Helen (Nalani) Blaisdell-Brennan, assistant clinical professor of psychiatry at the University of �鶹��ý at ����ԴDz� (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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The longest comparison of U.S. Army and civilian suicides suggests societal factors are driving both military and civilian suicides, challenging assumptions that military suicides are primarily driven by combat trauma or other war-related causes. The University of �鶹��ý at Hilo study, “” was published in Psychiatry Research in March 2023.

“While much has been studied about suicide in the active-duty military and veteran communities, it may be counter-productive to focus narrowly on military-related suicides apart from the larger societal context, including considering comparative rates among civilians and long-term historical data on suicide in both civilian and military populations,” said Jeffrey Allen Smith, co-author and �鶹��ýHilo professor and chair of the history department.

Smith and co-authors UH Hilo Research Assistant Ryan Hanoa, UH Hilo Psychology Professor B. Christopher Frueh and federal historian Michael Doidge studied cross-sectional data from U.S. military health and personnel readiness reports and academic journal articles that were published from 1900 to 2022. U.S. civilian population data came from the Center for Disease Control and Prevention’s National Vital Statistics System.

“The data show that U.S. servicemember and similarly aged male civilian suicide rates have increased substantially since the start of the Global War on Terror. However, we do not currently know what is driving these suicides,” said Hanoa.

“Suicide rates among U.S. males (U.S. Army service members and civilians) have surged upward since 2006.”

Among the significant findings:

• Historically, war did not appear to increase suicide rates in U.S. Army personnel or civilians.
• Since 1900, U.S. Army and similarly aged civilian male suicide rates have converged.
• It appears universal factors similarly affect both army and civilian populations.
• From 1900 to 2020, U.S. Army and civilian suicide rates appear to fluctuate similarly.

According to the article: “These results suggest that suicide rates among U.S. males (U.S. Army service members and civilians) have surged upward since 2006 and represent a new historical trend that is worrisome. …Rather than understanding military suicides as being primarily driven by combat trauma or PTSD, to be effective, prevention efforts should strive to understand military suicides through the lens of larger societal factors.”

“In other words, societal and cultural factors likely play a much larger role in military suicides than the military-specific factors of combat trauma or posttraumatic stress disorder (PTSD), per se,” Frueh said.

• Related UH News story: UH Hilo researchers conduct historical study of suicide in Army, December 13, 2019

The research is a follow-up to the , which was published December 13, 2019 in the Journal of the American Medical Association (JAMA) Network Open. That comprehensive study, also coauthored by a team of UH Hilo researchers, challenged the assumption that combat is the primary driver of suicide in active duty U.S. Army forces.

On August 29, (QHS) announced it will acquire Kāhi Mōhala hospital, which will allow the University of �鶹��ý at ����ԴDz� (JABSOM) to expand its training opportunities for students, residents and fellows. The transition is expected to take place this December.

Currently, JABSOM Department of Psychiatry faculty serve QHS as Queen’s University Medical Group physicians, providing care for child and adult psychiatric inpatients and outpatients, mainly at The Queen’s Medical Center in Honolulu. JABSOM officials said the announcement allows care and learning to reach past Honolulu, while including diverse age groups.

Located in ʻEwa Beach, Kāhi Mōhala, an 88-bed facility, is the only free standing, not-for-profit hospital-based residential program for behavioral health in the state, serving children, adolescents and adults.

“Our trainees will play a significant role in serving patients who otherwise would have challenges in accessing care,” said Anthony Guerrero, psychiatry clinical program chief at The Queen’s Medical Center and the chair of psychiatry at JABSOM. “This expansion will also open doors to multidisciplinary training and workforce development, in collaboration with licensed clinical social workers, clinical psychologists and advanced practice nurses.”

Kāhi Mōhala opened in 1983 on 14.5 acres in ʻEwa Beach. The current owner of Kāhi Mōhala is California-based Sutter Health network, which, like The Queen’s Health System, is an integrated, not-for-profit health system.

As the state begins to emerge from the COVID-19 pandemic, , a free health service tool developed by the University of �鶹��ý at ����ԴDz� (JABSOM), is reminding the public its behavioral health telemedicine program is still available for neighbor island residents.

The online telepsychiatry and telepsychology platform allows individuals to talk to a licensed professional about worries, stress, anxiety, substance use or other concerns at no charge. The service aims to provide mental health service to rural populations who might experience time constraints, financial burdens and transportation barriers when trying to access services.

�鶹��ý UTelehealth is staffed with a licensed mental health counselor, psychiatrist, psychologist, nurse practitioner and physician. The telehealth platform offers services from telehealth coordinators who can teach patients how to utilize telehealth eligible devices and gain technological literacy. Services are available until August 31, 2023. Call (808) 375-2745 for additional assistance or to set up your first appointment. Translators are available upon request.

The tool was developed by JABSOM in collaboration with the in the UH ����ԴDz� . Other partners include �鶹��ý State Rural Health Association and the �鶹��ý State Department of Health.

“These are trying times for everyone. It’s nice to have a number to call to get help,” said Kelley Withy, executive director of JABSOM’s .

Federal Communications Commission support

This month, the Federal Communications Commission (FCC) selected JABSOM’s �鶹��ý UTelehealth to be part of its , providing $320,535 to support their efforts. The program will offer guidance on eligible services, competitive bidding, invoicing and data reporting for selected participants. It joins other 58 pilot projects being conducted in 30 states plus Washington, DC. The Pilot Program will make available up to $100 million from the Universal Service Fund over a three-year period for selected pilot projects to help defray the costs of providing certain telehealth services for eligible health care providers, with a particular emphasis on providing connected care services to low-income and veteran patients.

U.S. Senator Brian Schatz, a member of the Senate’s Appropriations Committee, has led efforts to expand the use of telehealth services. Last month, he reintroduced the , the most comprehensive bipartisan telehealth bill in Congress.

“JABSOM has put together an impressive project that uses telehealth to help connect patients across �鶹��ý with health care providers. This new funding will help launch the project and get more people the care they need,” said Schatz.

Additional resources

For families and households struggling to afford internet services during the COVID-19 pandemic, the is a relief program to help bridge connectivity.

The Emergency Broadband Benefit will provide a discount of up to $50 per month towards broadband services. Low income households can also receive a one-time discount of up to $100 to purchase a laptop, desktop computer, or tablet from participating providers if they contribute more than $10 and less than $50 toward the purchase price.

Go to to apply online and to find participating providers near you. After you apply, contact a participating provider to select an eligible plan.

Rural, Native Hawaiian and Pacific Islander youth and communities have greater needs with respect to suicide prevention and mental health support. Now, with a new $3.5-million grant, researchers in public health and psychiatry will aim to reach at least 60,000 of these young people in �鶹��ý with suicide prevention efforts.

Researchers Jeanelle Sugimoto-Matsuda of the in the and Deborah Goebert of the , along with their colleagues, were awarded the federal grant from the . The grant will fund the �鶹��ý‘s Caring Systems Initiative for Youth Suicide Prevention.

“Our approach is to offer hope, help and healing to youth in �鶹��ý‘s rural and underserved areas,” Sugimoto-Matsuda said. “This grant will fund our efforts to reach youth in their schools, communities and health care facilities, and to also improve the effectiveness of these systems.”

This effort is an example of UH ����ԴDz�’s goal of (PDF), one of four goals identified in the (PDF), updated in December 2020.

Fostering collaboration across systems

The initiative uses a strengths-based approach, meaning it will work to enhance existing programs and tap into the resiliency and relationships in �鶹��ý families and communities. The researchers selected four best practice programs that will be involved:

• The Connect Suicide Prevention and Postvention Curriculum
• Sources of Strength
• The American Foundation for Suicide Prevention’s Suicide Bereavement Support Group Facilitator Training
• Zero Suicide (including Continuity of Care)

Sugimoto-Matsuda and Goebert’s initiative will foster collaboration across these various systems and communities, and integrate their work so that more youth can be reached. The initiative will impact teens, young adults, parents and families, healthcare and education providers, community members and professionals who work with youth.

“We want to work across all of the systems that serve the youth in our state—education, health care, and other social services systems—in partnership with our communities,” Goebert said.

Despite the adversity faced by today’s youth, most do not develop suicidality or self-harm behaviors, she noted. The team’s long-term partnerships with community organizations, including the Prevent Suicide �鶹��ý Taskforce, will help them to strengthen the capacity of the systems and improve prevention of youth suicide deaths and attempts.

“When we strengthen the systems that serve our youth to better prevent suicide and build resiliency, we strengthen all of �鶹��ý,” Sugimoto-Matsuda said.

Help is available

If you are having thoughts of suicide, or you are worried about a friend or loved one, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK), or text “ALOHA” to the national Crisis Text Line at 741-741. .

University of �鶹��ý at Mānoa students and faculty may face new challenges to their mental health during the COVID-19 pandemic. Jeanelle Sugimoto-Matsuda, an associate professor with the of the Myron B. Thompson School of Social Work and an expert on mental health and suicide prevention, is providing resources to help keep the UH Mānoa campus community safe.

Students who are worried about a fellow classmate, or those in distress themselves, need to know what support is available on campus and in the community. Faculty members also need to care for themselves, and because of their close relationships with students, they may need to provide guidance for students who disclose personal challenges and need support.

“I think about mental health and suicide prevention from a public health perspective,” said Sugimoto-Matsuda, a co-chair of the Prevent Suicide �鶹��ý Task Force. “Public health is all about prevention, and I want to prevent mental health problems from developing, or catch them as early as possible.”

Helping faculty support students

Sugimoto-Matsuda worked with Professor Deborah Goebert, of the John A. Burns School of Medicine , to create a (PDF). The guide was distributed campus-wide, and the two are now working on promoting mental well-being among faculty members and other campus employees.

“Some students have been very impacted by the pandemic,” Sugimoto-Matsuda said. “For example, they may have had to take on roles as caregivers, or may be living alone and isolated from the social connections that typically help them to stay healthy. Faculty members need training on what to do if they encounter someone in distress, how to acknowledge all of the stressors that everyone is under right now, and how to create accommodations for impacted students.”

The guide for faculty includes a list of tips on validating student reactions, providing honest reassurance and becoming trauma-informed teachers. The guide also includes links to the Centers for Disease Control and Prevention’s guidelines for managing stress and anxiety, resources from , information from the and more.

• Related UH News story: Free mental health workshops for UH Mānoa students, May 28, 2020

Invest now

Sugimoto-Matsuda emphasizes the importance of having more resources dedicated to the , and a smoother process when the center refers students to mental health providers in the community, especially in anticipation that the need will continue to grow during the upcoming academic year. Of particular concern are people who did not need mental health services prior to COVID-19, but are now coping with job loss, being isolated from others or suddenly taking on new roles such as being a full-time caregiver.

“Mental health and suicide prevention need to remain top priorities on our campus and across the state,” Sugimoto-Matsuda said. “We need to remind people that mental health is part of the COVID-19 response—it’s part of health. The more invisible impacts of the pandemic—the depression, the anxiety, the feelings of hopelessness that some are experiencing—we need to make those visible.”

“The mental health impacts of this crisis will last a long time, and the price down the line will be high if we don’t invest now. We can’t sweep mental health to the side,” added Sugimoto-Matsuda.

Examples of warning signs for suicide include withdrawing from usual social groups or activities, dramatic mood changes (e.g., feeling hopeless or uncontrollable anger), or talking or writing about death, dying or suicide.

Resources for those struggling with mental health:

(808) 956-7927

(808) 832-3100 (Oʻahu), 1-800-753-6879 (Neighbor Islands)

text ALOHA to 741741 (�鶹��ý), text TALK to 741741 (National)

1-800-273-8255

It is estimated that approximately 100,000 adolescents and young adults in the U.S. experience an initial episode of psychosis each year. Some symptoms include: auditory hallucinations; visual hallucinations; paranoid feelings; unusual beliefs; disorganized thinking; and/or changed behavior.

Offering a full complement of therapeutic and assessment services by a multidisciplinary specialty team, the clinic is designed for individuals ages 15 to 24 who are within the first two years of experiencing psychosis.

, a collaboration between the University of �鶹��ý at ����ԴDz�’s in the , the John A. Burns School of Medicine’s and the �鶹��ý State Department of Health’s Child and Adolescent Mental Health and Adult Mental Health Divisions, is expanding its services as the state’s coordinated specialty care treatment clinic for youth experiencing a first episode of psychosis. The program will open a new clinic in the Ala Moana Building this month.

“OnTrack �鶹��ý is based on early psychosis intervention and treatment models that have a long, successful history in Australia and Europe and are spreading throughout the United States,” said , associate professor of psychology in the College of Social Sciences and clinic director. “These models use a team-based approach and patient-centered shared decision-making to develop a coordinated specialty care plan to treat affected youth and young adults. Our clinic, which is the first of its kind in �鶹��ý , aims to help clients improve their quality of life by helping clients get back on track at work, school, and relationships with friends and family.”

Cicero said that youth experiencing their first episodes of psychosis are often frightened and struggle to understand what is happening to them. “Research has shown that these experiences are best treated through early, structured intervention tailored to fit the needs of each client,” he said. “The key is a collaborative environment where individuals and their OnTrack �鶹��ý team select the best mix of support services and treatment options. This increases the chances that the client will remain in treatment and improve over the long-term course.”

Early stage care produce best results

According to the Recovery After an Initial Schizophrenia Episode (RAISE) study funded by the National Institute of Mental Health (NIMH), schizophrenia, which is characterized by psychosis, usually begins between the ages of 16 and 30. It develops in stages and RAISE research has found that care provided at the earliest stage produces the best results.

In the U.S., an average of 74 weeks elapse between the time of the first episode of psychosis and engagement in appropriate treatment, while other countries have reduced this delay to a much lower 2 to 7 weeks. OnTrack �鶹��ý̵s goal is to reduce this timeframe.

�鶹��ý youth and young adults experiencing symptoms of psychosis can find the following services through OnTrack �鶹��ý:

• Individual and group therapy.
• Medication management using a shared decision-making model.
• Assistance and support to find employment or to return to school.
• Assistance and support for affected families.
• Case management.

OnTrack �鶹��ý offers its services to individuals regardless of ability to pay. Its team works with clients to arrange coverage for services such as medication and other related services. For more information about OnTrack �鶹��ý, call (808) 956-6289 or email TrackHi@hawaii.edu.

—By Lisa Shirota

Naleen Naupaka Andrade, professor and director of the ’s (JABSOM) National Center on Indigenous Hawaiian Behavioral Health, has been honored with the (AACAP) 2017 Jeanne Spurlock Lecture and Award on Diversity and Culture.

This distinguished award recognizes individuals who have made outstanding contributions to the advancement of the understanding of diversity and culture in children’s mental health and who contribute to the recruitment into child and adolescent psychiatry from all cultures.

Andrade is scheduled to present, “Ola—An Indigenous Health System That Could Change Our Homeland,” at AACAP’s 64th Annual Meeting on October 25 in Washington, DC.

Andrade was the first Native Hawaiian woman to become a psychiatrist and the first Native Hawaiian woman to lead the psychiatry department at a university medical school. During her time as chair of from 2005 to 2012, Andrade led the department to new heights of excellence in education, clinical care and research in Native Hawaiian and Pacific youth addictions.

Andrade was national president of the American College of Psychiatrists in 2012. She and former JABSOM psychiatry chair John McDermott, authored , now in its second edition.

For more information, read the .

More about the AACAP’s Jeanne Spurlock Lecture and Award

The AACAP’s Jeanne Spurlock Lecture and Award on Diversity and Culture is named in honor of Jeanne Spurlock, in recognition of her legendary commitment to recruiting members from diverse cultures into child and adolescent psychiatry. AACAP created this lecture and award in her honor to recognize her work and encourage others to follow her example.

—By Tina Shelton

Cheryl Puntil, a nursing instructor, is the 2017 recipient of the from the (APNA). Puntil will be recognized for her commitment, initiative, loyalty, integrity and exceptional and meritorious service at the 31st Annual National APNA Conference in Phoenix, Arizona on October 18.

Puntil and several APNA colleagues worked on the for nurse assessment and management of individuals at risk for suicide.

“Through [Cheryl’s] vision, determination and perseverance, the APNA Suicide Competencies initiative became a reality and an exemplar, continues to expand, and addresses both a major national public health problem and gap in nursing education, ” Puntil’s colleagues stated.

Through [Cheryl’s] vision, determination and perseverance, the APNA Suicide Competencies initiative became a reality and an exemplar, continues to expand, and addresses both a major national public health problem and gap in nursing education.
—Puntil’s colleagues

“It is an incredible honor to receive the American Psychiatric Nurses Association Award for Distinguished Service,” said Puntil. “I followed my passion and was lucky to find awesome mentors who paved the way for me to assist in establishing competencies that will change nursing practice and improve care for those at risk for suicide. I was very surprised and grateful for the acknowledgment from my esteemed colleagues who nominated me, and to the APNA board for voting on my behalf to receive the award.”

Puntil received her bachelor’s of science in nursing from the College of Saint Teresa and her master’s of science in nursing from the University of California, Los Angeles. She is certified as an advanced practice registered nurse and a psychiatric mental health clinical nurse specialist.

Puntil joined in 2014. �鶹��ý CC offers and a .

More about APNA

With more than 10,000 members, APNA is the largest professional membership organization committed to the specialty practice of psychiatric mental health nursing and wellness promotion, prevention of mental health problems, and the care and treatment of persons with psychiatric disorders.

For the full story, visit the .

—By Thatcher Moats

A University of �鶹��ý psychiatrist who helped form a statewide suicide prevention network was honored as an Outstanding Community Mental Health Leader by .

Jeanelle Sugimoto-Matsuda, assistant professor of the John A. Burns School of Medicine’s , “built thriving partnerships on each island that continue today as she leads the ,” said Mental Health America of �鶹��ý. “She exemplifies skills as a community-based researcher by working carefully and persistently to establish and maintain trusting relationships with community members and leaders, facilitating the implementation of suicide prevention programs and working closely with each site to develop suicide prevention action plans.”

Sugimoto-Matsuda was honored during Mental Health America of �鶹��ý’s 75th Anniversary Mahalo Awards Luncheon on May 16. The ceremony recognizes leaders like Sugimoto-Matsuda, advocates and companies that have dedicated themselves to promoting mental wellness and improving the care of people with mental health problems through positive and innovative programs and leadership.

—By Tina Shelton