Ka Wai Ola - Office of Hawaiian Affairs, Volume 1, Number 4, 1 Mei 1984 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

Some Health Questions by Kekuni Blaisdell, M.D. V

This ninth eolumn of He Mau Ninau Ola answers ninau (questions) about suicide, the ninth main cause of death of Hawai'i. Mahalo to you readers for your 'imi na'auao (inquiries) on this subject. Q: My fellow Hawaiian neighbor's 20-year-old son recently took an overdose of drugs and died. My boy was close to him. Now he is moody, but won't talk about it. How ean I help prevent the same thing happening to my son? A: Auwe, aloha 'ino i na 'opio Hawai'i. Your eoneem deserves the attentionofall po'e Hawai'i ( Hawaiian people). We have the highest overall suicide rate in Hawai'i compared to other ethnic groups, according to data published in 1979 by the State Department of Health. This rate of 20 per 100,000 for us po'e Hawai'i is twice the U. S. national average. Your neighbor's son's self-in(licted death underscores another salient statistic — kane 'opio Hawai'i (young Hawaiian males), ages 20 to 24, are at the greatest risk for suicide with a rate of 53 per 100,000, whieh is five times that for all races in this gender and age group. Without specific details in the case ol your keikikane (son) and his unfortunate nohohoaloha (neighbor eompanion), our advice on prevention must be limited to general information and guidelines. Since Emile Durkheim's classic study of suicide in 1897, sociologists have pointed out that suicide more often occurs in males, the unmarried, city and single dwellers, the unemployed, those without religious affiliation, and those with aleohol- or drug-abuse, depression and physical disability. Although the casual factors in suicide are mukiple, experts have grouped suicide into three main types: (a) Those resulting from social pressure so that the victim sometimes becomes a hero. From Hawai'i kahiko (ancient Hawai'i) is Samuel Kamakau's account of Kahulupue, only son of the famous 18th Century O'ahu prophet-kahuna Ka'opulupulu. In protest against the cruelty of the ruling Chief Kahahana, and sensing his own imminent death, the priest Ka'opulupulu ordered his son to throw himself into the sea. The lad unflinchingly complied. (b) A second type of suicide results from personal, often romantic attachment and disregard for society. Thus, King Kalakaua recorded the legend of Makakehau, a koa (warrior) of Lana'i, who lamented the death in a storm of his beloved wahine Pu'upehe. Singlehandedly, Makakehau built a tomb for her on a remote cliff, and then plunged to

his death in the pounding surf below. (e) Most cases of suicide in modern society, however, seem to be related to what Durkheim called "anomie" — loss of all social roots and supporting relationships with despair, so that life becomes meaningless. Often the fatal act represents a cry for help because of a sense of helplessness in the face of hopelessness. Such instances may be associated with family alienation, peer rejection, school failure and delinquency, and may stem, at least in part, from cross-cultural conflict whieh 1 will 'olelo kuka (discuss) in a future eolumn. Especially in this third group of anomie, often involving 'opio, prevention is of paramount importance. lt is everybody's responsibility and it begins with caring. However, when the individual's estrangement has reached a crisis stage, prevention of his fatal step may be effected only by someone who ean reach across the emotional gap, with understanding and trust, to communicate with the suicide-prone person. Ideally, this key confidant is a parent, spouse, or other 'ohana. If the family itself is part of the problem, then someone outside the 'ohana may need to fill the role of listening with empathy. When a suitable hoa (friend) cannot be found, professional services are available at the Suicide and Crisis Center, telephone 521-4555. Trained persons ean be reached 24 hours a day to talk with you and, if possible, the person-at-risk. These professionals listen, help to work through emergency pilikia, refer to specialists as needed, and if necessary, they will go as a team wherever the troubled individual is. The goal, of course, is not merely to prevent suicide, but to help the person restore a wholesome sense of identity with strong, supporting inter-relationships, so that his life ean regain meaningfulness. This was the essence of living in Hawai'i kahiko. lndividual strength and security were fostered in the growing child through harmony with oneself, with others, with the land, the sea, and one's ever-present 'aumakua (ancestral guardians). Readers' ninau concerning the wider problem of suicide risk and other kinds of self-destruction behavior current among us po'e Hawai'i in relation to our cultural history, and the need for collective Hawaiian community action will be the topic of a future eolumn. Meanwhile, e 'olu'olu (please) continue to submit your ninau ola, for whieh mahalo hou.