Hawai'i adults have the nation's lowest rate for experiencing "serious psychological distress," but young people here ranked in the highest ranges, according to a new report by the U.S. Department of Health and Human Services.

Hawai'i had the lowest rates in the nation for major depressive episodes and serious psychological distress among adults, said the report covering 2005 and 2006. But Hawai'i's children aged 12 to 17 were in the second highest range for depressive episodes.

And adults 26 years and older were in the highest category for needing treatment but not getting it in the previous year, according to the report by the Substance Abuse and Mental Health Services Administration.

"As good as those numbers look compared to the rest of the country for adults, these results tell me we have to spend even more attention on our youth," said Dr. Thomas Hester, chief of the state Department of Health's Adult Mental Health Division.

The study is consistent with other reports that show Hawai'i has a relatively low overall suicide rate but higher suicide rates for young people, Hester said.

"This isn't a brief period of having the blues," he said. "This is a clinical significant depression."

One sample in the study suggested that in Hawai'i 9,000 people 12 to 17 years old had an episode of major depression in the previous year.

"That should be a call for us to be very alert and supportive when there may be signs of depression in youth," Hester said. "That age group seems to be under great stress."

Dr. Stanton Michels, chief of the Department of Health's Child and Adolescent Mental Health division, called the report "a voluminous and exhaustive study."

But he cautioned about putting too much emphasis on the state-by-state rankings, in part because the results are based on self-reported surveys.

"The conclusions you can draw are really pretty limited," Michels said. "We are aware that there is depression, of course, among teenagers and we are subject to it here in Hawai'i. The important thing for the lay public to be aware of is the warning signs, which can manifest in a number of ways: declining school performance, less interest in peer group activities, a general withdrawal from social contact. Change in behavior is what's important. That remains true whatever the data shows."

Marya Grambs, executive director of Mental Health America of Hawai'i — formerly known as the Mental Health Association — said the trends identified in the study are consistent with others identified by the Centers for Disease Control and Prevention, and U.S. Department of Education and U.S. Department of Health that found higher rates of suicidal thoughts among young people in the Islands.

"We have among the highest rates in the nation of teenagers who are planning suicide, attempting suicide or are thinking seriously about suicide. Girls are the highest," she said. "This study shows some strengths but also identifies some serious problems we have here."

The study offers no insight into the disparate findings reported for adults and young people in Hawai'i.

But Grambs believes Hawai'i's strong Asian-based culture may be partly responsible for the differing results between adults and children.

"There may be a higher priority among Asians to keep problems to yourself and not disclose them to other people because of shame, because of loss of face," she said. "It could be a possibility that adults are self-reporting less while young people aren't. That same lack of telling people may partly also be the reason youth are experiencing higher rates of depression. Their families are saying, 'We don't talk about these things. We don't bring shame onto the family.'

"Maybe young people are not willing to talk about these problems but are willing to disclose them in a survey," Grambs said.

The high cost of living in Hawai'i also could be a factor, Grambs said.

"We have an awful lot of two-parent families that are working more than one job," she said. "They're less available to their children."

Young people who see their parents working so hard could also be depressed over their limited options to prosper in the Islands, Grambs added.

"That," she said, "is definitely a possibility."

Reach Dan Nakaso at dnakaso@honoluluadvertiser.com.