Researchers at the University of �鶹��ý at Mānoa are using artificial intelligence and machine learning (AI/ML) to better understand what improves outcomes for individuals receiving treatment for substance use disorders.

A recent study published in analyzed more than 7.9 million publicly available treatment records across the U.S. to identify patterns in services, recovery and outcomes. The research was led by Treena Becker, an assistant researcher with the , and Alberto Gonzalez-Martinez, a UH computer scientist.

“We believe our research findings can help states and local organizations better understand how to support people in substance use disorder treatment and their long-term recovery journey at a time when drug overdose deaths continue to be a major public health concern across the U.S.,” Becker said.

Top predictors of positive treatment outcomes

“We developed and used an ensemble machine learning model called Random Forest Model with the aim to predict the 10 most important features that increase the likelihood of positive treatment outcomes,” Becker said.

The analysis found the most important factor associated with positive outcomes was how long an individual remains in treatment, regardless of setting. According to Becker, longer engagement significantly increases the likelihood of reducing or stopping substance use.

Other key factors included treatment accessibility, depending on clinical need, treatment type at entry and at discharge, housing status, participation in self-help groups, employment status and referral source.

Mapping disparities in treatment services

AI/ML tools also allowed researchers to map and visualize the data, revealing patterns difficult to detect using traditional methods. Using the Machine Learning Random Forest Model, the team found that states with the highest overdose death rates tend to have fewer clinically appropriate treatment services available.

“It would have been virtually impossible to analyze so many treatment records without AI/ML assistance,” Becker said.

Based on the findings, Becker recommends that state governments prioritize behavioral health services and work collaboratively to expand access to longer-duration, clinically appropriate treatment programs. Increasing availability—especially in states with limited treatment infrastructure—could significantly improve recovery outcomes nationwide.

Becker, who recently received a pilot project award from (Center for Pacific Innovations, Knowledge and Opportunities), plans to build on the research by examining local data on addiction treatment and recovery among Native Hawaiians and Pacific Islanders.

Many aspiring mental health practitioners in �鶹��ý begin their career journey thinking they are embarking on a straightforward path toward helping their community, only to find themselves walking into many regulations and bureaucratic red tape.

John Souza, Jr., an assistant professor in the at the University of �鶹��ý at Mānoa, is working to change that with his “Do You Know the Way to Licensure?” project. The goal is to fix the critical disconnects in the state’s mental health workforce pipeline, leading to more fully licensed providers for local families.

Hidden hurdles

Souza’s preliminary research reveals that the transition from graduation to full licensure is where many practitioners get lost, often because of administrative and financial burden of accruing post-graduate supervised hours.

“Instead of being sure that people are ready to sit with individuals, couples and families and help them heal, we’re seeing that the licensure process is testing people’s ability to withstand financial hardship,” said Souza.

The initiative, part of the Marriage and Family Therapy Lab at the , is collecting data from four different routes—undergraduates, current graduate students, pre-licensed graduates and licensed providers. Souza wants to advocate for policy changes that will streamline the path to practice.

For more information or to participate in the study, contact Souza at john.souza@hawaii.edu.

Helen (Nalani) Blaisdell-Brennan, assistant clinical professor of psychiatry at the University of �鶹��ý at Mānoa (JABSOM), has recently received multiple national honors recognizing her leadership, mentorship and commitment to mental health equity.

A JABSOM alumna, Blaisdell-Brennan was named a Distinguished Fellow of the American Psychiatric Association (APA), a designation reserved for psychiatrists who demonstrate sustained and outstanding contributions to the field. She was also recognized as an APA Mental Health Equity Champion for her work expanding access to culturally responsive care and improving outcomes for underserved populations.

“Mental health equity means that every person has a fair opportunity to achieve the highest possible level of mental well-being, regardless of socioeconomic status, geographic location, or cultural identity,” said Blaisdell-Brennan.

Blaisdell-Brennan holds leadership roles at the local, state and national levels, including president-elect of the Honolulu County Medical Society and service on the American Psychiatric Association Assembly Executive Committee, where she is president of the American Indian, Alaska Native, Native Hawaiian Caucus. She has also received two national APA awards recognizing excellence in practice and mentorship.

Psychiatric care rooted in culture and community

With nearly two decades of experience, Blaisdell-Brennan emphasizes psychiatric care that considers cultural identity, community and lived experience. Her work has included advocacy for telehealth access and workforce development to support care in underserved areas.

“Cultural humility means recognizing that we don’t hold all the answers,” she said. “Our patients do. They bring the wisdom of their ʻohana, their community and their lived experience into the healing process.”

“Dr. Blaisdell-Brennan’s work continues to elevate mental health care in �鶹��ý and beyond,” said JABSOM Dean Sam Shomaker. “Combining clinical leadership, advocacy, and a focus on equity to advance practice in ways that are both respectful and impactful is everything we aim to do at JABSOM, and we congratulate Dr. Blaisdell-Brennan on these honors.”

Blaisdell-Brennan is the daughter of Kekuni Blaisdell, a physician who was among the founding faculty of JABSOM.

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Windward Community College’s commitment to transforming lives took center stage at the Women’s Community Correctional Center (WCCC) on January 30, as 10 inmates graduated from the Mental Health Technician Program. Offered through Windward CC’s Puʻuhonua Program and a partnership with the Department of Corrections and Rehabilitation (DCR), the college coursework equips incarcerated individuals with job-ready skills for successful reentry.

“It’s an overwhelming sense of pride to have accomplished something like getting your mental health tech certification,” said graduate Tiare Kuehnl.

The foundational training included three college-level courses—Survey of Psychology, Conflict Resolution and Mediation, and Abnormal Psychology—resulting in a Mental Health Certificate of Competence. The nine transferable credits will appear on the women’s University of �鶹��ý transcripts. The collaboration aligns with DCR’s mission to reduce recidivism.

“The Mental Health Technician Program provides knowledge and job skills to those in our custody and care to prepare them for reentry into the community,” said DCR Director Tommy Johnson.

Vital career pathway

With trained mental health technicians in high demand across �鶹��ý, this certificate opens vital career pathways at healthcare organizations, assisted care facilities and the �鶹��ý State Hospital. Windward CC Chancellor Ardis Eschenberg emphasized the program’s profound impact.

“Today’s graduates bring hope and light to our communities. They are acquiring skills and knowledge that help them now and are vital to the communities they will return to,” Eschenberg said.

Kuehnl said her background gives her empathy, and she plans to pursue a degree in psychology.

“Working with people to help make the community better is something that I look forward to doing,” Kuehnl said. “I feel a sense of fulfillment in doing something useful with my life.”

Eschenberg added, “This is really not just about education. It’s about collaboration to make our communities and state stronger.”

Caring for a loved one with cancer can be isolating, but more than 100 people found support, education and connection at “Caring for Caregivers,” a free interactive workshop held January 17, at the University of �鶹��ý Cancer Center in Kakaʻako.

Presented by the Susan C. Hirano Cancer CARE Community, the quarterly workshop brought together in-person and online participants to learn about caregiver research, practice journaling for emotional processing, and take part in facilitated breakout discussions for caregivers and for patients, survivors and thrivers.

“Caregiving can feel very lonely. But the message we want to convey to all caregivers is: You’re not alone,” said Peter Hirano, whose late wife, Susan Hirano, was a patient advocate and founder of the Cancer CARE Community. He shared personal reflections from his wife’s cancer journey and emphasized the importance of self-care and connection.

‘Acknowledge, uplift, educate and empower’

In �鶹��ý, more than 70,000 people are living with cancer, and about one in four adults are family caregivers. Hirano said the event was designed to “acknowledge, uplift, educate and empower caregivers, who often are among the unsung heroes of the cancer journey.”

Featured speakers included Kevin Cassel, associate director for community outreach and engagement at the UH Cancer Center, who highlighted current caregiver research and practical resources for patients and families. Faryal Michaud, a palliative care physician and certified life and wellness coach, led participants through a journaling exercise focused on reframing anxious or overwhelming thoughts.

“It is important to connect with other people in your environment and your community, to talk and hold space for each other,” Michaud said. “Your experience as a caregiver is legitimate and important as well.”

The next free workshop, “How Clinical Trials Save Lives,” will be held April 18. More information is available at the

Engaging in cultural and social activities is strongly linked to better mental health for Native Hawaiian, American Indian & Alaska Native elders, according to a new study from the University of �鶹��ý at Mānoa published in .

Researchers from the analyzed survey data from more than 19,000 older adults who participated in a national assessment sponsored by the . Conducted every three years, the survey helps inform planning, long–term care discussions & grant applications for programs that support Indigenous elders.

Traditions linked to better mental health

“We found that frequent participation in traditional cultural practices & social activities was strongly associated with better mental health,” said Miquela Ibrao, assistant professor and one of the study’s lead authors from the . “In contrast, functional limitations—such as difficulties bathing, dressing, cooking & cleaning for oneself—and caregiver burden were associated with poorer mental health.”

Among the three groups studied, Native Hawaiian elders reported the highest average mental health score.

“This may be because Native Hawaiian elders were most likely to regularly participate in cultural activities, as �鶹��ý traditions like hula & mele are celebrated across the islands,” said Kathryn Braun, professor of public health sciences. “Also, the Native Hawaiian sample had the highest proportion of retirees.”

Ibrao said the findings highlight the value of community programs that honor cultural traditions, helping Indigenous elders stay mentally & emotionally healthy.

The research was co-authored by Jane Lee, Yan Yan Wu & Jordan Lewis of the Thompson school, along with collaborators from the Center for Rural Health at the , the & Southcentral Foundation.

As LGBTQ+ youth across the U.S. continue to face higher rates of mental health challenges and substance use, community-based organizations (CBOs) are playing an increasingly vital role in providing safe, supportive spaces. Yet, despite their growing importance, these organizations remain largely understudied.

A new study published in the is helping to change that. The research “Community Efforts to Support LGBTQ+ Youth Mental Health: Programs Objectives, Development, and Delivery,” was a collaboration among the University of �鶹��ý at Mānoa, the University of Maryland School of Public Health and the University of Connecticut.

Researchers conducted in-depth interviews with staff from 16 CBOs across the nation that work with LGBTQ+ youth, identifying how these groups develop and deliver mental health services.

“At a time when LGBTQ+ youth face increased discrimination, stigma and health disparities compared to other groups, it is critical that they have access to supportive, affirming community spaces that celebrate their identities and foster inclusion, connection and well-being,” said co-author Danielle Phillips, assistant professor of social work at the at UH ����ԴDz�.

How community groups make a difference

The study found that CBOs support youth through four main strategies:

• Offering counseling and therapy
• Creating safe spaces and fostering community
• Providing case management services
• Delivering educational resources

Effective service delivery depended on strong planning and coordination, inclusive and intersectional practices, access to training and curriculum tools, and capacity-building resources.

Greater investment in CBOs needed

Despite their vital role, the study noted that many CBOs remain underfunded and overstretched. Researchers stress that with greater investment, these organizations could significantly expand their reach and impact.

“Community-based organizations that support LGBTQ+ youth consistently face a lack of funding, and it continues to be a serious concern that will directly impact the availability, delivery and quality of mental health services,” said Phillips. “We are at a pivotal moment in our collective experience, where it has never been more urgent to prioritize, support, and protect vulnerable youth. Securing sustainable funding is a crucial part of ensuring that communities can continue to offer safe and inclusive programs for youth who need it most.”

Most people who were affected by the November 2021 Red Hill fuel spill continued to experience physical, emotional, social and/or financial impacts more than 20 months after the incident, according to a released October 15, 2025, by the University of �鶹��ý Economic Research Organization (UHERO).

The report provides results from a follow-up self-administered online survey conducted in July 2023 (20 months after the spill) with 174 people who had participated in earlier studies by the Centers for Disease Control and Prevention.

Main findings reported in 2023

Ongoing physical and mental health impacts:

• About three quarters (79%) of respondents reported one or more new or worsening physical and/or mental health symptoms since the 2021 fuel spill.
• A majority (68%) reported ongoing symptoms in 2023, nearly two years after the spill.
• Nearly half of respondents (49%) continued to suffer from mental health impacts, followed by neurological symptoms (44%), gastrointestinal issues (36%) and skin/eye symptoms (34%).

Healthcare response:

• The majority (65%) of respondents sought medical care related to the spill.
• Experiences with medical care were mixed: 24% of respondents rated the medical care they received for their exposure to the fuel spill as excellent or good whereas 36% rated their care as bad or very bad.
• More than 50% of respondents said they have a great deal of trust in their healthcare provider to provide correct information; less than 5% said they have no trust.
• The vast majority of open-ended responses about healthcare described dismissed concerns, insufficient documentation of symptoms, inadequate testing options and challenges accessing specialists.

Social and economic impacts:

• Many reported feelings of isolation as a result of health impacts and disaster response.
• Some respondents also pointed to ways that the community organized and supported one another in disaster response.
• Some (18%) reported income loss (median = $13,750 annual income), while the majority (82%) incurred additional out-of-pocket expenses (median = $8,200).
• Only 12% of those with out-of-pocket expenses said they were fully reimbursed, and more than a third (36%) said they received nothing at all.

Institutional trust and perceptions of institutional crisis response:

• Respondents were most satisfied with how the Honolulu Board of Water Supply responded to the crisis and least satisfied with the response of the Navy.
• Many expressed feelings of betrayal, particularly toward the Navy. Many respondents said they felt lied to about the safety of the water, and cited inadequate medical and other crisis response as factors undermining trust.
• Participants discussed a need for greater transparency, accountability and empathy in future crisis response.

“Findings reveal significant and ongoing well-being impacts including physical and mental health challenges, disruptions to social networks and relationships and financial losses,” the study wrote.

The report was authored by experts from UHERO, , , , and , all at UH.

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UHERO is housed in UH ��ā�ԴDz�’s .

Community connections, cultural healing practices and emotional well-being are at the center of a University of �鶹��ý at Mānoa program that is building a peer support network for farmers, farmworkers, and paramedics and emergency medical technicians. The main goal—prevent suicide.

Strengthening essential workers

The (CCCR) project, led by Professor Thao Le of the Department of Family and Consumer Sciences at the (CTAHR), has already trained 34 peer mentors in its first year. The project is gearing up to recruit more peer mentors in its second year with $598,906 funding from the U.S. Department of Health and Human Services.

Farmers and first responders often experience high-stress and uncertainty. Farmers face unpredictable markets and weather conditions, while first responders care for patients in traumatic situations.

“It may seem suicide is a lone event—it is not,” said Le, the principal investigator. “Disconnection and loneliness are salient factors. We need a course correction and can only do this when we create conditions for care and connections in our communities.”

Two recent articles from Le and her colleagues provided a potential tool to , and that prevent some local agriculture workers from getting mental health care.

Healing with nature

CCCR’s contribution lies in its attention to community and culture as modality for preventing suicide. Its culturally infused aims include:

• Creating a sustainable and collaborative peer-mentor network among �鶹��ý‘s essential workers, giving them an internal support system.
• Reducing suicide and suicide risks by bolstering social connectedness and relationship building.
• Infusing culturally based healing practices into resilience training, recognizing that not everyone is comfortable with traditional therapy.

Embedding cultural practices led by Native Hawaiian practitioners is an essential component. This includes working in the loʻi (taro field) and connecting with nature at sites such as the Kīlauea volcano and the ocean. This approach allows farmers and first responders to restore and heal within their peers.

The federally funded CCCR model is drawing interest from other high-stress fields, such as the construction industry and 911 operators, suggesting a potent, scalable approach to building resilience across the state.

The program is a partnership with CTAHR, the �鶹��ý Department of Health’s Emergency Medical Services & Injury Prevention System Branch and Hoʻohanu, a nonprofit dedicated to supporting first responder mental health. It is also reaching out to connect with farmer and first responders focused nonprofits, suicide prevention and mental/behavioral health organizations.

The �鶹��ý CARES 988 is a free crisis, mental health and substance use call center. Call or text 988 24 hours a day, seven days a week.

A first–of–its–kind fellowship in �鶹��ý is training the next generation of culturally grounded behavioral health providers, thanks to a new collaboration between the University of �鶹��ý at Mānoa (JABSOM) Department of Native Hawaiian Health and (HILT).

The program, called Mohala Liko Lehua, will host three post–doctoral psychology (PsyD) fellows and three post–master of social work (MSW) fellows, who will be trained and supervised by licensed psychologists and social workers at JABSOM. Fellows will partner with HILT to design and deliver behavioral health services on Oʻahu, Maui, Kauaʻi and �鶹��ý Island, strengthening community capacity and promoting wellbeing.

Hands-on training rooted in Hawaiian values

Throughout the one–year fellowship, participants will receive advanced training in trauma–informed, ʻ�徱�Բ� (land)– and culture–based care rooted in Hawaiian values. Their work will be integrated into HILT’s community preserves and existing educational programs. The fellows will also receive their clinical training at Queen’s Health Systems sites on Oʻahu and Maui, as well as the Ka Malu a Waʻahila Behavioral Health program for Native Hawaiian/Pacific Islander students at UH ����ԴDz�. Program goals include serving at least 4,000 youth, enhancing HILT staff capacity, and measuring community impact.

Robin Miyamoto, program director at JABSOM, said the program’s name draws from the ʻō������� noʻeau (Hawaiian proverb), Mōhala i ka wai, ka maka o ka pua, suggesting that flowers thrive when the environmental conditions are good.

This reminds us of our responsibility to protect and sustain our culture and the health of our people so that future generations can thrive.
—Robin Miyamoto

“This reminds us of our responsibility to protect and sustain our culture and the health of our people so that future generations can thrive,” she explained. “This program will enhance and expand our existing training efforts and will serve as a new pipeline for behavioral health clinicians. It is grounded in a foundation of cultural humility and safety, focusing on promoting resilience rather than solely addressing disparities.”

In addition to meeting immediate behavioral health needs, the program serves as a workforce development pipeline, preparing homegrown providers who can deliver culturally fluent care across �鶹��ý.

“Mohala Liko Lehua is informed by and designed for underrepresented communities, especially Native Hawaiian and Pacific Islander populations that have long faced systemic health disparities and underinvestment in behavioral health,” said ʻOlu Campbell, president and CEO of HILT. “Addressing these inequities requires solutions that are community–driven, rooted in ʻ�徱�Բ� and culture, and grounded in trust–based relationships.”

Supported by the Health Resources & Services Administration, Maui United Way, UH, the Office of Hawaiian Affairs, and other partners, JABSOM and HILT plan to continue Mohala Liko Lehua for at least four years, training a minimum of 24 fellows. Additional funding is still needed to sustain the program.