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conflicts, and present competing incentives to maintain cooperative, Hawaiian collective lifeways or to adopt more contemporary, competitive and individualistic lifeways associated with modern American lifeways. A significant part of the problem is perhaps that there are no real alternatives that one can freely turn to aside from the dominant Western lifestyle. A great deal of evidence has been accumulated in particular on how a native Hawaiian child who wants to retain the Hawaiian lifestyle is heavily penalized in the state educational system.
Such conficts and stresses foster mental and emotional disorders among native Hawaiian families in particular. In addition, lower levels of formal education attainment and higher levels of unemployment and underemployment contribute to stresses and disorders . . . 149/

Hawaii State Department of Health Programs

According to the Hawaii State Department of Health, the community's needs for mental health services exceed the available public and private resources, although the State is attempting to decrease the gap and make its 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 centers also operate satellite facilities to reach more people. The first ethnic-oriented mental health clinic, 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 residential facilities.

The centers on the neighboring islands report some problems, mainly with manpower. The island of Hawaii has only one community residential facility for mentally-ill adults--with only four beds. The county hopes to expand the facility to twelve beds. Maui County reports that outpatient services are adequate in the Central Maui area, but are limited in West Maui, the South Shore and "up-country" areas, and on Molokai and Lanai.

In addition to its community mental health centers, the Mental health Division also operates four specialized programs:

  • Courts and Corrections, which provides mental health consultation to the State's court and correctional programs;
  • Children's Mental Health Services;
  • Hawaii State Hospital; and
  • Alcohol and Drug Abuse.

The first three of these programs report problems of manpower availability that may restrict services.

The Alcohol and Drug Abuse program does not provide direct services itself. Through contracts with private agencies, the program allocates State and Federal funds to twenty-one drug abuse and alcohol programs statewide. The State program does provide technical assistance, research, and training to these local programs.

The Alcohol and Drug Abuse branch completed a statewide population survey of the incidence and prevalence of substance abase in Hawaii. Preliminary data from the survey indicate that:

  • Hawaii has a significantly higher percentage of people