Mental health disparities, mechanisms, and intervention strategies: perspective from Hawai'i.

PURPOSE OF REVIEW: Although there is a growing body of literature describing the scope and impact of mental health disparities, there is relatively less literature focused on youth and on interventions that are grounded in the cultures of youth most significantly affected by disparities. From the perspective of Hawai'i, one of the world's most diverse communities where disparities nonetheless exist, the authors review the varieties of diversity encountered in psychiatry and healthcare, specific youth mental health disparities, and examples of locally tailored solutions. RECENT FINDINGS: Mental health disparities are born from the differential exposures to poverty, trauma, discrimination, and barriers to accessing care, especially mental healthcare, which is nationally in short supply. They exist even in supposedly high-resource settings and significantly impact indigenous populations, including in terms of risk for incarceration and risk for suicidal behavior. SUMMARY: Addressing disparities involves insuring access to preventive and treatment-focused mental healthcare and applying cultural humility in clinical and community settings. The authors add to the reviewed literature by highlighting interventions that are population-based, culturally grounded, and focused on indigenous youth.

Hope, help, and healing: Culturally embedded approaches to suicide prevention, intervention and postvention services with native Hawaiian youth.

Suicide rates have reached their highest documented levels in the United States with the greatest increases among indigenous youth, including Native Hawaiians. Culturally informed, effective prevention and treatment services are needed now more than ever for Native communities to heal and flourish. Multicomponent prevention and service strategies rooted in indigenous values and approaches show the most promise. Native Hawaiian communities are united around a common goal of suicide prevention, intervention and postvention, linking cultural meanings to improve understanding and guide local efforts. This paper highlights important cultural values to consider when developing and implementing suicide prevention, intervention and postvention. Strategies build upon the strengths of Native Hawaiian youth and their respective communities. Native Hawaiian sayings anchor each level and serve to organize a set of culturally informed and culturally embedded programs and approaches along the continuum of prevention, intervention and postvention. Application of indigenization to suicide prevention enhances connections to people and place, inspiring hope among Native Hawaiian youth, their families and their communities. (PsycINFO Database Record