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Column: Mental health care must be accessible for isle children, youth

Trina Orimoto, a licensed clinical psychologist, leads the program improvement and communications office for DOH’s Child and Adolescent Mental Health Division.
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Trina Orimoto, a licensed clinical psychologist, leads the program improvement and communications office for DOH’s Child and Adolescent Mental Health Division.

Trisha Kajimura, MPH, facilitator of the Mental Health Task Force, contributed to this commentary.
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Trisha Kajimura, MPH, facilitator of the Mental Health Task Force, contributed to this commentary.

Trina Orimoto, a licensed clinical psychologist, leads the program improvement and communications office for DOH’s Child and Adolescent Mental Health Division.
Trisha Kajimura, MPH, facilitator of the Mental Health Task Force, contributed to this commentary.

How are you feeling today?

This simple but powerful question can change the trajectory of a child’s life. The first step is finding the courage to ask. The next, being receptive to hearing the real answer, especially in these challenging times.

We’ve all been susceptible to the psychological symptoms COVID-19 has left in its wake. Adults and children equally feel the disruptive aftershocks to our sense of security and stability. Recent studies suggest eight out of 10 young people report that their mental health has been negatively impacted by school closures, while four in 10 say they’ve experienced a significant increase in stress. Feelings of social isolation, as well as exposure to violent images of systemic racism, are driving a wider spectrum of young people to confront new and different fears.

Thus, national research warns us to anticipate widespread increases in depression, anxiety, irritability and social withdrawal in children in the post-COVID-19 world. Further, there may be long-term effects, as studies indicate that such events in childhood, termed adverse childhood experiences, can be linked to numerous and costly health problems in adulthood.

Despite this, current statistics haven’t shown expected increases in service demand. The Hawaii Department of Health’s Child and Adolescent Mental Health Division saw a 33% decline in applications for services in 2020 relative to pre-pandemic levels in 2019. Similarly, the youth crisis mobile outreach saw a 51% decrease in 2020. The likely reason: COVID-related restrictions limited opportunities for in-person contact, which is essential to both identify and support vulnerable youth experiencing mental health challenges.

At the system level, it is critical to expand community outreach and mental health screenings, to get better at quickly finding youth in need. Easy access to telehealth counseling and digital solutions further break down typical barriers to care. Finally, taking into account the fact that current trauma influences future well-being, the policies of the youth-serving system must become even more compassionate and open-minded.

We owe it to our keiki to address this evolving challenge. During National Mental Health Awareness Month, we call on our communities to actively engage in asking their ‘ohana the vulnerable questions so that we can all work together to find positive solutions. At the basic level, this starts with parents taking the time to talk with their kids about mental health. Families can refer to the many online self-care resources available from the Mental Health America of Hawai‘i website. The DOH’s Help Your Keiki website (helpyourkeiki.com) is another useful resource. It provides a screening tool, information on common problems and treatments that have proven to work. If young people or parents need more intensive supports, therapy services are available in every county across the state.

Catching problems early is the best method for preventing emergency department visits, hospitalizations and even suicides. But should crises arrive, there are 24/7 hotlines staffed with local, professional crisis counselors. The Hawai‘i CARES hotline is available for Oahu residents at 832-3100. Neighbor island residents may call toll-free at (800) 753-6879. Hawaii residents can also reach the Crisis Text Line by texting the word, “ALOHA” to 741741.

We recognize not every teen has a parent they can confide in for support. Thankfully, those who are 14 years and older can access mental health services without parental consent. School counselors, pediatricians, coaches, and other clinicians are ready and waiting to ensure your voice is heard.

How we respond to this pandemic can make a world of difference for Hawaii’s children. As caring adults, we must all do our part to support the resiliency of young people and prepare them for a better future.


Trina Orimoto, a licensed clinical psychologist, leads the program improvement and communications office for DOH’s Child and Adolescent Mental Health Division. Mestisa Gass is the program director for Mental Health America of Hawai‘i. Trisha Kajimura, MPH, facilitator of the Mental Health Task Force, contributed to this commentary.


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