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c o n f l i c t s , and present competing incentives to maintain cooperative, Hawaiian c o l l e c t i ve lifeways or to adopt more contemporary, competitive and i n d i v i d u a l i s t i c lifeways associated with modern American lifeways. A s i g n i f i c a n t part of the problem is perhaps that there axe no real a l t e r n a t i v e s t h a t one can freely turn to aside from the dominant Western l i f e s t y l e . A great deal of evidence has been accumulated in p a r t i c u l a r on how a n a t i v e Hawaiian child who wants to r e t a i n the Hawaiian l i f e s t y l e is heavily penalized in the s t a te educational system. Such conficts and s t r e s s es f o s t e r mental and emotional disorders among native Hawaiian families in p a r t i c u l a r . In a d d i t i o n , lower levels of formal education attainment and higher levels of unemployment and underemployment contribute to s t r e s s e s and d i s o r d e r s . . . 1 4 9/ Hawaii State Department of Health Programs According to the Hawaii State Department of Health, the community's needs for mental health services exceed t h e . a v a i l a b l e public and p r i v a t e resources, although the State is attempting to decrease the gap and make i t s services available to more people. The Mental Health Division of the Health Department now operates eight community mental health centers—five on Oahu, and one in each of the other counties (Hawaii, Maui, and Kauai). 150/ Many of these c e n t e r s also operate s a t e l l i te f a c i l i t i e s to reach more people. The f i r s t ethnic-oriented mental health c l i n i c , which is for Chinese-speaking persons, was opened in June 1980. A new program has also been funded to set up a network of community r e s i d e n t i a l f a c i l i t i e s. The centers on the neighboring islands report some problems, mainly with manpower. The island of Hawaii has only one community r e s i d e n t i al f a c i l i t y fcr m e n t a l l y - i l l adults--wit only four beds. The county hopes to expand the f a c i l i t y to twelve beds. Maui County reports that outpatient services are adequate in the Central Maui area, but are limited in We&t Maui, the Soutn Shore and "up~countr> areas, and on Molokai and Lanai. In addition to i t s community menta health centers, the Mental healtr. Division also operates four specialized programs: • Courts and Corrections, whijh provides mental health consultation to the S t a t e 's court and correctional programs; • Children's Mental Health Services; • Hawaii State Hospital; and • Alcohol and Drug Abuse. The f i r s t three of these programs report problems of manpower availab i l i t y that may r e s t r i c t services. The Alcohol and Drug Abuse program does not provide direct services i t s e l f . Tnrough contracts with p r i v a t e agencies, the program a l l o cates State and Federal funds to twenty-one drug abuse and alcohol programs statewide. The State program does provide technical assistance, research, and t r a i n i n g to these local programs. The Alcohol arid Drug Abuse branch completed a statewide population survey of the incidence and prevalence of substance abase in Hawaii. Preliminary data from the survey indicate t h a t : • Hawaii has a s i g n i f i c a n t ly higher percentage of people
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