In Hawaiʻi, more young people die from suicide than from traffic crashes, cancer, or heart disease. According to the Hawaiʻi Department of Health’s latest statistics, suicide was the leading cause of death for youth ages 10–19.

For many keiki, the struggle is not just anxiety or depression, it is a growing loss of hope for the future. When young people cannot envision a place for themselves in the world, despair can take root long before a clinical diagnosis appears.

Today our keiki are growing up in a world of constant digital stimulation, global uncertainty, and rapid social change. In Hawaiʻi, these pressures are compounded by rising living costs, housing instability, geographic isolation, and limited economic opportunity. For many keiki, the future can feel unclear or out of reach.

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And yet, much of our response to youth mental health still begins after a crisis emerges. This raises a critical question: Are we intervening too late?

In physical health, we do not wait for illness to take hold before taking care of ourselves. We emphasize prevention — nutrition, movement, regular checkups. Mental health should be no different.

Just as every child is born with a body designed to maintain physical health, they are also born with an innate capacity for mental health — an inner resilience, intuitive wisdom, and well-being that is self-restoring when we understand how it works.

This underscores the importance of a preventative, upstream approach in mental health that strengthens well-being before distress becomes a crisis.

When The System Falls Short

Our current mental health model is largely built around diagnosing and treating illness. While this is essential, it is not sufficient. Former National Institute of Mental Health director Thomas Insel has acknowledged that despite decades of investment in treatment, rates of anxiety, depression, and suicide — especially among young people — continue to rise.

Public schools play a critical role. Many Hawaiʻi schools have begun incorporating social-emotional learning, which is an important step forward. However, implementation varies widely from campus to campus. Programs are often selected independently, and instructional time is limited.

Hawaiʻi has statewide coordinators for physical and sexual health education, but does not employ a statewide coordinator for social-emotional learning. A similar commitment to mental health and emotional well-being could ensure that every student develops these universal, essential life skills.

Current social-emotional learning programs have the right objectives in mind to enhance our children’s social and emotional skills; however, they often lack a more in-depth approach. Students may learn coping strategies like breathing techniques without ever understanding how they really work on the inside. If we are serious about improving youth mental health, education must move beyond teaching coping techniques and toward a more preventative, comprehensive approach that supports long-term well-being.

As Sharon Usagawa, co-founder of the Pacific Institute for Innate Mental Health, explains:  “We are missing an important piece of the puzzle. We are born healthy in both body and mind. Innate mental health is an inherent capacity for resilience, clarity, and well-being that is always present and available to us.”

When keiki understand their innate mental health, they become more confident and better able to face adversity with greater ease.

An Inside-Out Paradigm Shift 

We often innocently blame the outside environment for how we feel (relationships, circumstances, behavior of others, social media, etc.) without ever examining the internal processes at work behind it.

While outside factors matter, our emotional experience does not arise directly from them. An inside-out understanding of mental health helps people see that their emotional experience is created on the inside, via thought.

Two students can face the same situation and have completely different experiences — one overwhelmed, the other calm and steady. The difference is not in the circumstance, but in how it is interpreted in the moment.

This points us to the fact that our experience of life is created entirely within ourselves via thought. Psychologist Dr. George Pransky, in his book The Secret to Mental Health, states “the circumstances of our lives will only be seen as stressors or problems as our thoughts dictate.”

When young people begin to discover that their experience of life is not simply happening to them, but is being created by them moment by moment, a shift can occur. They learn to take ownership over their emotional experience, and something deeper begins to reveal itself.

Beneath all the noise of insecure, unsettling, troubled thoughts that undermine us, is a natural sense of ease, security, intuitive wisdom, and insight. This is where the shift towards innate mental health occurs. 

A Preventive Opportunity For Hawaiʻi

Hawaiʻi is uniquely positioned to lead a shift in mental health prevention. Our cultural values of aloha emphasize love, care, balance and a connection to something beyond ourselves — principles that align closely with emotional well-being. 

Rather than viewing youth mental health through the lens of problems to be fixed, we can learn to recognize the resilience, intelligence, and well-being already present within our keiki. Psychologist Dr. Rita Shuford emphasizes that we are all born inherently whole, never broken, and with nothing lacking. When this understanding becomes central to education, the role of adults shifts from trying to “build” something in children to helping them recognize and trust what has been there all along.

Hawaiʻi has the opportunity to equip young people with education that supports lifelong well-being. Our keiki deserve more than survival; they deserve to thrive and flourish. When we invest in this kind of mental health prevention, we strengthen not only individuals, but families, classrooms, and entire communities.

When taught early, taught well, and reinforced consistently, these social and emotional skills become one of the most powerful long-term investments a society can make. And perhaps most importantly, we offer our keiki something they urgently need: a future they can see themselves in.

Organizations such as the Pacific Institute for Innate Mental Health are advancing this approach through projects like a culturally grounded curriculum that helps keiki connect with and strengthen their innate capacity for well-being. Learn more at www.innatemh.com and www.AkamaiKids.com.