Eliminating Disparities in Youth Substance Use Among Native Hawaiian, Micronesian, and Sex and Gender Minorities: A Qualitative Needs Assessment From Interviews With Public Service Leaders

Youth substance use (SU) has been linked to adverse mental health outcomes. For those youth involved in public sector systems of care, reports of SU are consistently high compared to general populations. These public sector services systems of care include mental health, juvenile justice, child welfare, homeless intervention services, as well as SU service systems. In addition, minority and marginalized youth tend to report disproportionately high SU. As an example, in HawaiModified Letter Turned Commai, youth who are Native Hawaiian (NH), Micronesian, or who identify as sexual or gender minorities not only report elevated rates of SU, but are overrepresented in public sectors. In order to reduce youth SU health disparities, access to and quality of the system of care for youth must improve. To inform systems change, this needs assessment study used qualitative methods to engage professionals in HawaiModified Letter Turned Commai working within public sectors that may intersect with youth SU service system of care. Professionals identified several themes which have implications for practice, policy, and research: colonialism and inclusivity at the macro level, the need for policies at the exo level, meso level changes regarding family and community, and stigma and discrimination at the micro level. Impact Statement Results from this qualitative needs assessment study indicated the adverse effects of family and generational trauma, stigma and discrimination, and noninclusive policy on SU among NH, Micronesian, and sex and gender minority youth. Professionals working in public sectors of care expressed needs for system- and service-level improvements in order to improve the quality and accessibility of service for all youth.