A Call to Advocacy:Utilizing Culturally Relevant Approaches for Native Hawaiian Women//Melissa Leilani Devencenzi, M.S.

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Colonialism, which can be seen as a gendered process, has brought several negative implications for Kānaka Maoli (translated as “true” or “native” person; Rezentes, 1996), creating an intricate, generational problem that is compounded with cultural trauma.  Native Hawaiians are the most economically disadvantaged race in Hawai‘i with some of the highest rates of homelessness, incarceration, drug use, and educational inequalities. This has various psychological implications (Cook et al., 2005; Kauanui, 2016).  Due to a limited number of individuals who identify as Native Hawaiian, a call for Native values and a strengths-based approach to address the needs of Kānaka Maoli from a Kanaka Maoli perspective is imperative (Kaholokula, 2009; Kana‘iaupuni, 2004). 
So, what are “Native values?”  Prior to illegal annexation and Western contact in the 1800s, the people of Hawaiʻi had their own traditional methods of healing, including hula (dance), oli (chanting), and craftsmanship.  These methods were closely aligned with the prominent Native values of aloha (love, acceptance), ʻohana (family), ʻāina (land), and lōkahi (unity) (McCubbin & Marsella, 2009; Rezentes, 1996).  Emphasis on the interaction between those values and the values of humility (ha‘aha‘a), pride (ha‘aheo), honesty (kūpono), and forgiveness (huikala) are vital as these components work together to create psychological harmony within each person (Rezentes, 1996).  For traditional Kānaka Maoli, the practice and utilization of these values are displayed through one’s attitude: humble, unpretentious, and reverenced towards one’s kūpuna (elders) (Rezentes, 1996).
Many of the cultural practices Hawaiians engaged in were discouraged by missionaries and motioned toward extinction (Kauanui, 2016).  At the time, Westerners who witnessed Hawaiians engaging in their Native values and practices like hula were perceived as “savagely expressing themselves, rather than as “performers” with skills” (Teves, 2012, p. 212).  These very practices are what render lōkahi (unity) within Kanaka Maoli.  When there is a disconnect between the self, family, spirituality, and land, one is in a state of disharmony (McCubbin & Marsella, 2009). 
The problem here is multifaceted.  Much of the history, cultural prostitution, corporate tourism, and effects of colonialism have resulted in poverty, homeless, poor education, and disproportionately high incarceration rates for Kānaka Maoli (Cook et al., 2005; Kauanui, 2016).  Implications of the stereotypes cast on Native Hawaiians include negative perceptions of ambition, lower reports of self-esteem, decreases in achievement, and decreases in academic success (Kana‘iaupuni, 2004). When looking at the statistics, there is no doubting the aforesaid correlation.  Native Hawaiians are overrepresented in the justice system and homeless population, accounting for approximately 30% of the homeless population in Hawai‘i (Cook et al., 2005) and 40% of individuals who are incarcerated (Martinez, 2016).  The Native Hawaiian race accounts for approximately 600 more people than any other race per 100,000 individuals incarcerated in Hawai‘i (U.S. Census Bureau, 2010).  The percentages of homeless and incarcerated individuals may seem small, however, when taking into consideration Native Hawaiian’s account for only 6% of the Islands population as “pure” Hawaiian’s and approximately 20% of the Islands population as hapa (“part-Hawaiian”; Goo, 2015), the percentages mentioned are astronomical. 
To illustrate the importance of this issue, in 2016 Section 9 (Psychoanalysis for Social Responsibility) of Division 39 (the Division of Psychoanalysis) of the American Psychological Association (APA) provided a formal apology to the Native American, Alaskan Native, and Native Hawaiian people (“Full Apology,” 2016).  In this letter, Section 9 of Division 39 states the United States is a settler colonial nation that became wealthy by colonizing, stealing, and decimating the Native lands of the aforementioned cultures (“Full Apology,” 2016).  Section 9 of the Division of Psychoanalysis further admits the deplorable treatment of these individuals have come in the form of abusive assimilation attempts, involuntary relocation, lack of voting ability, and the absence of religious freedom (“Full Apology,” 2016); all of which the dominant culture has maintained silence over yet maintained ample documentation regarding the racial and cultural disparities.  Psychologically, the cultural traumas Native Americans, Alaskan Natives, and Native Hawaiians have undergone have led to higher than normal rates of chronic illness, psychological distress, and incarceration, as well as attempts of suicide that did not originally exist in the pre-colonized cultures (“Full Apology,” 2016). 
In the “Full Apology” (2016), Section 9 maintains that the aforementioned treatment is unacceptable and apologizes for: the use of a diagnostic system that is not culturally appropriate, the use of culturally inappropriate assessments and testing measures that have caused inaccurate beliefs about abilities and competencies, the unethical conduction of research for the benefit of the researcher only, the utilization of treatment methods that ignored culturally relevant healing ideologies, and the continued silence and absence of advocacy regarding political policies.  Section 9 of Division 39 has affirmed the need and support in listening, advocating, following, collaborating, and including more of the voices from Native American, Alaskan Native, and Native Hawaiian populations (“Full Apology,” 2016).  Section 9 states the future of psychology will be ready to incorporate the voices of the Native people, along with the inclusion of higher numbers of Native psychologists and mental health clinicians (“Full Apology,” 2016).
            For Native women who are often seen as nurturers, psychological issues are multifaceted.  The life expectancy of Native Hawaiian women within Hawai‘i is the lowest among all other races or ethnicities (Office of Hawaiian Affairs; OHA, 2018).  When it comes to the mental health of these women, the statistics are alarming: more Native Hawaiian girls in high schools have had serious suicidal ideation (24.1%) when compared against females statewide (20.1%); they have the highest rate of reported self-harm in 9th grade (42.2%); during the 2012-2016 time period one in five women considered their psychological well-being to be “not good” for 1-6 days out of the month (19%), with the highest rates in the state of a combined psychological and physical well-being identified as “not good” for 7-13 days out of the month (OHA, 2018).  Similarly, rates of post-partum depression and struggles with weight are higher than non-Hawaiians on the island.
As both a Native Hawaiian woman and a future psychologist who aims to work with the Native Hawaiian population. I take all of this to heart.  It is evident there have been faults in the past, such as the Section 9 of Division 39’s statement shows, when attempting to provide culturally competent therapeutic treatment.  I see so much room for growth, and coming from a resilient cultural background I think that an approach founded by Hawaiians for Hawaiians is essential.  There is such a great need to continue this discourse and advocate for policy change that can benefit these women and allow for awareness and appropriate mental health treatment.  Who we are, as Hawaiian women, is an energetic force that encompasses compassion, relationships, knowledge, leadership, and the strength of our ancestors.  As women, we are the center of our families.  This means our health and well-being greatly impact ourselves and our families.  We are resilient beings with Native values that are much more important than hegemonic ideology.  I think we need to continue to discuss how to support our women at all ages, especially when considering the current statistics.



By: Melissa Leilani Devencenzi, M.S.

References
Cook, B. P. I., Tarallo-Jensen, L., Withy, K., & Berry, S. P. (2005). Changes in Kanaka Maoli men's roles and health: Healing the warrior self. International Journal of Men's Health4, 115.
Full apology to the Native American, Alaska Native, and Native Hawaiian people. (2016, December 5). Retrieved from https://psychoanalyticactivist.com/2016/12/05/full-apology-to-the-native-american-alaska-native-and-native-hawaiian-people/
Goo, S. K. (2015). After 200 years, Native Hawaiians make a comeback. Pew Research Center. Retrieved from http://www.pewresearch.org/fact-tank/2015/04/06/native-hawaiian-population/#
Kaholokula, J. K. A., Nacapoy, A. H., & Dang, K. O. (2009). Social justice as a public health imperative for Kānaka Maoli. AlterNative: An International Journal of Indigenous Peoples5, 116-137.
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Office of Hawaiian Affairs. (2018). Haumea – Transforming the health of Native Hawaiian women and empowering Wāhine well-being. Honolulu, HI: Office of Hawaiian Affairs.
Rezentes, W. J. (1996). Ka lama kukui: An introduction to Hawaiian psychology. (n.p.): ‘Aalii Books.
Tamaira, A. M. K. (2017). Walls of empowerment: Reading public murals in a Kanaka Maoli context. The Contemporary Pacific29, 1-35. https://doi.org/10.1353/cp.2017.0001
Teves, S. N. (2012). We’re all Hawaiians now: Kanaka Maoli performance and the politics of aloha (Doctoral dissertation). Retrieved from https://deepblue.lib.umich.edu/bitstream/handle/2027.42/91591/tevess_1.pdf?sequence=1
U.S. Census Bureau. (2010). Hawaii incarceration rates by race/ethnicity, 2010 (Summary File 1). Retrieved from https://www.prisonpolicy.org/graphs/2010rates/HI.html


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