Hidden suicidal ideation or intent among Asian American Pacific Islanders: A cultural phenomenon associated with greater suicide severity

"Hidden suicidal ideation" (HSI)-the concealment or nondisclosure of suicidal distress to others-is often cited in suicide and ethnic minority research as a phenomenon that occurs frequently among ethnic minorities. Yet, there has been limited research to further understanding of this phenomenon, particularly in a within-group investigation among Asian American Pacific Islanders (AAPI). The aims of the current study were to characterize HSI in a community sample of 73 actively suicidal AAPI adults. Results indicated that a majority of participants (N = 44, 60.30%) hid their desire to kill themselves from others. A logistic regression showed that AAPI respondents who endorsed HSI reported greater severity of suicidal distress than their non-HSI counterparts and that HSI among AAPIs was associated with culturally salient suicide risk. These results provide critical information that highlights HSI as a "cultural phenomenon" (defined as having a relationship with cultural risk factors) and potential indicator of suicide disparities and may have implications for culturally responsive detection and management of suicide risk for AAPI populations. The current study represents the first dedicated examination of the phenomenon of HSI among AAPI individuals.