and Asian Indian adolescents at the lowest (13.3%). Multiethnic and multiracial adolescents face even greater risks, with rates increasing by up to 9.4 percentage points in some groups.
- Aggregating AANHPI data masks disparities, making data disaggregation essential for identifying at-risk youth and ensuring targeted interventions.
- Early-life adversity, particularly before age 5, increases the risk of frequent alcohol and cannabis use later in life. Early intervention programs focusing on family stress reduction and parental well-being can help prevent future substance use, especially among marginalized communities.
- Using both cannabis and e-cigarettes poses the highest risk for depression and anxiety—more than using all three substances together. Male students experience stronger mental health risks from substance use than female students.
- African American students had lower odds of anxiety and depression than White students, possibly due to protective factors or differences in reporting.
- Targeted mental health interventions should focus on students using multiple substances, as risks are not simply additive—combinations of certain substances may be more harmful than others.
- College health programs should prioritize screening and interventions for cannabis and e-cigarette users to reduce anxiety and depression risks.
- Future research should explore how intersectional identities shape suicide risk and substance use, ensuring prevention efforts are culturally responsive and equity-focused.
Key Studies
Unmasking Suicide Risk Among Asian American, Native Hawaiian, and Pacific Islander Adolescents Through Data Disaggregation
Authors: Camillia Lui, Yu Ye, Joyce Gee
Suicide is a leading cause of death among AANHPI adolescents, but aggregate data obscure subgroup risks. This study analyzed data from 77,735 California high school students, revealing significant variations. Filipino adolescents had the highest suicidal ideation rates (21.2%), while Asian Indian adolescents had the lowest (13.3%). Risk was notably higher among multiethnic youth, with Chinese multiracial adolescents experiencing a 9.4 percentage point increase over their monoethnic peers. These findings highlight the need for disaggregated data and targeted prevention efforts.
The Long-Term Impact of Childhood Adversity on Adolescent and Young Adult Substance Use
Authors: Nina Mulia, Libo Li, Edwina Williams, Zihe Guo, Jane Witbrodt, Christina Tam, Camillia Lui
This study analyzed data from 4,582 children (born 1984–2000) in the National Longitudinal Study of Youth-1979 cohort. Results showed that exposure to high parental conflict or maternal substance use predicted more frequent alcohol and cannabis use in adolescence and early adulthood. In contrast, deprivation-related adversity (low cognitive stimulation, emotional support, or household poverty) had no significant or negative associations with later substance use.
